Perceptions and attitudes of kidney transplant recipients towards SARS-CoV-2 vaccination: a single-centre study

Kidney transplant recipients are at increased risk of severe outcomes from coronavirus disease 2019. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has been shown to reduce hospitalisation and mortality rates in kidney transplant recipients, but vaccine hesitancy remains a concern. We surveyed kidney transplant recipients in a single centre to examine their perceptions and attitudes towards SARS-CoV-2 vaccination.

A cross-sectional survey of kidney transplant recipients was conducted between June 2021 and August 2021. Questionnaire responses collected included demographic data, intention to receive SARS-CoV-2 vaccine and factors related to vaccine acceptance or hesitance. Predictors and reasons for vaccine acceptance were analysed.

In the sampled cohort of 313 respondents, the vaccine acceptance rate was 75%; 61% of the respondents were aged 51-70 years, and 31% had transplant vintages of 10-20 years. In a multivariable model, transplant physicians' recommendation (odds ratio [OR] 4.1, 95% confidence interval [CI] 2.4-7.1, P < 0.001), male gender (OR 2.3, 95% CI 1.3-4.0, P = 0.003) and transplant vintage of <10 years (OR 2.0, 95% CI 1.2-3.5, P = 0.01) were predictors of vaccine acceptance. Recipients' perceptions that SARS-CoV-2 vaccination confers protection and their trust in the government and health authorities on vaccine efficacy and safety were reasons for vaccine acceptance, while concerns about the effects of vaccination on allograft function and the safety and efficacy of vaccines were reasons for vaccine hesitancy. Assurance from transplant physicians played an important role in increasing vaccine acceptance.

A high level of knowledge and trust in the doctor-patient relationship remain critical for kidney transplant recipients to improve vaccine acceptance. Continued efforts are required to address concerns about vaccine efficacy and safety in this population.