Abstract: TH-PO1134
Mortality among Patients on Hemodialysis Who Received Heterologous and Homologous COVID-19 Vaccine Regimens in Thailand
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
- Pattharanitima, Pattharawin, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
- Anumas, Suthiya Anumas, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
- Rattanasompattikul, Manoch, Golden Jubilee Medical Center, Nakorn Pathom, Thailand
- Srithongkul, Thatsaphan, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Raksasuk, Sukit, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Sritippayawan, Suchai, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Background
Although studies showed the effectiveness of a 2-dose homologous regimen, it was impractical in Thailand due to limited vaccine supply. Consequently, heterologous vaccine regimens were implemented. This study aims to evaluate the mortality rate and risk factors for mortality in maintenance hemodialysis (HD) patients who received various vaccine regimens.
Methods
We retrospectively reviewed the data of patients receiving HD in Thailand from January 2021 to December 2022. The demographic, vaccination history, SARS-CoV-2 test results, and other laboratory data were retrieved from the Department of Medical Sciences and Thailand RRT registry. Mortality was defined as death within 30 days after a positive RT-PCR or rapid antigen test for SARS-CoV-2.
Results
Among 121,761 HD patients, 71,455 (58.7%), 67,953 (55.8%), and 46,288 (38.0%) patients received 1,2 and 3 vaccine doses, respectively (Figure 1). Of these, 8,836 (40.9%) and 44,900 (97.0%) patients received heterologous vaccines for their first 2 and 3 doses. The most common regimens were viral vector (VV)-VV-mRNA (33.9%), inactivated (IA)-VV-mRNA (12.7%), and VV-VV (10.2%), with mortality rates of 0.2%, 0.2%, and 1.3%, respectively. The mortality was 601 (1.2%) and 667 (0.9%) among unvaccinated and vaccinated patients (P <0.001), and 0.7% and 6.0% among who tested negative and positive for SARS-CoV-2 (P <0.001). Multivariate analysis showed that female, age ≥50 years, no vaccination, single-dose VV and IA vaccination, high BMI, admission to advanced care wards, and requirement for high oxygen therapy were risk factors for mortality. The VV-VV-mRNA regimen was a protective factor.
Conclusion
This study showed that a single dose of VV and IA vaccines was associated with higher mortality compared to the mRNA-mRNA regimen, while the VV-VV-mRNA vaccine was a protective factor. The mortality in patients who received other vaccine regimens was comparable to those who received the mRNA-mRNA regimen.