Dialysis clinics offer vaccines to aid people at higher risk
Charles Brown, 58, thought he was going to lose his son.
Charles Brown III spent his 33rd birthday hospitalized with COVID-19, fighting complications from kidney disease, diabetes and an infection that spread to his brain, his dad said.
Six months later, the South Carolina man is still in the hospital.
“They had to resuscitate him twice. He done been through a lot,” said Brown. “Thank God, he’s still here.”
Dialysis patients like Brown and his son are extremely vulnerable to COVID-19 and its severe complications, in part because of comorbidities that coincide with chronic kidney disease and kidney failure.
The first known U.S. COVID-19 death was a dialysis patient at Northwest Kidney Centers in Seattle, according to reports. And a CDC report published Friday found evidence of excess deaths among COVID-19 patients with kidney failure.
Black people make up about 13% of the U.S. population but comprise more than a third of the nation’s 500,000 kidney failure patients, according to the National Institutes of Health.
About a fifth of dialysis patients are Hispanic and are roughly 1.3 times more likely to be diagnosed with kidney failure than non-hispanics.
Indigenous people are about 1.2 times more likely.
With people of color suffering disparate rates of both COVID-19 and kidney failure, the Biden administration made providing vaccines directly to outpatient dialysis clinics a part of its $10 billion vaccine equity plan.
Charles Brown received both his shots at Fresenius Kidney Care in Columbia, South Carolina, where he goes three times a week for dialysis treatment to rid his body of toxins and excess fluid, functions his kidneys can longer do.
“I have a full-time job and go (to dialysis treatment) Monday, Wednesday, Friday after work,” said Brown, a truck driver.
“I was excited when they said they have the shots for us.”
Dr. Marcono Hines, a nephrologist at Fresenius, which received an allotment of vaccine through the federal effort, said many of his patients rely on public transportation to go to the clinic, or even ambulance services. Inoculation was easier because the dialysis treatment was already built in to patients’ schedules.
“We’re in so much contact with these patients on such a frequent basis, it’s just extremely convenient and broke that initial barrier of access to it,” Hines said.
Most of his patients have several comorbidities. Chronic kidney disease is called a “disease multiplier” because it often comes with other medical conditions, including diabetes and high blood pressure – both of which also occur at disproportionate rates in people of color.
The many layers of disparities and comorbidities long seen among chronic kidney disease patients make the disease a perfect illustration of systemic racism and health inequities, explained Dr. Allen Kaufman, chief medical officer of dialysis provider, Dialyze Direct.
“It’s not a medical mystery how to treat those things. It’s really a social function. It’s an organizational thing, it’s a system-wide thing,” said Kaufman, a nephrologist for three decades.
Long-standing access disparities – long hours at low-wage jobs, lack of access to quality health care and healthy foods, transportation barriers – put communities of color at higher risk for developing diseases like high blood pressure, diabetes and chronic kidney disease.
“The story has to start three, four decades before,” he said. “It’s much more complicated than just getting to my office. But you know what? If that plan can’t be implemented, they still might fail in their health care. This is the big challenge.”
Outset Medical is piloting a curriculum with the National Kidney Foundation of Michigan to help patients of color become more aware of their treatment options, such as home dialysis, and how to implement them.
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