Dr Sunil Prakash, Senior Director & HoD, Nephrology & Renal Transplantation, BLK Super Speciality Hospital spoke about the relation between the Covid-19 vaccine and kidney disease.
Q. There is a rising concern in the community of patients with Chronic Kidney Disease (CKD) on getting Covid-19 vaccination as raised levels of blood and use of immunosuppressive agents can potentially hamper vaccination responses. Do you think these fears are true?
A. Patients with CKD will indeed be less responsive to the drugs but such patients also have more susceptibility to getting a very bad infection. They must get the Covid-19 vaccine. If a normal person gets vaccinated, 70% will get a good immune response. In CKD patients, the immune response will be less but they should take it as the benefit is more and the risk is less.
Q. Will vaccination help lower infection rates and reduce morbidity and mortality rates?
A. It will. Although it may not be as effective as in normal people but will certainly help CKD patients. In India, 2-3% of normal people die because of Covid-19. But in my own experience, if a CKD patient gets Covid-19 then the mortality is 8-10%, more on the higher side and if a transplant patient gets it then it is as high as 25%. So, CKD patients must take the vaccine and that is why they are given priority.
Q. Should patients with CKD, including those on dialysis or living with a renal transplant, take Covid-19 vaccination?
A. Yes, as they have very high chances of mortality. Although, the immune conversion will be less, whoever gets vaccinated can still be saved.
Q. How should transplant patients go about getting the Covid vaccine?
A. Transplant patients should get the vaccine in the same way as non-transplant patients. But the conversion will be less among them as they are taking immunosuppressive medicines so their immunity is hampered and the immune conversion will be less.
Q. Has the morbidity and mortality rate in CKD patients been higher due to Covid-19 vis-à-vis the rest of the population?
A. Yes, mortality in CKD patients has been much higher. If they get Covid-19, their immune system is not so competent to fight it and they have other comorbidities as well like diabetes, high blood pressure for which they are taking medicines. All this is also there so they should get the vaccine.
Q. Is the vaccine especially important for kidney transplant patients and other immunocompromised patients? Are they at greater risk of severe Covid-19 complications?
A. Yes, as there is 25% mortality in transplant patients, which is extremely high.
Q. Are Covid vaccines safe for transplant recipients and kidney donors?
A. With the Covid vaccine, there are a lot of worries around certain side effects but my take on this is a little philosophical. I believe that there is nothing in this world that is 100% safe. If you leave home for work, there is a fear of road accident, our food may contain pollutants, there are many things that can happen to us. The side effects may be there with the vaccine but so are the benefits. It is a case of 70% benefits and 10% side effects but these side effects are not very severe.
Q. After getting the vaccine, will CKD patients be totally protected from contracting the infection?
A. No, the conversion rate is 70% but still, some people can get Covid-19 even after getting vaccinated. Case in point, 100 people get vaccinated, 30 can get the infection, 70 will not. In CKD patients, if 100 people get vaccinated, 70 can get the infection, 30 will not. Such is the ratio. The benefit is in taking the vaccine.
