Abstract: TH-PO1155
Impact of COVID-19 Vaccination on Racial Disparity in COVID-19 Mortality from a National US Dialysis Provider
Session Information
- COVID-19
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Shieu, Monica, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Gibson, Austin, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Li, Nien Chen, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Manley, Harold, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Harford, Antonia, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Hsu, Caroline M., Tufts Medical Center, Boston, Massachusetts, United States
- Weiner, Daniel E., Tufts Medical Center, Boston, Massachusetts, United States
- Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
- Johnson, Doug, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Lacson, Eduardo K., Dialysis Clinic Inc, Nashville, Tennessee, United States
Background
The pandemic has negatively affected vulnerable dialysis patients especially minorities. We examined the impact of providing universal access to COVID-19 vaccines in dialysis clinics on COVID-19 mortality by racial/ethnicity (RE) group from a national provider.
Methods
Adult maintenance dialysis patients at Dialysis Clinic, Inc. from 2020-2023 were included. The percentage of 3+ doses and/or latest updated vaccine at the end of each year was examined. The outcome of interest was death with COVID as the primary cause within 90 days of diagnosis. Distribution of vaccine status among RE groups was analyzed with ANOVA. Change in mortality rate over the years and by RE groups were both assessed by linear regression.
Results
The cohort included 41,257 patients of White (42%), Black (37%), Hispanic (7%), and Other (14%) race. In 2020, White had the lowest mortality rates (1.3 per 1000 person-months) while Other (2.0) and Hispanic (1.6) had the highest rates (p<.001). All RE groups had similar percentages of 3+ doses and/or latest vaccine: 50-58% in 2021 to 60-64% in 2023 (p>0.08) (Fig 1a). Since COVID vaccines became available in 2021, mortality rates among all RE groups have decreased significantly (b=-0.45, p <.001) (Fig 1b). In 2022, mortality rate declined the least among Whites but was similar again in 2023.
Conclusion
With universal access to vaccines provided in the dialysis clinics, more than 50% of dialysis patients were vaccinated with 3+ doses and/or the latest vaccine. Mortality rate among all RE dropped significantly after the availability of COVID vaccines in 2021. Availability of vaccination in the dialysis clinics may have improved racial disparity in COVID-19. Maintaining equal access to vaccines may enable better outcomes and reduce disparities in this high-risk population, even beyond the COVID-19 pandemic.