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. 2022 Nov 10;10(11):1899.
doi: 10.3390/vaccines10111899.

Hesitancy toward the Full COVID-19 Vaccination among Kidney, Liver and Lung Transplant Recipients in Italy

Andrea Costantino  1   2 , Letizia Morlacchi  3 , Maria Francesca Donato  4 , Andrea Gramegna  2   3 , Elisa Farina  4 , Clara Dibenedetto  4 , Mariarosaria Campise  5 , Matteo Redaelli  6 , Marta Perego  6 , Carlo Alfieri  5   7 , Francesco Blasi  2   3 , Pietro Lampertico  4   8 , Evaldo Favi  6   7
Affiliations

Hesitancy toward the Full COVID-19 Vaccination among Kidney, Liver and Lung Transplant Recipients in Italy

Andrea Costantino et al. Vaccines (Basel). .

Abstract

Background: Coronavirus disease 2019 (COVID-19) vaccination hesitancy is a threat as COVID-19 vaccines have reduced both viral transmission and virus-associated mortality rates, particularly in high-risk subgroups. Solid organ transplant recipients (SOTRs) are particularly vulnerable, as the underlying causes of their organ failure and the chronic immunosuppression are associated with a lower immune response to COVID-19 vaccines, and with an excessive risk of death due to SARS-CoV-2 infection. We aimed to evaluate COVID-19 vaccination hesitancy and its reasons in a population of SOTRs.

Methods: All the SOTRs attending our post-transplant clinics were asked to fill in a vaccination status form with specific validated questions related to their willingness to receive a third vaccine dose. In the case of negative answers, the patients were encouraged to explain the reasons for their refusal. Among the SOTRs (1899), 1019 were investigated (53.7%).

Results: Overall, 5.01% (51/1019) of the SOTRs raised concerns regarding the future third dose vaccination. In more detail, hesitancy rates were 3.3% (15/453), 4.2% (7/166), and 7.3% (29/400) among the investigated liver, lung, and kidney transplant recipients, respectively (p = 0.0018). The main reasons for hesitancy were fear of adverse events (30/51, 58.8%) and perceived lack of efficacy (21/51, 41.2%).

Conclusions: Full adherence to ongoing or future vaccination campaigns is crucial to prevent, or at least reduce, COVID-19-related morbidity and mortality in fragile patients. The identification of the reasons influencing COVID-19 vaccination hesitancy in these patients is very important to establish appropriate and targeted patient-doctor communication strategies, and to further implement specific vaccination campaigns.

Keywords: COVID-19; COVID-19 vaccine; kidney transplantation; liver transplantation; lung transplantation; solid organ transplant recipients; vaccine hesitancy.

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Conflict of interest statement

The authors declare no potential conflict of interest.

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