Zou Guangchen, Appel Lawrence, Crews Deidra C, Dowdy David, Matsushita Kunihiro, Riekert Kristin A, Jaar Bernard G, Ishigami Junichi
Department of Nephrology, Mercy Hospital Saint Louis, Saint Louis, Missouri, USA,
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA.
Am J Nephrol. 2025 May 23:1-13. doi: 10.1159/000544935.
Vaccination rates for influenza and COVID-19 remain low among people with chronic kidney disease (CKD). Nephrology care offers an opportunity to boost vaccination rates. Understanding provider perceptions can be key to developing effective intervention programs.
We conducted a nationwide survey among nephrology care providers. In a questionnaire, we assessed the providers' agreement with potential barriers to recommending influenza and COVID-19 vaccines and perceptions of selected vaccination programs on their acceptability, appropriateness, and feasibility.
Between February and June 2023, 312 providers responded to the survey. Most providers agreed that there is sufficient evidence for influenza vaccines (270/311, 86.8%) and that vaccines reduce the risk of serious complications of influenza (277/310, 89.4%). However, 40/312 (12.8%) felt that recommending influenza vaccines is less important than other issues they must address. By profession, more physicians agreed with the evidence (112/123 or 91.1% vs. 39/49 or 79.5% for NPs and 83/101 or 82.2% for RNs, p = 0.007) than nurse practitioners (NPs) or nurses (RNs). The most perceived barrier was lack of self-efficacy: 95/311 (30.5%) felt that many patients will not get vaccinated even if they recommend it. Similar responses were seen for COVID-19 vaccines. Regarding vaccination programs, 209/235 (88.9%), 197/224 (87.9%), and 183/222 (82.4%) providers considered provider reminders acceptable, appropriate, and feasible. 209/239 (87.4%), 198/226 (87.6%), and 187/224 (83.5%) did so for standing orders. Onsite/walk-in vaccinations were viewed as acceptable by 192/242 (79.3%) but less feasible (137/222 or 61.7%). Fewer than 33% of providers perceived patient incentives as acceptable, appropriate, or feasible.
Most nephrology care providers believe that influenza and COVID-19 vaccinations offer evidence-based benefits, with slightly higher belief among physicians compared to NPs or RNs. However, important barriers to vaccination remain. Standing orders, provider reminders, and onsite/walk-in vaccination are favorably perceived by providers.
慢性肾脏病（CKD）患者中流感疫苗和新冠疫苗的接种率仍然很低。肾脏病护理提供了提高接种率的机会。了解医护人员的看法对于制定有效的干预计划可能至关重要。
我们对肾脏病护理提供者进行了一项全国性调查。在一份问卷中，我们评估了医护人员对推荐流感疫苗和新冠疫苗的潜在障碍的认同度，以及他们对选定的疫苗接种计划在可接受性、适宜性和可行性方面的看法。
在2023年2月至6月期间，312名医护人员回复了调查。大多数医护人员认为有足够的证据支持流感疫苗接种（270/311，86.8%），并且疫苗可降低流感严重并发症的风险（277/310，89.4%）。然而，40/312（12.8%）的医护人员认为推荐流感疫苗不如他们必须处理的其他问题重要。按职业划分，与执业护士（NP）或护士（RN）相比，更多医生认同这些证据（112/123或91.1%，而NP为39/49或79.5%，RN为83/101或8
