Joint Statement On Covid-19 Vaccination Of Patients With Chronic Kidney Disease In Malaysia

The following is a joint statement by the by National Kidney Foundation, Malaysian Society of Nephrology and Malaysian Society of Transplantation.

We view with great concern the rising prevalence of Covid-19 in the country over past few weeks. We are particularly concerned on the impact of Covid-19 infection in patients with chronic kidney disease (CKD) especially those with CKD stage 5 who are receiving treatment with dialysis or kidney transplantation.

Experience worldwide have shown this group of patients are very vulnerable to serious complications of Covid-19 infection and there is a significant mortality amongst those infected. Similarly, there is increased risk of healthcare workers (HCW) attending to these patients acquiring this infection due to frequent encounters.

There are now about 50,000 patients living on dialysis or have a functioning kidney transplant in the country, the vast majority of whom are on haemodialysis (HD).  These patients have impaired immunity either inherently from their illness or induced by medications, making them eminently vulnerable to complications should they be infected with SARS Cov-2 virus.

The financial impact to a patient and his family, the staff and to the HD centre’s management once a Covid -19 infection occurs is huge. There are tests for the virus to be done, PPEs to be donned, and the affected centre has to be sanitised. Th emotional strain on patients and staff once a centre has an infected patient is unmeasurable. We thank the Ministry of Health’s nephrologists and their HD units for accepting most infected HD patients from the private and NGO centres.

Patients on HD and the staff looking after them are particularly vulnerable. They stay in a confined space for long hours and any undetected infection amongst them can have disastrous consequences. Presently all HD centres follow stringent guidelines set by national and international bodies to prevent cross-infection. Haemodialysis staff are specialized nurses and if infected, they have to be quarantined, reducing the centre’s capability to look after the patients, as they are not readily replaceable.

We now know that the government will start vaccination against the virus soon. We hope the Ministry of Health will give special priority to the patients with CKD. This will reduce the overcrowding in the Ministry of Health’s HD centres and help return to some normalcy in the HD centres in the private and the NGO programs. We urge priority be given to the following groups:

  1. Patients on Haemodialysis and Peritoneal Dialysis
  2. Patients with functioning kidney transplants
  3. Healthcare workers directly attending to Haemodialysis and Peritoneal Dialysis patients
  4. Family members of Haemodialysis/Peritoneal Dialysis/Kidney transplant patients
  5. Patients with CKD stage 3-4 (pre-dialysis)

We are happy to assist the Ministry of Health in the vaccination programme. The National Renal Registry of the Malaysian Society of Nephrology and the National Kidney Foundation of Malaysia can assist in disseminating information as well assist the Ministry in scheduling vaccinations.

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