Press release

Two Covid-19 vaccines not enough for kidney failure patients

Published on 2 March 2022

New research shows that for patients with kidney failure who are on dialysis or have a kidney transplant, two doses of a Covid-19 vaccine do not provide sufficient protection

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Research conducted by the Scottish Renal Registry (SRR) on behalf of Public Health Scotland has found that in patients who require dialysis or have a kidney transplant, the risk of death following a Covid-19 infection remains high even after two doses of vaccine.

The University of Dundee’s Dr Samira Bell, who led the research as Chair of SRR, said the results highlight the urgent need for these patients to access a third and, if necessary, a fourth vaccine.

It is known that patients on dialysis or with a kidney transplant have a weakened immune system and therefore have a substantially increased risk of death after infection with Covid-19 than the general population.

While vaccination against Covid-19 has been shown to reduce risk of death and hospitalisation, the new research, published in the Journal of American Society of Nephrology, shows that two doses of a Covid-19 vaccine has limited impact on the infection and its complications in this patient group.

“We examined the effect of two doses of Covid-19 vaccines in patients on dialysis and with a transplant in Scotland by using linkage of real-world data for the entire Scottish population of patients,” said Dr Bell.

“Our aim was to establish the effect of two doses on rates of infection and patient outcomes such as death and hospitalisation. Our work shows that whilst outcomes following two doses of Covid-19 vaccine are improved, there is still a nine percent risk of death following infection in this patient group. This highlights the urgent need for a third dose of vaccine.”

Despite highlighting the need for a booster dose of vaccine and, if eligible, a booster dose after three doses, data from Public Health Scotland show that vaccine uptake among patients on dialysis or with a kidney transplant in Scotland for two doses currently sits at 93%, while uptake for a third dose is only around 85%.

Kidney transplant patients in Scotland have also been offered a fourth dose of Covid-19 vaccine. In these patients, the third dose of the Covid-19 vaccine is different from a booster dose and helps increase the level of protection for people who may not have generated a full immune response to the first two doses.

Dr Bell said, “I strongly recommend that any patients on dialysis or with a kidney transplant ensure they receive a full course of vaccination including a third dose, and a fourth dose in the case of kidney transplant patients. Please contact NHS Inform or your local renal unit if you are unsure whether you are eligible.”

Dr Nick Phin, Director of Public Health Science and Medical Director for Public Health Scotland added, “Research like this is critical in helping us refine our future immunisation strategy for Scotland so that we make sure the needs of all groups in the population receive the right level of protection.”


Jessica Rorke

Media Relations Officer

+44 (0)1382 388878
Story category Research, Staff