For patients receiving hemodialysis who become infected with SARSCoV-2, prior SARS-CoV-2 vaccination is associated with reduced risk for severe COVID-19, according to a study published in the Clinical Journal of the American Society of Nephrology. Damien R. Ashby, MBBS, and colleagues conducted a multicenter observational study in a hemodialysis population during the period of vaccine rollout with BNT162b2 and AZD1222. SARS-CoV-2 infection was identified in 1,323 patients, including 79%, 7%, and 14% unvaccinated, after first-dose vaccination, and after second-dose vaccination, respectively. Most patients had a mild course, but 39% and 13% were hospitalized and died, respectively. Greater illness severity was seen in association with older age, diabetes, and immune suppression. Prior two-dose vaccination was associated with 75% and 88% reductions in risks for admission and mortality, respectively, compared with unvaccinated patients after adjustment for age, comorbidity, and time period. In patients older than 65 or with increasing time since vaccination, there was no loss of protection.
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