The Covid-19 vaccines and kidney disease

We've been working with the professional kidney organisations and charities to ensure we all provide consistent, accurate information about the Covid-19 vaccines and work together to drive change for people affected by kidney disease.

Things change quickly, so we’ll try and keep the information as up-to-date as we can.

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About the vaccine

Millions of people in the UK have received one or more of the Covid-19 vaccines. They are all suitable for adults with kidney disease.
There are several types of vaccine. Find out more about them and how they work in the frequently asked questions below.
You should have the vaccine when you are offered it, and any booster doses. Evidence suggests that people diagnosed with chronic kidney disease are more at risk of serious complications if they catch Covid-19.

Continue to take care

Even if you have received the vaccine, we recommend you seek advice from your GP or other care provider to assess the risk to you and your friends and family.

Your questions answered

You may have questions about the Covid-19 vaccines and how they affect you.
Here are some of the most common questions with answers from kidney specialists.

About Covid-19 and the vaccines

What are the different vaccines?

Four different vaccines are currently available in the UK (April 2023):

Moderna (Spikevax)
Pfizer/BioNTech (Comirnaty)
Novavax (Nuvaxovid)
Sanofi and GSK (VidPrevtyn Beta)

The Moderna vaccine works by using a molecule called messenger ribonucleic acid (mRNA) to tell the body how to make a copy of the spike protein that is found on Covid-19. The body then responds to this by making antibodies against the spike protein which will provide protection against COVID-19.

The Pfizer/BioNTech vaccine contains a small section of messenger RNA (mRNA). The mRNA carries the instructions – like a recipe - for making the spike protein of SARS-CoV-2 (the virus that causes Covid-19) infection, which the virus uses to enter cells.

When the Pfizer/BioNTech vaccine is injected into the body, it enters cells in our immune system which follow its instructions to make the spike protein, just as it would if it was infected with the virus. Our immune system recognises the spike protein as foreign and creates antibodies and other immune cells against it, to fight the infection. The Moderna vaccine works in the same way as the Pfizer vaccine, but uses a different type of mRNA, called mRNA-1273.

Novavax combines a version of the spike protein, and some medicines designed to encourage the immune system to respond to the vaccine, leading to the creation of immune cells against Covid-19.

The Sanofi/GSK vaccine helps the immune system to recognise Covid-19 infection by using a piece of the viral spike protein alongside a compound known as an 'adjuvant' which helps to trigger a stronger immune response to vaccination.

Find out more on the NHS website.

What vaccine should I have?

Are the vaccines live?

The Covid-19 vaccines are not live vaccines. This means they don’t contain the active, or ‘live’ virus that causes Covid-19 itself.

The vaccines all work slightly differently. But they all deliver an instruction for the body to make the important spike protein from the Covid-19 virus. This allows the body to prepare the immune system so that it can recognise and fight the actual virus if it is encountered in the future.

What side effects and safety considerations are there around the Covid-19 vaccines?

What measures can I take to stay safe during in-centre dialysis sessions?

Vaccine efficacy in kidney patients

Could medication affect my antibody response?

The stronger your immunosuppressant medication, the less likely you are to have an antibody response to any type of vaccine and this is reflected in the Covid-19 vaccine data we’ve seen. Specific studies have shown people taking certain combinations of immunosuppressant drugs, such as Belatacept and Mycophenolate mofetil (MMF), have lower antibody response than healthy people.

Despite this effect, no one should adjust their medication before talking to their doctor. This is extremely important for transplant recipients because reducing immunosuppressant medication puts their transplant at risk.

If you are about to start immunosuppression, for example if you have a planned living donation, you should have both doses of vaccine beforehand. This is because you will mount a better response to the vaccine before you start this medication. More information is here.

If you have previously contracted Covid-19 infection you should still go ahead and get both doses of vaccine, as you could get it again. You will have some immune response from the infection, but this will be strengthened by having both doses of the vaccine. You should wait 4 weeks from the date you first tested positive for Covid-19 before you book an appointment.

What are the options if I don’t produce enough antibodies?

Our knowledge of how to treat Covid-19 has advanced hugely and we continue to support research into new ways to protect against and treat the virus. Get the latest information on these treatment options.

We are helping to fund the PROTECT-V study; a clinical trial to find out if the drug niclosamide, given as a nasal spray, can prevent Covid-19 infection in vulnerable, high-risk kidney patients and reduce the number of people who become seriously ill or die.

AstraZeneca has developed Evusheld, a therapy containing the antibodies tixagevimab and cilgavimab, which can be used before someone is exposed to Covid-19. Evusheld is now in use across 32 countries. In March 2022, Evusheld was licensed for use in the UK by the Medicines and Health Products Regulatory Agency (MHRA). However, so far, the Government has refused to make Evusheld available through the NHS; it can currently only be accessed privately.

Coping with risk and uncertainty now restrictions are lifted

Keeping safe at work

It is really important that clinically vulnerable people who go out to work have Covid-secure workplaces. The “SafeAtWork” coalition of charities wrote to all employers to remind them of their duties to maintain safety measures at work particularly for people who may remain at higher risk from Covid-19. People with kidney disease may like to and share with their employers.

Doctors recommend people should ask for a risk assessment and for any issues arising from that process to be dealt with before they return to the workplace. If you have access to an Occupational Health team at work, you should ask them for support with risk assessments and appropriate adjustments. If employees face any difficulties they could approach their kidney doctors who may be able to write to employers.

Other avenues for support with returning to work include unions, ACAS and kidney patient charity support services and websites.

Coping with anxiety about getting back to normal life

Some kidney patients are feeling anxious about the easing of restrictions and rejoining society, whilst others may be looking forward to it. If you are apprehensive, give yourself permission to feel a bit anxious. Meeting friends and family and resuming activities is a very positive thing to do, but no-one should be expected to forget the very difficult time that they have been through .

People feeling worried can choose to return to normality gradually and slowly, whilst maintaining the measures we know can minimise risk of infection. Planning trips out and social occasions in advance, to avoid high risk environments and follow risk reducing measures, can help people feel more prepared and comfortable with what they are doing.

If you have any other concerns, do address these with your doctors.

The Covid-19 vaccines and kidney disease