ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1478745
This article is part of the Research TopicKidney impacts of COVID-19 and COVID-19 vaccinationView all articles
Status of COVID-19 Vaccination in patients undergoing dialysis in China: a National Cross-Sectional Study (2022)
Provisionally accepted
Ping Li
Delong Zhao
Hong Wang
Yue Niu
Jianhui ZhouWeicen LiuXueying CaoZhifang Ma
Pan SaiYuan Liang
Xuefeng Sun
GUANGYAN CAI
Xiangmei Chen*- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China., Department of Nephrology, Chinese PLA General Hospital, Beijing, China
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ABSTRACTDue to their comorbidities and frequent exposure to healthcare settings, patients undergoing dialysis are at a high risk of developing severe COVID - 19. However, there are no customized vaccination guidelines for this group in China. This study had two aims: to systematically evaluate the current status of COVID - 19 vaccination among Chinese dialysis patients and to offer a basis for policy - making and further research.Conducted as a national cross - sectional study from May to July 2022, it involved 131,149 dialysis patients from 2,865 centers. The study examined vaccination coverage, the barriers to vaccination, and the safety of vaccines. Only 21.0% received ≥1 vaccine dose, predominantly inactivated vaccines (84.5%). Adverse reactions occurred in 19.0%, with higher rates for adenovirus vector vaccines (27.3%) than for recombinant protein (19.4%) and inactivated vaccines (18.5%, P<0.001). Among unvaccinated patients, 53.5% faced institutional barriers (e.g., site refusal or lack of provider recommendations), while 88.7% had no contraindications. Older age (OR=1.32, 95% CI 1.28–1.36), female gender (OR=1.18, 1.14–1.22), and hemodialysis (OR=1.12, 1.06–1.19) predicted non-vaccination. In general, this study highlights critical barriers to COVID-19 vaccination in dialysis patients: guideline gaps, provider hesitation, and non-specialized vaccination settings. Recommendations include updating guidelines to prioritize this population, training non-specialized staff, and launching dialysis center-based vaccination programs. Future research should investigate vaccine immunogenicity in dialysis patients to refine booster strategies.
Keywords: COVID-19, Vaccine, Dialysis, Health Policy, Cross-sectional study
Received: 05 Nov 2024; Accepted: 19 May 2025.
Copyright: © 2025 Li, Zhao, Wang, Niu, Zhou, Liu, Cao, Ma, Sai, Liang, Sun, CAI and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiangmei Chen, Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China., Department of Nephrology, Chinese PLA General Hospital, Beijing, China
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