Recommendations for third or booster COVID-19 vaccines

Clarification on kidney patients who are eligible for the third primary dose or booster COVID-19 vaccination is now available.

Further to their recommendations on third primary vaccination, the JCVI (Joint Committee on Vaccination and Immunisation) has now recommended a booster vaccine dose for patient groups that include patients on dialysis and CKD 3-5 patients not on dialysis. The renal patient groups for a third primary vaccination or booster vaccination are as follows:

1. All kidney patients who have a transplant including those who have returned to dialysis but still receive or have received immunosuppression in the last 6 months: third primary vaccination
2. Patients who at the time of the original 2 vaccine programme were receiving significant immunosuppression: third primary vaccination
3. All patients on the transplant waiting list: booster vaccination unless also in group 1 or 2 in which case a third primary vaccination
4. All patients on dialysis: booster vaccination unless also in group 1 or 2 in which case a third primary vaccination
5. Chronic kidney disease stage 3-5 not on dialysis treatment: booster vaccination unless also in group 1 or 2 in which case a third primary vaccination

JCVI advises a preference for an mRNA vaccine (Pfizer/Moderna) for the third primary dose where possible - regardless of previous vaccines - as laboratory studies indicate these offer better protection in kidney patients.

The UK Kidney Association (UKKA) will continue to make the strong case that a third vaccination for dialysis patients should be considered a third primary vaccination rather than a booster vaccination.

How will people be able to obtain their third dose?

The JVCI has requested that specialists provide clear advice to GPs regarding:

• each patient’s need for a third dose
• finding the optimal time in their treatment cycle to generate the best response

Patients will be contacted by their renal team, dialysis unit, or GP to arrange a time for administering either the third dose or booster vaccine. For further information we advise patients to contact their renal team or GP directly. 

What’s next?

Whilst this is reassuring for kidney transplant patients, we await further advice for those on dialysis or with advanced kidney disease who remain highly vulnerable and may be at risk of being left behind in the vaccine programme.

The vaccine efficacy research study that we helping to fund together with our charity partners (kidney Research Uk, the National Kidney Federation, Kidney Wales, and several Kidney Patient Associations) will monitor the impact of third doses for at-risk kidney patients. Further research is being carried out through the OCTAVE DUO study to establish the immune efficacy of third doses in a wider group of patients, including people on dialysis. Using the evidence from both of these studies we will continue our efforts to help highlight the specific needs of the kidney community to ensure the best outcomes for patients and their families.