Kidney Week

Abstract: FR-PO0944

Provider Perspectives on Vaccine Hesitancy for Pediatric Patients with Nephrotic Syndrome

Session Information

• Pediatric Nephrology: Genetic Diseases, Development, Neonatal Nephrology, Glomerular Diseases, and More
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Hotchkiss, Jenny, Cohen Children's Medical Center, New York, New York, United States

Jenny Hotchkiss

• Basalely, Abby Miriam, Cohen Children's Medical Center, New York, New York, United States

Abby Miriam Basalely, MD, MS

• Castellanos, Laura J., Cohen Children's Medical Center, New York, New York, United States

Laura J. Castellanos, MD

• Shen, Carol L., Cohen Children's Medical Center, New York, New York, United States

Carol L. Shen, MD

• Frank, Rachel, Cohen Children's Medical Center, New York, New York, United States

Rachel Frank, CNN, RN

• Sethna, Christine B., Cohen Children's Medical Center, New York, New York, United States

Christine B. Sethna, MD, MEd

Background

Children with nephrotic syndrome face increased infection risk due to disease- and treatment-related immunodeficiency, making vaccination critical. However, vaccine guidance is complex given concerns about live vaccines during immunosuppression and vaccine-induced relapse. Despite rising vaccine hesitancy, its scope and drivers in nephrotic syndrome remain poorly characterized.

Methods

A survey of pediatric nephrology providers assessed vaccine hesitancy trends, provider confidence, clinical consequences, and resource needs. The survey was distributed to the Pediatric Nephrology Research Consortium and PEDNEPH Listserv.

Results

Eighty-nine providers responded (Table 1). Over 75% encountered vaccine hesitancy, and half perceived it to be increasing over the past five years. Nearly 70% attributed this rise to the COVID-19 pandemic. The most refused vaccines were influenza (80.9%) and COVID-19 (73.0%). Perceived drivers include general vaccine mistrust (80.9%), side effect concerns (49.4%), COVID-related mistrust (48.3%), and disease-specific relapse fears (42.7%). Notably, 46.1% of respondents witnessed a vaccine-preventable infection in a nephrotic syndrome patient, including reported deaths. While 97.8% personally discuss vaccines with patients, only 40% felt confident doing so. A majority were dissatisfied with current nephrotic syndrome-specific vaccine guidance and endorsed the need for patient-facing materials (79.8%), counseling tools (60.7%), and consensus guidelines (46.1%).

Conclusion

Nearly all respondents provide vaccine counseling, yet most lack the confidence and resources to do so. Almost half have seen preventable infections, including deaths. These findings highlight the need for disease-specific guidelines and counseling frameworks to protect this high-risk population.

Funding

• NIDDK Support