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Coronavirus Disease 2019 Vaccination Booster Effectiveness Based on the 2022 Japanese Dialysis Registry

Yuka Sugawara1, Masao Iwagami2, Yuki Sakurai1

  • 1Division of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan.

Nephrology (Carlton, Vic.)
|July 15, 2025
PubMed
Abstract

Insights

Japanese haemodialysis patients receiving COVID-19 vaccine boosters showed reduced infection risk and mortality. While the third dose had variable effectiveness against infection, subsequent boosters consistently lowered risks during the Omicron era.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Vaccinology

Background:

  • The Omicron variant significantly impacted coronavirus disease 2019 (COVID-19) vaccine effectiveness, particularly in vulnerable populations like Japanese haemodialysis patients.
  • Understanding the impact of multiple COVID-19 vaccine booster doses is crucial for managing infections in immunocompromised individuals.

Purpose of the Study:

  • To evaluate the effectiveness of the third, fourth, and fifth COVID-19 vaccine booster doses in Japanese haemodialysis patients.
  • To assess the impact of these boosters on infection risk and mortality during the Omicron variant's dominance.

Main Methods:

  • Analysis of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) year-end survey data from 2021 to 2022.
  • Calculation of monthly COVID-19 infection and mortality risks by vaccination status.
  • Logistic regression analyses to determine adjusted odds ratios (aORs) for infection and mortality.

Main Results:

  • Over 225,000 haemodialysis patients were analyzed; 54.3% received five doses by end of 2022.
  • The third vaccine dose showed reduced infection risk early in 2022 but increased risk during the BA.1/2 to BA.5 transition.
  • The third dose consistently reduced COVID-19-related mortality, while fourth and fifth doses lowered both infection risk and mortality throughout the study period.

Conclusions:

  • The third to fifth COVID-19 vaccine booster doses were associated with reduced mortality in Japanese haemodialysis patients.
  • Booster doses generally decreased infection risk, with some exceptions for the third dose during specific Omicron subvariant transitions.
  • Continued vaccination is recommended for haemodialysis patients to mitigate COVID-19 risks.
Keywords:
COVID‐19SARS‐CoV‐2coronavirushaemodialysiskidneyrenal insufficiencyvaccination

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