ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2022 and some content may be unavailable. To unlock all content for 2022, please visit the archives.

Abstract: TH-PO919

Adherence to Preventive Measures Before and After Vaccination Against SARS-CoV-2 in Kidney Transplant Recipients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)


  • Frölke, Sophie Carmen, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands
  • Bouwmans, Pim, Maastricht Universitair Medisch Centrum+, Maastricht, Limburg, Netherlands
  • Messchendorp, A. Lianne, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands
  • Hemmelder, Marc H., Maastricht Universitair Medisch Centrum+, Maastricht, Limburg, Netherlands
  • Bemelman, Frederike J., Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands
  • Nieuwkerk, Pythia T., Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands
  • Geerlings, Suzanne E., Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands

Group or Team Name

  • RECOVAC consortium

At the start of the COVID-19 pandemic, kidney transplant recipients (KTR) were warned for a high risk of complications in case of infection. After SARS-CoV-2 vaccination, KTR appeared to still be at risk of fatal COVID-19 disease, especially when they had limited or no antibody formation. The aim of this study was to describe the self-reported change in behavior of KTR before and after SARS-CoV-2 vaccination in groups with different antibody responses.


Questionnaires were sent to 2793 KTR, asking for adherence to preventive measures before vaccination, after vaccination and after receiving their level of antibody response. Adherence was reported on a 5-point Likert scale. From April till June 2021 blood samples were collected measuring anti-spike IgG by ELISA 28 days after full SARS-CoV-2 vaccination. Participants were categorized based on antibody response to vaccination as non-responder (≤50 BAU/mL), low-responder (>50 ≤300 BAU/mL) or responder (>300 BAU/mL), which was shared with the participant as a correlate of protection. Adherence to preventive measures before vaccination was compared with the two time points after vaccination by the Wilcoxon signed rank sum test. The impact of category on adherence was measured by ordinal logistic regression, taking non-responder as reference.


The median antibody titer was 7 BAU/mL in the non-(N=1109), 122 BAU/mL in the low-(N=564) and 1751 BAU/mL in the responder cohort (N=1120). Of all preventive measures, adherence to ‘keep 1.5 m distance’, ‘avoid supermarket or shops’ and ‘rules for visitors or visits’ was significantly higher (p<0.001) before than after vaccination within all cohorts. Adherence was decreased among participants, with a dose response effect, who were informed of being a (low-)responder compared to KTR with no antibody response.


SARS-CoV-2 vaccination in KTR leads to decreased adherence to some, but not all preventive measures, even when the antibody response was absent or low. A greater decrease in adherence was seen in (low)-responders to vaccination.