Vaccine Effectiveness of BNT162b2 and CoronaVac against SARS-CoV-2 Omicron BA.2 in CKD

Franco Wing Tak Cheng, Vincent Ka Chun Yan, Eric Yuk Fai Wan, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Carlos King Ho Wong, Xue Li, Cheyenne I Ying Chan, Boyuan Wang, Sydney Chi Wai Tang, Ian Chi Kei Wong, Esther Wai Yin Chan

Research output: Contribution to journalArticlepeer-review


Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic has posed increased risks of hospitalization and mortality in patients with underlying CKD. Current data on vaccine effectiveness of COVID-19 vaccines are limited to patients with CKD on dialysis and seroconversion in the non-dialysis population. Methods: A case–control study was conducted of adults with CKD using data extracted from the electronic health record database in Hong Kong. Adults with CKD and COVID-19 confirmed by PCR were included in the study. Each case was matched with up to ten controls attending Hospital Authority services without a diagnosis of COVID-19 on the basis of age, sex, and index date (within three calendar days). The vaccine effectiveness of BNT162b2 and CoronaVac in preventing COVID-19 infection, hospitalizations, and all-cause mortality was estimated using conditional logistic regression adjusted by patients' comorbidities and medication history during the outbreak from January to March 2022. Results: A total of 20,570 COVID-19 cases, 6604 COVID-19–related hospitalizations, and 2267 all-cause mortality were matched to 81,092, 62,803, and 21,348 controls, respectively. Compared with the unvaccinated group, three doses of BNT162b2 or CoronaVac were associated with a reduced risk of infection (BNT162b2: 64% [95% confidence interval (CI), 60 to 67], CoronaVac: 42% [95% CI, 38 to 47]), hospitalization (BNT162b2: 82% [95% CI, 77 to 85], CoronaVac: 80% [95% CI, 76 to 84]), and mortality (BNT162b2: 94% [95% CI, 88 to 97], CoronaVac: 93% [95% CI, 88 to 96]). Vaccines were less effective in preventing infection and hospitalization in the eGFR <15 and 15–29 ml/min per 1.73 m2 subgroups as compared with higher GFR subgroups. However, receipt of vaccine, even for one dose, was effective in preventing all-cause mortality, with estimates similar to the higher eGFR subgroups, as compared with unvaccinated. Conclusions: A dose-response relationship was observed between the number of BNT162b2 or CoronaVac doses and the effectiveness against COVID-19 infection and related comorbidity in the CKD population.
Original languageEnglish
Pages (from-to)418-428
Number of pages11
JournalClinical Journal of the American Society of Nephrology
Issue number4
Early online date26 Dec 2023
Publication statusPublished - 1 Apr 2024

Bibliographical note

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.


  • Transplantation
  • Nephrology
  • Critical Care and Intensive Care Medicine
  • Epidemiology
  • Humans
  • Vaccines, Inactivated
  • Vaccine Efficacy
  • Case-Control Studies
  • BNT162 Vaccine
  • SARS-CoV-2
  • COVID-19/epidemiology
  • COVID-19 Vaccines
  • Adult
  • Renal Insufficiency, Chronic/epidemiology
  • Infant, Newborn


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