COVID-19 vaccination among adolescents and young adults with chronic kidney conditions: a single-center experience

Abstract

Background Following the pandemic of COVID-19, the main focus has been on COVID-19 vaccines and herd immunity. Although the safety of the COVID-19 vaccines has been shown in clinical trials, children with chronic diseases were not included. We investigated the side effect profile and safety of the COVID-19 vaccines in adolescents with kidney disease.

Methods A questionnaire including demographic information, history of COVID-19, vaccination status, and vaccine-related side effects was administered to the patients with chronic kidney disease (CKD) stage 2–5, glomerular disease treated with immunosuppression, and kidney transplant recipients.

Results Ninety-eight patients were vaccinated with CoronaVac-inactivated SARS-CoV-2 (n=16) or BNT162b2 messenger RNA (mRNA) COVİD-19 (n=82) vaccine. The mean age was 16.90±2.36 years. The most common side effects were local pain, fatigue, and fever. No serious side effects or renal disease flare were observed. There was no significant difference in the side effects reported after the BNT162b2 mRNA-RNA as compared to the Corona Vac-inactivated SARS-CoV-2 vaccine. No significant relationship was found between the frequency of side effects according to age, glomerular filtration rate, immunosuppressive treatments, CKD stage, and the underlying disease.

Conclusion Although the reported data are subjective because they were obtained through a questionnaire and studies with long-term follow-up are needed, our early experience suggests that the vaccine is safe and adolescents and young adults should be encouraged to be vaccinated.

Zusammenfassung

Hintergrund Nach der COVID-19-Pandemie standen COVID-19-Impfstoffe und Gemeinschaftsschutz (Herdenimmunität) im Mittelpunkt. Zwar war ein Nachweis der Sicherheit der COVID-19-Impfstoffe in klinische Prüfungen erfolgt, doch wurden Kinder mit chronischen Erkrankungen in diese Studien nicht eingeschlossen. Wir untersuchten deshalb das Nebenwirkungsprofil und die Sicherheit der COVID-19-Impfstoffe bei Jugendlichen mit Nierenerkrankungen.

Methoden Patientinnen und Patienten mit chronischer Niereninsuffizienz im Stadium 2–5, mit Immunsuppressiva behandelter Glomerulonephritis und mit Zustand nach Nierentransplantation wurde ein Fragebogen ausgehändigt, mit dem neben demografischen Daten anamnestische Informationen zu COVID-19, Impfstatus und impfbedingten Nebenwirkungen erhoben wurden.

Ergebnisse Insgesamt waren 98 Patientinnen und Patienten gegen SARS-CoV-2 geimpft: 16 mit CoronaVac (inaktivierter SARS-CoV-2-Impfstoff) und 82 mit dem mRNA-basierten SARS-CoV-2-Impfstoff BNT162b2. Das mittlere Alter betrug 16,90 ± 2,36 Jahre. Die häufigsten Nebenwirkungen waren lokale Schmerzen, Müdigkeit und Fieber. Es wurden keine schwerwiegenden Nebenwirkungen und keine Exazerbation der Nierenerkrankung beobachtet. Es gab keinen signifikanten Unterschied in den berichteten Nebenwirkungen zwischen den mit dem mRNA-Impfstoff BNT162b2 und den mit dem Totimpfstoff CoronaVac geimpften Patientinnen und Patienten. Auch fand sich kein signifikanter Zusammenhang zwischen der Häufigkeit von Nebenwirkungen und Alter, glomerulärer Filtrationsrate, immunsuppressiver Therapie, Stadium der Niereninsuffizienz und Grunderkrankung.

Schlussfolgerung Obwohl es sich bei den Daten um subjektive, im Rahmen eines Fragebogens erhobene Patientenangaben handelt und Langzeit-Follow-up-Studien erforderlich sind, deuten unsere ersten Erfahrungen darauf hin, dass der Impfstoff sicher ist und Jugendliche und junge Erwachsene zur Impfung ermutigt werden sollten.

Keywords

COVID-19 vaccination - vaccine adverse events - vaccine hesitancy - chronic kidney disease

Schlüsselwörter

COVID-19-Impfung - unerwünschte Impfereignisse - Impfskepsis - chronische Nierenerkrankungpublished online 2024

Publikationsverlauf

Artikel online veröffentlicht:
31. Mai 2024

• References

• 1 Williamson EJ, Walker AJ, Bhaskaran K. et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020; 584: 430-436
• 2 Richardson S, Hirsch JS, Narasimhan M. et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. Jama 2020; 323: 2052-2059
• 3 Dong Y, Mo X, Hu Y. et al. Epidemiology of COVID-19 Among Children in China. Pediatrics 2020; 145
• 4 Melgosa M, Madrid A, Alvárez O. et al. SARS-CoV-2 infection in Spanish children with chronic kidney pathologies. Pediatric Nephrology 2020; 35: 1521-1524
• 5 Marlais M, Wlodkowski T, Al-Akash S. et al. COVID-19 in children treated with immunosuppressive medication for kidney diseases. Archives of Disease in Childhood 2020; 106: 798-801
• 6 Vasconcelos MA, Mendonça ACQ, Colosimo EA. et al. Outcomes and risk factors for death among hospitalized children and adolescents with kidney diseases and COVID-19: an analysis of a nationwide database. Pediatric Nephrology 2023; 38: 181-191
• 7 Krishnasamy S, Mantan M, Mishra K. et al. SARS-CoV-2 infection in children with chronic kidney disease. Pediatric Nephrology 2022; 37: 849-857
• 8 Leventoğlu E, Atikel Y, Nalçacıoğlu H. et al. COVID-19 in pediatric nephrology centers in Turkey. Turkish journal of medical sciences 2022; 52: 1762-1770
• 9 Baltu D, Kurt-Sukur ED, Tastemel Ozturk T. et al. COVID-19 in Children with Chronic Kidney Disease; Does it Differ Much?. Klinische Padiatrie. 2024
• 10 https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum Acsess date:12/12/2023
• 11 Schwartz GJ, Muñoz A, Schneider MF. et al. New equations to estimate GFR in children with CKD. Journal of the American Society of Nephrology : JASN 2009; 20: 629-637
• 12 Akchurin O, Meza K, Biswas S. et al. COVID-19 in Patients with CKD in New York City. Kidney360 2021; 2: 63-70
• 13 Twichell S, Ashoor I, Boynton S. et al. COVID-19 disease among children and young adults enrolled in the North American Pediatric Renal Trials and Collaborative Studies registry. Pediatric nephrology 2023;
• 14 Cotugno N, Amodio D, Buonsenso D. et al. Susceptibility of SARS-CoV2 infection in children. European journal of pediatrics 2023; 182: 4851-4857
• 15 Bouwmans P, Malahe SRK, Messchendorp AL. et al. Post COVID-19 condition imposes significant burden in patients with advanced chronic kidney disease:a nested case-control study. International Journal of Infectious Diseases 2024; 106990
• 16 Català M, Mercade-Besora N, Kolde R. et al. The Effectiveness of COVID-19 Vaccines to Prevent Long COVID Symptoms: Staggered Cohort Analyses of Data from the UK, Spain, and Estonia. Lancet Respir Med 2024; 12: 225-236
• 17 Alhumaid S, Rabaan AA, Dhama K. et al. Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis. Vaccines 2022; 10: 1289
• 18 Mateus C, Theias Manso R, Martins AR. et al. Membranous nephropathy after a recent SARS-CoV-2 infection. BMJ case reports 2023; 16: e252468
• 19 Lazareth H, Péré H, Binois Y. et al. COVID-19-Related Collapsing Glomerulopathy in a Kidney Transplant Recipient. American journal of kidney diseases 2020; 76: 590-594
• 20 Leow EH, Chong SL, Yap CJY. et al. IgA nephropathy in children: before and after the start of COVID-19. Pediatric Nephrology 2023; 10
• 21 García-Fernández S, Fernández-Morán E, López-Martínez C. et al. Tubulointerstitial nephritis and uveitis syndrome and SARS-CoV-2 infection in an adolescent: just a coincidence in time?. Pediatric nephrology 2023; 38: 4203-4207
• 22 Olson SM, Newhams MM, Halasa NB. et al. Effectiveness of BNT162b2 Vaccine against Critical Covid-19 in Adolescents. The New England journal of medicine 2022; 386: 713-723
• 23 Polack FP, Thomas SJ, Kitchin N. et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. The New England journal of medicine 2020; 383: 2603-2615
• 24 Thomas SJ, Moreira ED, Kitchin N. et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine through 6 Months. The New England journal of medicine 2021; 385: 1761-1773
• 25 Du Y, Chen L, Shi Y. Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis. Frontiers in public health 2022; 10: 829176
• 26 Choe YJ, Ahn YH, Gwak E. et al. Safety of BNT162b2 mRNA COVID-19 vaccine in children with chronic kidney disease: a national population study from South Korea. Pediatric nephrology 2023; 25
• 27 Oster ME, Shay DK, Su JR. et al. Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021. JAMA 2022; 327: 331-340
• 28 Singer ME, Taub IB, Kaelber DC. Risk of Myocarditis from COVID-19 Infection in People Under Age 20: A Population-Based Analysis. medRxiv: the preprint server for health sciences 2022; 21 2021.07.23.21260998
• 29 Voleti N, Reddy SP, Ssentongo P. Myocarditis in SARS-CoV-2 infection vs. COVID-19 vaccination: A systematic review and meta-analysis. Frontiers in cardiovascular medicine 2022; 9: 951314
• 30 Ou MT, Boyarsky BJ, Motter JD. et al. Safety and Reactogenicity of 2 Doses of SARS-CoV-2 Vaccination in Solid Organ Transplant Recipients. Transplantation 2021; 105: 2170-2174
• 31 Haskin O, Ashkenazi-Hoffnung L, Ziv N. et al. Serological Response to the BNT162b2 COVID-19 mRNA Vaccine in Adolescent and Young Adult Kidney Transplant Recipients. Transplantation 2021; 105: e226-e233
• 32 Del Bello A, Marion O, Delas A. et al. Acute rejection after anti-SARS-CoV-2 mRNA vaccination in a patient who underwent a kidney transplant. Kidney international 2021; 100: 238-239
• 33 Ota Y, Kuroki R, Iwata M. et al. Association between COVID-19 vaccination and relapse of glomerulonephritis. Clinical and experimental nephrology 2023; 27: 236-242
• 34 Hummel A, Oniszczuk J, Kervella D. et al. Idiopathic nephrotic syndrome relapse following COVID-19 vaccination: a series of 25 cases. Clinical kidney journal 2022; 15: 1574-1582
• 35 Wang CS, Doma R, Westbrook AL. et al. Vaccine Attitudes and COVID-19 Vaccine Intention Among Parents of Children With Kidney Disease or Primary Hypertension. American journal of kidney diseases : the official journal of the National Kidney Foundation 2023; 81: 25-35.e21