Approximately 50 percent of dialysis patients in the United States are Black, Latinx, Native American, or Native Hawaiian or other Pacific Islanders (NHPIs). These individuals are underrepresented in COVID-19 vaccination rates.1 In Virginia, for instance, Black people represent 19% of residents while accounting for 21% of the state’s COVID-19 cases and 24% of its deaths; however, Black Virginians have received only 12% of vaccines administered in the state to date.2
People with kidney failure receiving dialysis are the most vulnerable group of individuals in all of Medicare.3 Therefore, ASN is urging the federal government to immediately provide a direct federal allocation of COVID-19 vaccines to all dialysis facilities nationwide for all people receiving dialysis treatment, and facility staff. Providing vaccines to these minoritized patients, along with other dialysis patients, through the known, trusted care environments of their dialysis units will expedite their access and help address the racial inequity in vaccine rollout.
Vaccinating in the dialysis facility, where 90 percent of patients receive dialysis three times a week, is the most expeditious, safe approach. Most patients on dialysis have multiple co-morbidities, heightened vulnerability to COVID-19 infection, and poor outcomes if infected: they are simply unable to safely go to a separate vaccination center or pharmacy and wait in line.
Dialysis organizations are also highly experienced vaccinating patients for seasonal influenza annually. On average, 90 percent of patients are vaccinated in one week.
1) Release a federal COVID-19 vaccine allocation to be distributed equitably to dialysis patients in dialysis units, improving access for a vulnerable population that mostly includes Americans who are Black, Latinx, Native American, and NHPIs.
2) Have the two large dialysis organizations (LDOs) coordinate distribution of vaccine from the federal government directly to their patients, and to small and medium-sized dialysis organizations.
3) Allow small and medium dialysis organizations that have the capacity and desire to receive the vaccine directly from the federal government to do so.
3. Sim JJ, et al. COVID-19 and survival in maintenance dialysis. Kidney Med [published online ahead of print November 24, 2020]. doi: 10.1016/j. xkme.2020.11.005; https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC7685033/