Abstract
RATIONALE & OBJECTIVE: Persons with kidney disease are at risk of infections such as influenza, pneumonia, shingles, and coronavirus-2019 (COVID-19), which can be prevented by vaccination. However, comparative uptake across these vaccines in people with and without kidney disease has not been well described. STUDY DESIGN: A cross-sectional analysis. SETTING & PARTICIPANTS: Vaccine-eligible adults in the Behavioral Risk Factor Surveillance System (BRFSS) 2018-2022. EXPOSURES: Self-reported status of kidney disease. OUTCOMES: The uptake of the influenza (past 12 months), pneumococcal (lifetime), shingles (lifetime), and COVID-19 (at least one dose) vaccines. ANALYTICAL APPROACH: Multivariable logistic regressions to compare the odds of vaccine uptake between those with and without kidney disease. The results were pooled to show the overall uptake from 2018 to 2022, except for the COVID-19 vaccine, for which data were only available for 2022. RESULTS: In the pooled sample of BRFSS 2018-2022, 4.0% had kidney disease. In people with kidney disease, the highest uptake was observed for COVID-19 (87.0%), followed by pneumococcal (63.6%), influenza (59.6%), and shingles (37.1%) vaccines. These numbers were higher compared with those without kidney disease (78.4% for COVID-19, 52.9% for pneumococcal, 41.8% for influenza, and 31.1% for shingles vaccines), but the differences varied by vaccine type. In multivariable logistic models, the largest odds ratio in uptake of those with versus without kidney disease was observed for pneumococcal vaccine (aOR, 1.58 [95%CI, 1.48-1.69]), followed by COVID-19 (1.50 [1.18-1.89]), influenza (1.35 [1.28-1.43]), and shingles (1.03 [0.91-1.17]) vaccines. These findings were consistent across age and race/ethnicity groups, with lower uptakes generally in younger (vs older) and non-Hispanic African American and Hispanic (vs non-Hispanic White) participants. LIMITATIONS: Possible misclassification of kidney disease status due to self-report. CONCLUSIONS: Vaccine uptakes in people with kidney disease varied by vaccine type and remained suboptimal, particularly for shingles vaccine. Efforts are needed to increase vaccine uptake and ensure all recommended vaccines are offered to people with kidney disease.