Perceptions About Influenza and COVID-19 Vaccines Among People With CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

RATIONALE &

objectiveVaccine uptake among individuals with chronic kidney disease (CKD) is suboptimal. Understanding the perceptions associated with vaccine hesitancy can help inform programs aimed at addressing these concerns. STUDY

designCross-sectional survey. SETTING &

participantsA subset of participants from the Chronic Renal Insufficiency Cohort (CRIC) Study, recruited from 3 study sites. EXPOSURE: Participants' perceptions about influenza and COVID-19 infection risks, benefits and harms of vaccines, vaccine skepticism, access barriers, and cues to action, according to the Health Belief Model. OUTCOME: Influenza and COVID-19 vaccine hesitancy, defined as being uncertain about or not planning to receive a future dose of these vaccines. ANALYTICAL APPROACH: Responses were measured on a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree). Linear regression models were used to analyze differences in mean Likert scale scores between participants with and without vaccine hesitancy.

resultsBetween July 2022 and June 2023, 278 CRIC participants completed the survey, of whom 47 (16.9%) and 46 (16.8%) had influenza and COVID-19 vaccine hesitancy, respectively. Linear regression models identified key perceptions associated with vaccine hesitancy, including perceived harms of the vaccines (eg, the vaccine causes influenza; ΔMean Likert scale, 1.25 [95% CI, 0.96-1.55]) and vaccine skepticism (eg, benefits of the influenza vaccine are exaggerated, 0.96 [95% CI, 0.65-1.26]). Perceived benefits were negatively associated with vaccine hesitancy (eg, influenza vaccines prevent serious illness, -0.93 [-1.23 to -0.62]). More than 40% perceived that they were not at risk of influenza, but this perception was not associated with vaccine hesitancy (0.02 [-0.35 to 0.40]). These findings were overall consistent for COVID-19, although vaccine skepticism was more prevalent and more strongly associated with vaccine hesitancy. LIMITATIONS: The study population consisted of individuals with CKD who were enrolled in a cohort study and voluntarily responded to the survey.

conclusionsAmong individuals with CKD, perceptions of vaccine harms and vaccine skepticism were significant factors contributing to vaccine hesitancy. Improved dissemination of accurate vaccine information through tailored patient education initiatives may enhance vaccination uptake in this population. PLAIN-LANGUAGE SUMMARY: People with chronic kidney disease (CKD) are at higher risk for infections, but some are hesitant to get vaccines. This study surveyed 278 CKD patients to understand why some avoid flu and COVID-19 vaccines. The study found about 17% were hesitant about each vaccine. People who were hesitant often believed the vaccines could be harmful or doubted their benefits. For example, some thought the flu vaccine could cause the flu or that vaccine benefits were exaggerated. By contrast, those who believed vaccines prevent serious illness were less hesitant. These findings suggest that clear, trustworthy information about vaccine safety and effectiveness-shared in ways that address patient concerns-could help increase vaccination rates in people with CKD.