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UBC Theses and Dissertations

COVID-19 vaccination in patients with chronic kidney disease : exploring humoral immunity, perceptions, and health information-seeking behavior Enilama, Omosomi

Abstract

Background: People living with chronic kidney disease (CKD) face an increased risk of severe illness from COVID-19, making vaccination a key strategy to reduce hospitalization and death in this population. There is limited information regarding the humoral immune response over time to COVID-19 vaccination in non-dialysis-dependent CKD (NDD-CKD) patients, particularly after the third dose, and whether this response varies by kidney function, assessed by estimated glomerular filtration rate (eGFR). Information on factors that shape COVID-19 vaccine uptake, including health information-seeking behavior (HISB) and perceptions, within the CKD population are also undefined. Methods: This thesis consists of two studies (Chapter 2 and 3), conducted within British Columbia and Ontario, Canada, between Aug 2021 – April 2023. Chapter 2: A prospective observational study that investigated the serologic response after a third mRNA COVID-19 vaccine dose in NDD-CKD patients over a 9-month follow-up period. Chapter 3: A mixed methods cross-sectional web-based survey that investigated perceptions, HISB, comprehension, and trust in information on COVID-19 in CKD patients (including dialysis and transplant). Results: Anti-spike and Anti-RBD antibody levels peaked 2 months after the third dose (1131 and 1672 BAU/mL, respectively), and high seropositivity rates (above 93% and 85%, respectively) were seen over the 9-month follow up period. There was no association found between eGFR and mounting a robust antibody response or on the magnitude of antibody levels over time. Chapter 3: A majority (65%) of CKD patients sought out information on COVID-19 and those with a higher number of COVID-19 vaccine doses were associated with having sought out (P =.017), comprehended (P < .001), and trusted (P =.005) COVID-19 related information. Most CKD patients strongly agreed to statements regarding the benefits of COVID-19 vaccination. Questions posed by survey respondents about COVID-19 centered on four major categories: vaccination strategy, vaccine effectiveness, vaccine safety, and the impact of COVID-19 on kidney health. Conclusion: NDD-CKD patients had a strong humoral immune response following a third mRNA COVID-19 vaccine dose and there were no observed differences in this response by eGFR. CKD patients exhibited high HISB, trust, and comprehension on COVID-19 information, and perceptions towards the COVID-19 vaccines were mostly favorable.

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Attribution-NonCommercial-NoDerivatives 4.0 International