Key points:
- The vaccines have all passed stringent safety tests before being approved. They are not live vaccines and there is no evidence that they would lead to rejection of a kidney transplant.
- People with kidney disease on immunosuppressants may have a weaker response to the vaccines, but kidney doctors recommend that it is still important to have all the available vaccinations. Some protection is better than none.
- Even after having the vaccine, people at highest risk should continue to follow precautionary measures.
How can I get a Covid-19 vaccine?
Here is information from each UK country about their vaccine programme and how to book.
Autumn booster campaign
An autumn booster to top up the immunity of those most vulnerable to Covid-19 is now being rolled out. This will be a sixth dose for people who are immunosuppressed and most likely a fourth dose for those with late kidney disease and on dialysis and is intended to boost protection, which may wane over time.
If you have not yet had a Covid-19 vaccine, the programme is open to anyone at any time.
View the Kidney Charities Together Group's autumn booster guide.
Who is offered an autumn booster?
- All adults aged 50 and over
- People aged 5 to 49 years old in a clinically at-risk group, including pregnant women. This includes people with kidney disease stage 3 or over and any age on dialysis
- People aged 5 to 49 years old who are household contacts of people with immunosuppression
- Care Home for older adults - residents and staff
- Front line health and social care workers
- People aged between 16 and 49 who are carers
There is more detail in the ‘Green Book’ on eligibility for vaccination.
How can I access my vaccine?
- England - people will be contacted to invite them to book their vaccine. You should wait until you have received this invite before trying to book an appointment either via the online booking system or by calling 119. You can also attend a walk-in clinic once you have been invited. It may be helpful for people with a weakened immune system to take a medicine box or a letter about the cause of immunosuppression, but it is not required and vaccination sites have been told this evidence is not necessary.
- Scotland – People who are eligible will be written to with the time and date of their appointment. If you have not yet received this, you can book an appointment online or phone the national vaccination helpline on 0800 030 8013.
- Wales – People who are eligible will be written to with the time and date of their appointment.
- Northern Ireland - You will receive an invite from your GP. People aged over 50 and carers can get their booster from a participating community pharmacy.
Which vaccines will be offered?
The vaccines advised for use in the autumn booster programme are:
For adults aged 18 years and above
- Moderna mRNA (Spikevax) bivalent Omicron BA.1/Original ‘wild-type’ vaccine
- Moderna mRNA (Spikevax) Original ‘wild-type’ vaccine
- Pfizer-BioNTech mRNA (Comirnaty) Original ‘wild-type’ vaccine
- In exceptional circumstances, the Novavax Matrix-M adjuvanted wild-type vaccine (Nuvaxovid) may be used when no alternative clinically suitable UK-approved Covid-19 vaccine is available
For people aged 12 to 17 years
- Pfizer-BioNTech mRNA (Comirnaty) Original ‘wild-type’ vaccine
For people aged 5 to 11 years
Pfizer-BioNTech mRNA (Comirnaty) Original ‘wild-type’ vaccine paediatric formulation
All of the available boosters provide good protection against severe illness from Covid-19 and emphasised that getting a booster in good time is more important for those eligible than the type of vaccine that is received.
What is a Bivalent vaccine?
‘Bivalent’ vaccines have been developed by global manufacturers since the emergence and dominance of the Omicron variant. These vaccines contain two different antigens (substances that induce an immune response) based on two different Covid-19 strains, or variants. The original mRNA vaccines contain one antigen (monovalent), based on the original strain.
Booster campaign 2023
Following the 2022 Autumn booster campaign, the Government have announced a further booster will be offered to higher risk groups in Autumn 2023. Further details will be published closer to the time. Government are currently considering whether to offer a Spring 2023 booster and we will update our information once a decision is made.
Covid-19 vaccine campaign FAQs
If I have a weakened immune system and do not respond well to vaccines, why is it important to continue to get vaccinated?
Even though you might not develop full immunity, you may continue to develop some immunity, so even a limited response to a further dose should help to reduce your risk of being severely ill or admitted to hospital if you catch Covid-19. Repeated vaccinations will gradually improve and maintain your level of antibodies and enhance the other parts of your immune system that protect you from Covid-19 infection.
Is it safe to get so many doses of the Covid-19 vaccine?
Covid-19 vaccination is safe and has been approved for use by the Medicines and Healthcare Products Regulatory Agency, which regulates safety, as well as recommended by the Joint Committee on Vaccination and Immunisation (JCVI). The vaccines used by the NHS have been rigorously tested and multiple doses have been given across the UK and the world, with continued monitoring of safety.
What adjustments are being made to support people who are severely immunosuppressed attending walk-in vaccination appointments?
Vaccination sites have been asked to ensure that appropriate arrangements and reasonable adjustments are in place, such as priority lanes, to support people who are less able to queue, including those in higher-risk groups.
I have recently recovered from Covid-19, do I still need to get vaccinated?
Yes. You still need to get a booster dose of the vaccine for extra protection, even if you have had Covid-19. If you’ve recently recovered from the virus, you need to wait before getting any dose of the vaccine. You will need to wait:
- 4 weeks (28 days) if you're aged 18 years old or over
- 12 weeks (84 days) if you or your child are aged 5 to 17 years old
- 4 weeks (28 days) if you or your child are aged 5 to 17 years old and at high risk from Covid-19, or live with someone who has a weakened immune system
How can someone report an issue if they are struggling to access the vaccinations they need?
If an individual encounters a problem when trying to get a Covid-19 vaccine, it is important they report it so that the NHS can resolve the issue and improve services to prevent it happening again. There are a number of ways you can provide feedback or make a complaint. Information about how to contact NHS England is available here on their website.
How well do the vaccines work for kidney patients?
Evidence to date shows that far fewer fully vaccinated people with kidney disease become very ill and die should they contract Covid-19, than people who have not been fully vaccinated. It is therefore important to get all doses for which you are eligible.
Research has been looking at the levels of antibodies people have produced after vaccine doses. This can help our understanding of response to the vaccine but can’t give us the full picture of how well people are protected against Covid-19. This is because we do not know what level of antibodies are needed for good protection. There also other parts of the immune system that can help protect against the virus.
- People with CKD 4 and 5 and on dialysis
Research looking at antibody responses found people on dialysis and with chronic kidney disease (CKD) have responded well to the vaccine. Three doses are more likely to provide a good enough level of protection than two, so it is very important that people in this group have all of their vaccine doses.
- People who are immunosuppressed
People who are immunosuppressed may respond less well to the vaccine, but research shows that for each additional dose there will be more people who respond. A small number of people will not respond to additional doses, but they will not be harmed by having repeated doses. Therefore, it is very important that people who are immunosuppressed have all doses to secure their best chance of protection.
After the first two vaccine doses, research found about half of kidney transplant patients had an antibody response. And after the third and fourth dose, around half of the patients who had not yet responded had gone on to make antibodies. Laboratory data also indicates that around 1 in 5 people with kidney disease who are immunosuppressed (and had not had a Covid-19 infection in the past) showed a T-cell response following vaccination.
People who had had Covid-19 were more likely to have an antibody response following vaccination. Younger transplant recipients with a well-functioning kidney are more likely to have a better response to the vaccine.
Please have a look at the recording and written summary of our Covid-19 Question Time Webinar on Monday 5 December 2022, where a panel of kidney doctors and researchers answered your questions on Covid-19, including a discussion of what research is telling us about vaccines.
What if I have produced no antibodies after multiple doses?
Researchers have reminded us that a lack of antibody response does not mean a lack of protection from severe disease and death from Covid-19. Antibodies are just one part of the immune response. There are many different types of antibodies and we also have T-cells, which are also important in the body’s immune response. T-cells have a range of different functions within the immune system to help the body attack the virus in a number of different ways. It is not currently possible to buy a test for T-cells. The immune system is like a jigsaw, with the different parts coming together to protect the body. Looking at just one part of the jigsaw, such as antibodies, does not give the whole picture.
If you have not produced any antibodies after four or five doses, it is sensible to be cautious when you go out and about, for example by wearing a mask and meeting people in the fresh air, but there is reason for optimism and many people who have no antibodies have caught Covid-19 and recovered well. New medicines are also available which are effective at treating immunosuppressed people with Covid-19.
How can I find out how much protection the vaccine gives me? Should I get an antibody test?
Unfortunately, at the moment it is not possible to determine exactly how well the vaccine is protecting a person against severe disease with Covid-19. We recommend speaking to your kidney doctor about your own circumstances. We do not recommend that individuals undertake private antibody testing without first discussing with your kidney doctor as they will not give a clear picture of how well protected you are from Covid-19. In addition, there are many different types of antibodies and most antibody tests will only test for one specific antibody which will not give a full picture of your immune response. A positive antibody test does not necessarily mean a person is protected against Covid-19 and a negative test does not necessarily mean you are not protected.
If you do have an antibody test via your hospital kidney team, your doctor will be able to help explain what the results mean for you.
The Government is planning to launch an antibody testing study this winter to investigate the level of protection in immunosuppressed groups following the programme of vaccination boosters. The results of this study will inform decisions about additional vaccinations, any future pre-exposure treatment and the level of protective behaviours, based on an individual’s risk. The details are currently being finalised and we will update once we have more information,
Are the vaccines safe? Should I be worried about how quickly the vaccines have been developed?
The vaccines are only approved for use once they have passed stringent safety tests. The speed of development might make people concerned, but corners have not been cut. During the development of the Covid-19 vaccines, regulators and researchers have worked together to avoid delays and funding was made available quickly.
Oxford University have published a short film entitled ‘How to make a vaccine in record time’.
Are there any side effects to the vaccines?
As with other vaccines, there may be mild and short-lasting side effects to the Covid-19 vaccine such as having a sore arm or feeling tired for a day or two. These can be treated with paracetamol. There is no evidence that side effects are worse for people with underlying conditions such as kidney disease or based on any medication they are taking or that the vaccines have an impact on kidney functioning.
If you have had a more severe reaction to a Covid-19 vaccine you can speak to your GP about referral to a specialist vaccine clinic for subsequent doses, where they will assess whether an alternative vaccine should be used
The MHRA encourages people to report suspected side effects to the vaccine on their Yellow Card reporting site.
The Government have published information for older people and the general population on what to expect after your Covid-19 vaccination.
Oxford/AstraZeneca vaccine and rare blood clots
People aged under 40 with no underlying conditions will now be offered an alternative vaccine to the Oxford/AstraZeneca (AZ) vaccine where this is possible. This follows a review of data on an extremely rare blood clot reported after first exposure to the AstraZeneca vaccine, with a slightly higher incidence in younger age groups.
This advice does not apply to people with underlying health conditions, because the JCVI consider the benefits of getting a vaccination as soon as possible, including, with the AstraZeneca vaccine, far outweigh the risk of adverse events.
Anyone who has the following symptoms four days to 4 weeks after vaccination is advised to seek prompt medical advice:
- a new onset of severe or persistent headache, blurred vision, confusion or seizures
- develop shortness of breath, chest pain, leg swelling or persistent abdominal pain,
- unusual skin bruising or pinpoint round spots beyond the injection site
There are no known factors which put people more at risk of this extremely rare blood clot.
Are the Covid-19 vaccines live? Could the vaccines cause rejection of my transplant?
None of the Covid-19 vaccines currently in development are traditional “live” vaccines. The Oxford/AstraZeneca vaccine uses an adenovirus, but its genes have been edited so it cannot replicate and cause infection.
Many thousands of people with solid organ transplants, of which many are kidney transplants, have received the Covid-19 vaccine. This has not shown any adverse effect on kidney function or complications, for example rejection.
There is a theoretical concern with all vaccines that they might damage transplanted kidneys or cause rejection because they stimulate the immune system. This has not been proven to happen with other vaccines or the Covid-19 vaccines. The benefits of reducing the known risk of Covid-19 for kidney patients outweigh concerns and your kidney team recommends that you have the vaccination.
How long should I wait after a transplant before receiving the vaccine?
It is recommended to wait until your immunosuppressant is at maintenance level. Different people may be vaccinated at different times depending on their clinical circumstances and it best to discuss with your doctor. There is no evidence that the vaccines will lead to a loss of transplant.
Do I need to change any of my medications such as immunosuppressants when I receive the vaccine? Will the vaccines interact with any other medicines?
There is no evidence that the vaccines interact with other medicines. You should not stop any of your medications or adjust your immunosuppressants unless your doctor advises you to do so. This is extremely important for transplant recipients because reducing immunosuppressant medication puts your transplant at risk.
Your doctors will advise you if there is anything that you should be concerned about.
Should I have the vaccine if I am waiting for a transplant?
Yes, all of the vaccines are safe if you are waiting for a transplant.
Should I take the vaccine if I am pregnant, trying to become pregnant or breastfeeding?
It is safe to have the vaccine if you are trying to get pregnant or are breastfeeding. There also is no evidence that any of the UK vaccines can affect fertility. In response to misinformation about vaccination and fertility, theRoyal College of Obstetricians and Gynaecologists have published advice which highlights that having the two doses and booster makes pregnant women 88% less likely to be admitted to hospital with Covid-19 than those who are unvaccinated.
Women should speak to their clinicians if they have any concerns relating to the Covid-19 vaccines.
Will I be taken off of the transplant waiting list if I have not had the Covid-19 vaccination?
False reports were circulating that individuals would be taken off of the transplant waiting list if they chose not to have the Covid-19 vaccine. This is not the case.
Children and vaccination
2 doses are being offered to all children aged 12 to 15, and some aged 5 to 11, to give them the best protection against Covid-19. Please speak to your child’s doctor for more information about the Covid-19 vaccine.
See here for information about the vaccine from the British Association for Paediatric Nephrology. Extending vaccination to children aged 5 and above follows a safety and effectiveness review by the Medicines and Healthcare products Regulatory Agency (MHRA). All children aged 5 (on or before 31 August 2022) and over can get a 1st and 2nd dose of the Covid-19 vaccine.
Children who turned 5 on or after 1 September 2022 can only get a 1st and 2nd dose of a Covid-19 vaccine if they’re either:
- at high risk due to a health condition or because of a weakened immune system
- living with someone who has a weakened immune system
Children aged 5 and over with a severely weakened immune system can get an additional primary dose (3rd primary dose).
Some children at high risk from Covid-19 may also be able to get booster doses.
Arrangements for accessing the vaccine vary between UK nation. Please look at the vaccine information for where you live and contact your GP if you have any questions: