COVID-19 vaccine hesitancy and uptake amongst a multiethnic hemodialysis population

Background: Broad adoption of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is key to fighting the spread of Covid-19. Hemodialysis patients are at increased risk of exposure to SARS-CoV2 and associated with high morbidity and mortality if they contract Covid-19, therefore attaining high vaccination rates in dialysis patients is of utmost importance. The aim of this study was to establish the prevalence of vaccine hesitance across the multi-ethnic population of dialysis patients in North East London, and to assess whether vaccine uptake could be improved by offering vaccination in a familiar setting by trusted healthcare professionals. Methods: Prior to the initiation of the hemodialysis vaccine programme, a survey was conducted of 837 in-centre haemodialysis patients to identify those willing to accept the vaccine. The vaccine was then offered to all haemodialysis patients during their dialysis attendance, by their dialysis team of nurses and nephrologists. Results: Of 674 responses, 476 (71%) patients reported willingness to accept the vaccine. However only 41% of the 232 patients of Black ethnicity stated that they would accept the vaccine with 59% undecided or declined, compared to acceptance of 77% and 82% of the Asian and White patients respectively (p<0.0001). The actual acceptance rate was significantly higher in all ethnic groups than that predicted by the survey (82.2% uptake in total), with 71.5%, 86.0% and 89.3% in Black, Asian and White cohorts respectively (p<0.0001). In total, 59.1% of patients who responded 'no' in the initial survey, accepted the vaccine when offered on the unit. Conclusions: Though vaccine hesitancy remains a concern, even in this particularly vulnerable patient group, our data show that uptake can be improved by offering Covid-19 vaccination in a familiar environment by a trusted healthcare team.