Dr Erin Vaughan1, Prof KATE WYBURN1, Prof STEVE CHADBAN1, Dr MELANIE WYLD2
1Royal Price Alfred Hospital, Camperdown, Australia, 2Westmead Hospital, Westmead, Australia
Biography:
Dr Erin Vaughan (B.BioMed, MBBS, FRACP, M. Clin Epi) is a Staff Specialist Nephrologist at RPA Hospital with clinical interest and expertise in obstetric nephrology, dialysis and kidney supportive care. She is Co-Director of ANZSN Kidney School Program and member of ANZDATA Parenthood Working Group and ANZSPAM Kidney Supportive Care Special Interest Group. Dr Vaughan combines her academic interests with clinical training and mentorship roles for both basic and advanced trainees. She is passionate about improving consumer experiences and fostering a culture of wellbeing in medicine and medical training.
Aim:
To explore clinician perspectives and practices regarding vaccination in haemodialysis recipients, and to identify actionable barriers and facilitators to improve vaccination rates.
Background:
Patients with kidney failure receiving haemodialysis are highly vulnerable to vaccine-preventable infectious diseases, yet vaccination uptake remains sub-optimal.
Methods:
An online survey was conducted via Qualtrics (August 2024 -January 2025) targeting nephrologists, trainees and dialysis nurses. The survey assessed four domains: (i) vaccination beliefs, (ii) practice patterns, (iii) barriers and facilitators, and (iv) proposed solutions. Quantitative data were analysed descriptively using STATA.
Results:
A total of 86 clinicians participated (78% nephrologists, 14% dialysis nurses, 7% nephrology trainees). Confidence in vaccine safety was high (96%), while confidence in vaccine efficacy was moderate (53%). Over 95% of clinicians reported limited patient understanding regarding vaccination. Vaccination practices were predominantly ad-hoc or nursing-led. Influenza, hepatitis B and COVID-19 were routinely recommended, but often not administered within dialysis units, with reminders largely manual. Key barriers to vaccination included logistics (58%), patient hesitancy (52%), poor communication with other vaccine-providers (46%) and time constraints (39%). Patient hesitancy was attributed to misinformation (78%), mistrust (62%), complacency (58%) and previous adverse experiences (51%). At a systems level, the major barriers identified were fragmentation of vaccine providers (52% respondents) and frequently changing guidelines (51%).
Priority solutions identified by participants included integrated vaccination registries, updated accessible guidelines, clinician education initiatives, and culturally appropriate patient education materials. Patient hesitancy must also be addressed through patient-centred approaches.
Conclusion:
Despite strong clinician support for vaccination in haemodialysis recipients, substantial patient and systems-level barriers exist. Sustainable improvement will require incorporating vaccination into routine dialysis care, integrating health records and earlier vaccination planning within kidney disease care.
Presentation Slides PDF – Click Here