#4023 FEELINGS OF SAFETY AND SOCIAL BEHAVIOURS AFTER COVID-19 VACCINATION IN PEOPLE LIVING WITH KIDNEY DISEASE AND THEIR SIGNIFICANT OTHERS
Authors: Sohansoha Gurneet K , Patel Naeema A , Ford Ella , Wilkinson Thomas , Lightfoot Courtney J , Smith Alice 
Published: June 2023

Abstract

Background and Aims
Throughout the majority of 2020, the COVID-19 pandemic forced the UK population, and especially clinically vulnerable people such as those with chronic kidney disease (CKD), to isolate and cease their usual activities outside the home. The COVID-19 vaccine became available in early 2021, with the aim of protecting against COVID-19 infection, reducing the risk of serious illness or death, and consequently allowing a return to more normal social behaviours. In May 2021 we conducted a survey to explore perceptions of increased COVID-19 safety and resultant changes in social mixing behaviour in people with non-dialysis CKD (ND-CKD), kidney transplant recipients (KTRs), and their significant others (SOs) after receiving the COVID-19 vaccination.

Method
ND-CKD, KTR and SO participants from 11 hospital sites across England were invited to complete an online survey in May 2021. The survey included items asking about changes to their feelings of COVID-19 risk and safety, and their social behaviours after receiving the COVID-19 vaccine. Participants ranked questions on 7-point Likert scales (perceived COVID-19 safety, 1: feel not safe at all to 7: feel completely safe; changes in social behaviour, 1: no change to 7: complete change), and provided free-text explanations for their ranked responses. Question ratings were analysed by ANOVA, and free-text responses by content analysis to identify common themes.

Results
114 ND-CKD (mean age 65.5 (±1.2) years, 59% male), 120 KTR (60.95 (±9.9) years, 51% male), and 77 SO (63 (±11.08) years, 62% male) participants completed the survey. In total, 109/114 (96%) ND-CKD, 116/120 (97%) KTR, and 71/77 (92%) SO participants had received the COVID-19 vaccine. There were no significant differences between the groups for perceived COVID-19 safety, with all three groups reporting feeling safe from the virus (mean perceived safety rating 6.0 [±1.3] out of a maximum of 7). However, all groups reported limited changes in behaviour after receiving the vaccine (scale rating 3.6 [±1.3]/7). Common reasons identified for perceived feelings of safety were ‘risk perception’ e.g. reduced risk of severe illness, death and hospitalisation and ‘availability of vaccine evidence’ e.g. data that supported the safety of the vaccine being available to the public as well as trust in science and health care professionals. ‘Relaxed shielding’, ‘compliance with government guidance’, and ‘using own discretion’ were common reasons underlying changes in social behaviour.

Conclusion
These results show that the majority of participants had received at least one dose of the COVID-19 vaccine by May 2021. Participants did report feeling safer from COVID-19, but despite this, changes to isolation and social mixing behaviour were limited. The free text responses provided explanations for this: participants stated they felt safer after receiving the vaccine due to reduced risk of severe illness and hospitalisation, and new variants. However, despite feeling safer, changes in social behaviour were limited. This may be partly explained by the continuation of some government restrictions at the time of the survey. However, increased social mixing and abandonment of mask-wearing by the general public potentially increased risk for the clinically vulnerable. Together with uncertainty around vaccine efficacy in clinical populations, this resulted in ongoing social avoidance behaviour. These factors persist in today's environment and highlight the need for communication of high-quality research evidence to encourage uptake of booster COVID-19 and flu vaccines, and effective public education campaigns, to allow clinically vulnerable people to confidently return to pre-pandemic social activity.