On Tuesday 9 February 2021, Kidney Care UK, the Renal Association and the British Renal Society, supported by Gift of Living Donation (GOLD) and the African Caribbean Leukaemia Trust (ACLT), hosted a free Zoom webinar for patients, carers and health professional on the topic of the Covid-19 vaccination and chronic kidney disease.
The specific focus of this session was on key questions asked by people from the BAME community.
The webinar was chaired by Amjid Ali, BAME Engagement and Inclusion, Kidney Care UK, and was split into three parts. The first part consisted of a clinical overview, chaired by Amjid Ali and supported Dr Huzaifa Adamali, Dr Javeed Ahmed, Dr Phil Bright, Dr Valentine Ngwa, Dr Adnan Sharif, Dr Sapna Shah and Dr Rebecca Suckling. This was followed by a question-and-answer session chaired by Dela Idowu and Primrose Granville with support from community leaders Yvonne Muttillo, Bertram Jones, Carleen Kerr. The webinar concluded with a discussion with faith leaders, chaired by Orin Lewis with support from Pastor Ian Sweeney, Mufti Mohammed Zubair Butt, Dr Markand Patel and Rev. Eve Pitts. Thank you to them all for their advice and answering your questions.
Introduction
Orin Lewis introduced special guest Charlene White who emphasised the importance of everyone in the BAME community taking up their offer to get a Covid-19 vaccination, to protect both themselves and their families. The increasing prevalence of fake news was noted, with the need to rely on accurate and factual information which can save lives. People from BAME communities are four times as likely to die from Covid-19 but half as likely to have the vaccine than people from non-BAME communities. Attendees were strongly encouraged to take up their offer of a vaccine as soon as possible.
Part One – Clinical overview – Chaired by Amjid Ali
What is Covid-19? – Dr Javeed Ahmed, Consultant Virologist
Covid-19 is an illness called by a new type of coronavirus. It was first identified in China in late 2019 and rapidly spread across the world. It is highly contagious and there is no natural immunity. Previous coronaviruses were transmitted by people who had symptoms so were aware they were affected. The difficulty with Covid-19 is that many people do not have any symptoms so are unware that they are affected and yet may still spread the virus to other people. Research on previous forms of coronavirus gave scientists a head start in investigating Covid-19. Symptoms tend to develop within five days of infection whereas vaccines can take two weeks to take effect as the antibodies take time to kick in. All viruses change as they replicate and mutate.
Vaccines
What are vaccines? - Dr Phil Bright, Consultant Clinical Immunologist
Vaccines are substances created to cause an immune response to provide protection against a particular infection. They are made by taking all or part of the bug that causes the infection and altering it so that it doesn’t cause infection but still produces an immune response. The Covid-19 vaccines use the spike protein of the virus to induce this immune response.
Vaccine case study - Dr Phil Bright, Consultant Clinical Immunologist
Smallpox was eradicated by vaccines in 1980.
Polio is almost entirely eradicated throughout the world after the introduction of vaccines in the 1950s.
Meningitis C case numbers have dropped to almost zero since vaccination began in the late 1990s.
It is estimated that current vaccines save five lives a minute.
Vaccine development - Dr Phil Bright, Consultant Clinical Immunologist
The speed at which the Covid-19 vaccines have been developed was acknowledged and this has been done with full adherence to all safety measures. The vaccines would not have been approved if they were not proven to be safe and effective. The speed was due to almost unlimited funding, global collaboration, prior knowledge of effective vaccine development and the large number of willing trial participants.
Both the Pfizer and Oxford vaccines were developed by using a small bit of the virus’s RNA genetic code – the code it uses to reproduce itself – to produce an immune response. The vaccines cannot cause infection and cannot alter our own DNA.
There is a small amount of alcohol in the Oxford vaccine.
Vaccine trials - Dr Phil Bright, Consultant Clinical Immunologist
Trials examine if the vaccine is effective in preventing infection and if there are any side effects. The Pfizer study recruited around 40,000 volunteers who received either two doses of the vaccine or a salty water-based solution called a placebo. Volunteers were allocated randomly to receive either the vaccine or the placebo. he Pfizer vaccine prevented 19 out of 20 cases of Covid-19 with symptoms. This was much better than expected and there were no serious safety concerns.
The Oxford study recruited just under 24,000 volunteers and used the Meningitis vaccine instead of a placebo. The Oxford vaccine prevented 14 in 20 cases of Covid-19 with no serious safety concerns. No one who received the Oxford vaccine needed to be hospitalised or died in the trial.
It is not known if kidney patients were included in either trial.
As the vaccines stimulate your immune system, side effects are expected. These are mild and generally include symptoms such as headache, fever or a sore arm, and may show that the vaccine is working. Serious side effects such as an allergic reaction are extremely rare.
New evidence suggests that vaccination also reduces the transmission of Covid-19 by around two thirds, so it helps to protect you and those around you.
The similarities in immune response between people of different ethnicities is much greater than any differences. Data from non-BAME groups can therefore be applied to BAME groups. 5,000 participants in the Pfizer trial and 2,000 participants in the Oxford trial were from BAME backgrounds. An estimate of over half a million BAME people have now received a Covid-19 vaccination in the UK without any serious safety concerns. Vaccination isimportant to protect both yourself and those around you.
Which vaccine is best for me?
For kidney patients and their families, the best vaccine is the one you are offered first as this will ensure that you are protected as quickly as possible.
Why is the gap between doses different from the trials?
In order to give as many people as possible some immunity as quickly as possible, the second dose is being given up to twelve weeks after the first. The first dose of the Oxford vaccine has been shown to give good protection for 12 weeks. Therefore, the delay in giving the second dose is justified.
Are the vaccines effective against the new variants?
The Pfizer and Oxford vaccines are effective against the main currently circulating variants in the UK. This is an evolving situation and further booster vaccines may be needed in the future as new strains of the virus become more prevalent.
Is it safe to receive the vaccine in pregnancy or while breast feeding?
At the moment the government do not recommend that you receive the vaccine if you are pregnant unless you are at very high risk of getting Covid-19 or of becoming seriously ill if you did get it. You should talk to your doctor if you are concerned about this. It is considered safe to receive the vaccine if you are trying to get pregnant or are breastfeeding.
Can the Covid-19 vaccine cause infertility?
There is no evidence that the vaccine can cause infertility in men or women. Women who have received the vaccine have become pregnant.
Covid-19 Vaccines - Dr Javeed Ahmed, Consultant Virologist
There are a lot of myths circulating on social media on vaccines. As the previous speakers have noted, the work on the Covid-19 vaccine built upon many years of previous work and was supported by thousands of volunteers. No corners have been cut. The science behind the vaccines has been independently verified. All of the vaccines are safe, and any side effects are very mild and short-lasting. Over ten million people have safely received the vaccine in the UK. They do not contain gelatin or any animal products.
Covid-19 and kidney patients – Dr Adnan Sharif, Consultant Nephrologist
Kidney patients have been very vulnerable to Covid-19. We want to protect kidney patients and get back to normality. Vaccination is the way out of this situation. It is very important for both yourselves and your loved ones to get vaccinated. There is so much information and misinformation out there. This is a constantly evolving situation, and we are still learning. It is concerning that there are reports that the BAME community is less likely to take the vaccine, especially given that they are more vulnerable to Covid-19.
Impact of Covid-19 on BAME communities – Dr Valentine Ngwa, Consultant Physician
The BAME community has an increased risk of catching and becoming seriously ill with Covid-19. This vulnerability is due to an increased prevalence of the disease within the community which is partly due to close living situations and employment in close contact sectors such as transport. Age is also one of the biggest risk factors of having serious complications from Covid-19. Chronological age can be different from biological age. For example, a 60-year-old with diabetes, CKD and hypertension, will have a higher biological age than a 60-year-old without these conditions and will therefore be more of risk to Covid-19. It is therefore extremely important for people in BAME communities to take extra precautions to protect themselves and those around them.
Impact of Covid-19 on BAME communities –Dr Huzaifa Adamali, Consultant in Respiratory Medicine
There are a lot of frightening stories on social media about Covid-19. It is important to remember that the vast majority of patients will recover at home and less than 20% of patients have to be admitted to hospital. If you do need to be admitted to hospital, you will find that the NHS is very multi-cultural, and everyone is committed to supporting your recovery. You may be encouraged to participate in research trials which are crucial to find cures to help us to fight this virus as quickly as possible. Covid-19 treatment may include antivirals, antibiotics and/or oxygen therapy. Only a very small proportion of patients need to be admitted to intensive care and be put on a ventilator under general anesthetic to help with their breathing. We have treatments to help survival and it is important to seek help and come to hospital if you are advised to do so by NHS 111. We are enormously committed to your full recovery. We must stop the transmission of this virus so remember – Hands – Face – Space – and take the opportunity to have the vaccine to protect yourself, your loved ones and your community.
Part two – question and answers – Chaired by Dela Idowu and Primrose Granville
As a living kidney donor, will having the vaccine place any pressure on my remaining kidney?
No, having the vaccine as a living kidney donor places no extra pressure on your remaining kidney and having one kidney will not affect the effectiveness of the vaccine.
What is so different about Covid-19 that means it needs this synthetic mRNA?
It is more that the technology to create the vaccine is new, rather than anything specific about Covid-19. mRNA It is a way of putting the spike protein of the virus into the body to create an immune response. All of the vaccines are very effective, and they all use RNA, but it is packaged differently (inside a common cold virus) in the Oxford vaccine, rather than in a lipid (fat) package in the Pfizer and Moderna ones. The Moderna and Pfizer vaccines are not live. The Oxford virus is technically live but is safe for everyone to have as it cannot replicate. Unlike other live vaccines, the Oxford vaccine is safe for people who have had transplants. All of the vaccines are therefore safe for all kidney patients and you should take the first one you are offered.
Can the mRNA affect your body’s DNA?
No. The mRNA does not alter your own DNA at all.
How do we prioritise other vaccines that transplant patients require with the Covid-19 vaccine?
It is important that kidney patients get all of their recommended vaccines, including the annual flu jab. Forward planning will help ensure that this goes smoothly and includes any Covid-19 boosters that may be needed.
Part three – faith leaders – chaired by Orin Lewis
Pastor Ian Sweeney – Seventh Day Adventist Church
Our Church places a strong emphasis on health and well-being. Our community encourages responsible vaccination and has no religious or faith-based objection to the Covid-19 vaccination. Faith in an all-powerful God is not in contrast to taking the vaccine. Christians can demonstrate their faith by protecting others by following social distance measures. Individual choice must be respected however we have a responsibility to protect others. Seek information from reliable sources which can be backed up with evidence, not just social media.
Mufti Mohammed Zubair Butt – Islamic scholar and Muslim Hospital Chaplain
Muslims pride themselves on the tradition of verification. It is important to find out the truth, so you don’t hurt others from misinformation. If you see something on social media, don’t just take it at face value. Dig below the headlines to find out the truth. After extensive research and discussion, we advise our community to take up the vaccine. There is no religious objection to taking the vaccine. Muslims should be encouraged to take the vaccine so that our lives can go back to normal as quickly as possible and so that we can protect as many people as possible.
Dr Markand Patel – BAPS Shri Swaminarayan Mandir
Covid-19 is an extreme health crisis which has disproportionally affected BAME communities. Vaccination is the light of hope. The Hindu community are encouraged to take the vaccine as a moral duty and a great service to our country. Vaccination is permitted in the Hindu faith and the vaccines do not contain any animal products or egg. Hindu temples are being used as vaccination sites for both the Hindu and wider community.
Rev. Eve Pitts, Holy Trinity Church, Birmingham
We need to respect the mistrust that people in BAME communities may have for the government and people in authority. We cannot force people to have the vaccine. It has to be an individual choice. It is okay to have questions and doubts. God wants us to live and enjoy the richness of life. Base your decision on people who love you and information that you can trust
Conclusion
Amjid Ali concluded with the webinar by thanking the speakers for a very informative session. Having the vaccine is a personal choice but it is important that your decision is based on facts and trusted information.
- Please keep checking the Kidney Care UK Covid-19 guidance for updates and further webinars
- British Islamic Medical Association -
- Caribbean & African Health Network -
- Please get in touch for general support, advocacy, counselling or grants
Thank you for joining us.