# XBB1.5-Adapted COVID-19 Vaccine Acceptance Among Dialysis and Kidney Transplant Patients: A Bi-National Survey Study

## TL;DR

This study surveyed dialysis and kidney transplant patients in Austria and Israel about their willingness to get a new XBB1.5-adapted COVID-19 vaccine.

## Contribution

The study provides bi-national insights into vaccine acceptance among high-risk kidney patients for a new variant-specific vaccine.

## Key findings

- 54% of Austrian and 63% of Israeli patients accepted the XBB1.5-adapted vaccine.
- Concerns about side effects were the main reason for hesitancy in both countries.
- Flu vaccine willingness, older age in Austria, and transplant status in Israel predicted higher acceptance.

## Abstract

Background: A decrease in governmental vaccination initiatives and diminishing public enthusiasm for vaccines could jeopardize vaccine uptake, potentially endangering those who are most at risk. In this survey study, we evaluated the current acceptance rates of the newly developed monovalent XBB1.5-adapted COVID-19 vaccine among kidney transplant recipients and dialysis patients in Austria and Israel and identified factors influencing vaccine acceptance. Methods: The survey involved a total of 656 patients aged 18 and older and was carried out from 20 November to 21 December 2023, at the Medical University of Vienna, Austria and the Rabin Medical Center in Petah Tikva, Israel. Logistic regression analysis was used to explore the relationships between vaccine acceptance and variables such as age, gender, country, past COVID-19 infection status and severity, renal replacement therapy, education level, and willingness to receive the annual flu vaccine. Results: The survey showed that 54% of patients in Austria and 63% in Israel expressed acceptance of the modified XBB1.5-adapted COVID-19 vaccine. The main hesitancy was due to concerns about potential side effects, with 44% in Austria and 53% in Israel expressing apprehension. A willingness to receive the influenza vaccine, older age in Austria, and kidney transplant status in Israel were key predictors of greater COVID-19 vaccine acceptance. Conclusions: This study showed that more than 50% of our kidney transplant recipients and dialysis patients were willing to receive the adapted COVID-19 vaccine. Yet, vaccine hesitancy remained a significant barrier even among these high-risk groups, despite the availability of an updated COVID-19 vaccine targeting the Omicron subvariant XBB1.5.