Study affirms increased access and equity for COVID-19 vaccines administered in dialysis centres

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A federal partnership established to help increase access to COVID-19 vaccines for end-stage kidney disease (ESKD) patients receiving dialysis was successful in reducing racial disparities in vaccination coverage, new research published in JAMA Internal Medicine has affirmed. Compared to white patients, Hispanic, Black and Asian patients were more likely to receive at least one dose of COVID-19 vaccine in a dialysis centre.

The Centers for Disease Control and Prevention (CDC) collaborated with DaVita, Fresenius Medical Care North America and other partners in March 2021 to create the Federal Dialysis Provider COVID-19 Vaccine Partnership. Both providers received allocations of COVID-19 vaccines from the US federal government to administer to patients in dialysis centres and distribute to other dialysis providers across the country—as per a press release from DaVita.

“We were steadfast in our advocacy efforts to support patients with kidney failure by providing access to the vaccine through the pandemic,” said Jeff Giullian, chief medical officer for DaVita and study co-author. “We are incredibly grateful for the collaboration between the CDC and the kidney care community to leverage our capacity, experience and footprint to bring dialysis patients direct access to COVID-19 vaccines. The results of this study affirm that providing vaccines at trusted sites of care is an effective approach to helping to reduce hesitancy and advance equity for patients of colour who have been disproportionately affected by the COVID-19 pandemic.”

“I appreciate all the members of our frontline care teams who worked so hard to efficiently vaccinate our vulnerable patient population,” said Jeffrey Hymes, global head of clinical affairs for Fresenius Medical Care and study co-author. “This important partnership with the CDC shows how well our dialysis centres can be used to reach often underserved populations and improve equitable access to care, especially for people at highest risk of complications from viruses like COVID-19.”

The new study evaluated the impact of dialysis clinics serving as COVID-19 vaccine providers on vaccination coverage and disparities from 1 December 2020 through 13 June 2021. Vaccination coverage was calculated using the number of patients at nearly 5,200 Fresenius and DaVita dialysis centres who received at least one dose of vaccine, regardless of location. According to the release, the researchers found that:

  • As of 28 March 2021, shortly after the federal partnership launched, vaccination coverage among white patients was 52%, exceeding coverage in Black (45.2%) and Hispanic (51.3%) patients. Asian patients had higher vaccination coverage (60%) than white patients.
  • By 13 June 2021, vaccination coverage among Asian (74.1%) and Hispanic (69.5%) patients exceeded that of white patients (65.5%), with vaccination coverage among Black patients slightly lower (63%).
  • Overall, 50.7% of vaccinated patients (n=312,046) were vaccinated in a dialysis clinic during the evaluation. Compared to white patients (42.5%), Hispanic (62.2%), Black (55.4%) and Asian (49.5%) patients were more likely to receive the COVID-19 vaccine in a dialysis centre.

As per DaVita’s press release, researchers recommend that public health agencies and policymakers prioritise dialysis centres for federal vaccine allocations and on-site vaccine administration in the future.

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