Bivalent COVID-19 vaccine protects dialysis patients, but effectiveness wanes

A bivalent mRNA COVID-19 vaccine dose protects against infection in patients with kidney failure receiving maintenance dialysis, although the vaccine’s effectiveness gradually decreased, according to a retrospective cohort study.

Researchers used Medicare Fee-for-Service (FFS) claims data and identified adult beneficiaries with kidney failure receiving maintenance dialysis who had no additional immunocompromising conditions. They looked at the group of patients who received bivalent mRNA COVID-19 vaccination and those who received the original monovalent COVID-19 doses alone.

Vaccine effectiveness was measured against medically attended COVID-19—defined as the occurrence of a COVID-19-associated outpatient encounter, COVID-19-associated hospitalization, critical COVID-19 illness, or COVID-19-associated death—overall and each COVID-19-associated outcome.

Compared with receipt of original monovalent COVID-19 vaccine doses, the receipt of a bivalent mRNA COVID-19 vaccine dose had a relative estimated effectiveness of 41 percent (95 percent confidence interval [CI], 37–46) against medically attended COVID-19, 49 percent (95 percent CI, 43–54) against COVID-19-associated hospitalization, 53 percent (95 percent CI, 44–61) against critical COVID-19 illness, and 54 percent (95 percent CI, 42–63) against COVID-19-associated death among adults with kidney failure treated with maintenance dialysis.

Estimated vaccine effectiveness of the bivalent vaccine against medically attended COVID-19 dropped from 50 percent (95 percent CI, 44–55) within days 7–59 after dosing to 33 percent (95 percent CI, 26–39) within days 60–206 after dosing.