POST-PANDEMIC TRENDS IN COVID-19, INFLUENZA AND PNEUMOCOCCAL VACCINATION AMONG PATIENTS WITH NON-DIALYSIS DEPENDENT CKD AND ON MAINTENANCE DIALYSIS IN BRITISH COLUMBIA, CANADA

 

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https://storage.unitedwebnetwork.com/files/1099/ae22abaed0df6e5cdecd254cd1236320.pdf
POST-PANDEMIC TRENDS IN COVID-19, INFLUENZA AND PNEUMOCOCCAL VACCINATION AMONG PATIENTS WITH NON-DIALYSIS DEPENDENT CKD AND ON MAINTENANCE DIALYSIS IN BRITISH COLUMBIA, CANADA

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Mohammad
Atiquzzaman
Mohammad Atiquzzaman matiquzzaman@bcrenal.ca University of British Columbia Division of Nephrology Vancouver Canada *
Lee Er ler@bcrenal.ca BC Renal Analytics and Methodology Vancouver Canada -
Alexandra Romann aromann@bcrenal.ca BC Renal Analytics and Methodology Vancouver Canada -
Ognjenka Djurdjev ODjurdjev@phsa.ca BC Renal Analytics and Methodology Vancouver Canada -
Anurag Singh Anurag.Singh@northernhealth.ca University of British Columbia Division of Nephrology Vancouver Canada -
Melanie Brown Melanie.Brown@fraserhealth.ca University of British Columbia Division of Nephrology Vancouver Canada -
Adeera Levin adeera.levin@phc.ca University of British Columbia Division of Nephrology Vancouver Canada -
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People with chronic kidney disease (CKD) are vulnerable to severe infections that may accelerate decline in kidney function and add to cardiovascular risk. Vaccination play a critical role in reducing complications from infections and preventing hospitalizations, yet uptake among CKD patients remains suboptimal globally. We investigated post-pandemic trends in seasonal vaccination among real-world patients with CKD in British Columbia (BC), Canada.

This retrospective observational study used aggregated data from PROMIS and PANORAMA, both population-based integrated registries that capture all patients with CKD or receiving kidney replacement therapy in BC, Canada. Four annual prevalent CKD cohorts were constructed, including non-dialysis and dialysis dependent patients as of July 1 in each year from 2022 to 2025. Primary vaccines of interest included COVID-19, influenza and pneumococcal.  Receipt of COVID-19 and influenza vaccine was defined as vaccination within the previous year of the study cohort date, while pneumococcal vaccine was defined as having ever vaccinated on or before the study cohort date. We calculated the proportion of patients with CKD who were vaccinated with each vaccine separately, as well as at least one of the three vaccines or the annual ones. Vaccination rates were compared across years and between non-dialysis and dialysis-dependent patients.

The 4 prevalent cohorts included 32541 individual CKD patients. Number and characteristics of patients appeared to be balanced by year of inclusion (Table 1). Between 2022 and 2025, vaccination rates among patients with CKD (both dialysis and non-dialysis dependent) dropped substantially by 30–50% (Figure1). In 2022, 90% patients with CKD had at least one annual vaccine, mainly because of the COVID-19 vaccine. COVID-19 vaccine declines thereafter with only 46% reported in 2025 (Figure1A). This was similar in non-dialysis and dialysis dependent patients (Figure1B). Influenza vaccine uptake hovered between 42% to 56% and was similar in both non-dialysis and dialysis dependent patients. The proportion of patients who received pneumococcal vaccines substantially differed between non-dialysis and dialysis dependent patients, 43% vs. 64%, respectively.

Vaccination rates among patients with CKD in British Columbia have declined markedly in the post-pandemic period, particularly for COVID-19 and influenza vaccines. Given the heightened vulnerability of this population to infection-related complications and cardiovascular events, these declining trends may translate into increased morbidity and health system burden. Strengthening vaccine uptake through education, outreach, and integration into routine CKD care pathways is critical. Ongoing work is evaluating the impact of a targeted education program on vaccination rates and its association with kidney function decline, cardiovascular outcomes, and healthcare utilization over time.

Kewords