Kidney patients and the Covid-19 Vaccine Roll-out Programme

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TDs in Cork East constituency

Pat Buckley TD (SF)

James O'Connor TD (FF)

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Dear (each TD will get a separate, personalised email),

Published data indicates a Covid-19 case mortality rate amongst kidney patients similar to that of residents of long-term care facilities (averaging between 20% and 25%) yet they are in group 7 in the vaccine roll-out plan.  I am writing to seek your support to convince the Minister for Health, Stephen Donnelly T.D., of the need to adjust the plan to remove this inequity and take into account the particular vulnerability of kidney patients (people on dialysis and kidney transplant recipients).

ALL kidney patients must be added to group 1 for vaccination without delay. Currently, kidney patients aged between 18 and 64 years old are part of group 7 (People aged 18-64 years with certain medical conditions) and kidney patients under the age of 18 are in group 15. Those in the 16-18 years age category are in uncertain territory given that the Pfizer-BioNTech has been approved for 16 years and older. A Parliamentary Question asking for clarity in the prioritisation process and seeking specific answers in relation to the needs of kidney patients may be appropriate.

Domestic and international expert medical opinion make a strong case on both medical and ethical grounds for the need for ALL kidney patients to be vaccinated earlier than currently planned. This position is supported by the National Renal Office (NRO) and Organ Donation Transplant Ireland in the HSE and internationally by the European Renal Association; the European Society for Organ Transplantation; the American Society of Nephrology and the British Transplantation Society. The Irish Kidney Association can provide you with supporting materials.

In a statement released on December 9th 2020, the HSE’s National Renal Office (NRO) stated that in-centre haemodialysis patients (2,014 people as of 31 December 2020) should be considered similar to people aged 65 and older who are residents of long-term care facilities in terms of prioritisation for the first wave of COVID 19 vaccination. These patients are extremely medically vulnerable and have a very high mortality risk. Due to their illness, they cannot self-isolate and must attend hospital care facilities for treatment three times per week, 156 times a year, for a minimum of three hours at a time. Despite strict protocols to minimise infection, such patients remain at risk of inadvertent transmission between patients, and to and from staff. 296 more patients (including adults and children), who are ‘Extremely Vulnerable’ are receiving dialysis therapy in their homes.

Most organ transplant recipients, including over 2,600 kidney transplant recipients, have been cocooning since March 2020 meaning that the available data pointing to a 20% mortality rate is likely to underestimate the real risk in this group*. Similar to people receiving chemotherapy, a transplant recipient’s immune system is suppressed so the risk of complications with Covid-19 is high. It is also known that the virus frequently causes kidney damage and that is a very real concern for a transplant recipient as the prospect of potential kidney failure and a return to dialysis, is not something to be taken lightly. ( *Article in NDT International · November 2020 DOI: 10.1093/ndt/gfaa261)

As my local T.D. I would very much appreciate it if you could raise my case, and the case of every other kidney patient, with the Minister and ask him to reprioritise us to a level that reflects our disproportionate vulnerability to Covid-19.

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Yours sincerely
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