COVID-19 vaccine and kidney disease: frequently asked questions

covid vaccine
Latest updates about the vaccines
Medically reviewed by
AKF's Medical Advisory Committee
Last updated
November 10, 2023

Which vaccines are fully approved?

On August 23, 2021, the U.S. Food and Drug Administration (FDA) gave full approval for two doses of the Pfizer COVID-19 vaccine for people ages 16 and older. Full FDA approval means that experts decided there is enough data to say, with certainty, that a medical product is safe and works well, as it was made to work.

The Moderna and Johnson & Johnson vaccines have not yet received full FDA approval but are still safe and available under Emergency Use Authorization (EUA). Experts continue to review the data and they are likely to receive full approval in the coming months.

Learn more about approval for the Pfizer vaccine

Which vaccines are under Emergency Use Authorization (EUA)?

The FDA has fully approved Pfizer for people ages 16 and older. Moderna and Johnson & Johnson remain under EUA, but it is likely that the FDA will fully approve these other two vaccines over the coming months.

The Pfizer and Moderna vaccines are also currently available under EUA for people ages 12 to 15, and for a third dose for people who are immunocompromised (have a weakened immune system). The FDA will continue to review data to decide if a third dose for all people will be fully approved and if the vaccines will be approved for people ages 12 to 15.  

During public health emergencies, the FDA gives EUA for medical products after they review existing clinical trial data and conclude there are known and possible benefits that outweigh the risks. Once enough research has been done, the FDA will consider a medical product for full approval.

The American Kidney Fund will provide updates as new information about the COVID-19 vaccines becomes available.

Who can get a third dose of the COVID-19 vaccine?

The FDA has given EUA for a third dose of the COVID-19 vaccine for people who are immunocompromised (have a weakened immune system). Experts believe a third vaccine could help protect people who are immunocompromised from COVID-19. If you are on dialysis or have had a kidney transplant, talk with your doctor to decide if you should get a third dose of the COVID-19 vaccine.

Also, starting the week of September 20, 2021, the U.S. Department of Health and Human Services (HHS) is planning to give EUA for a third dose of the COVID-19 vaccine to anyone who received the Pfizer or Moderna vaccines. People will be able to get a third dose eight months after their second dose. Experts believe a third vaccine could help add protection against COVID-19 variants that are more easily spread such as the Delta variant.

Learn more about a third dose of the COVID-19 vaccine

This page has general answers to common questions about COVID-19 vaccines. Talk with your doctor about your COVID-19 vaccine questions.

Most common questions for people who have kidney disease

Who should get the COVID-19 vaccine?

The U.S. Centers for Disease Control and Prevention (CDC) recommends everyone age 12 and older get vaccinated against COVID-19.

Should I get the COVID-19 vaccine if I have kidney disease?

Yes, the National Kidney FoundationAmerican Society of Nephrology and American Society of Transplantation all recommend the COVID-19 vaccine for people living with kidney disease or who have had a kidney transplant. People with kidney disease have a higher chance of getting very sick from COVID-19, including needing a hospital stay or even death. The vaccines work well to prevent you from getting COVID-19 and can prevent you from getting very sick if you do get COVID-19.

While the COVID-19 vaccine is very effective, data shows that people with kidney disease or who have had a kidney transplant may not have the same level of protection from COVID-19 as other people. Even if a person with kidney disease or kidney transplant is vaccinated, it is extremely important that they follow all guidelines to avoid being exposed to COVID-19. The FDA and CDC recommend a third dose of the vaccine for these people.

If you have questions about getting a COVID-19 vaccine, talk to your doctor.

Is the COVID-19 vaccine safe for me?

If you have kidney disease or are on dialysis

There is no information about the safety of the vaccine specific to people with kidney disease or who are on dialysis. However, the vaccine clinical trials included participants who have other health problems, such as diabetes, high blood pressure, heart disease, liver disease, lung disease, asthma and HIV. The results of the clinical trials showed that the vaccine is safe for people who have these health problems. Talk with your doctor to know if the COVID-19 vaccine is safe for you.

If you have a kidney transplant

The COVID-19 vaccine clinical trials did not get enough data on the safety of the vaccines for people who take immunosuppressive drugs, such as kidney transplant recipients. However, vaccines that do not include a living virus, like the COVID-19 vaccine, are generally safe. The Pfizer and Moderna vaccines do not include a living virus, so they are expected to be safe for transplant recipients.

If you have a transplant, ask your nephrologist (kidney doctor) if the COVID-19 vaccine is safe for you.

If you are a living kidney donor or plan to donate your kidney in the future

The COVID-19 vaccine clinical trials did not get information about the effect on people who have donated their kidney in the past. However, if you are in good health and do not have a history of severe side effects from vaccines, there are no special safety concerns for you at this time. Talk to your doctor if you have questions about the COVID-19 vaccine and being an organ donor.

Does the COVID-19 vaccine work well to protect against the virus?

Yes. The vaccines work well to protect against COVID-19. However, a small number of people who are fully vaccinated will still get COVID-19 if they come into contact with the virus. These are called "breakthrough cases." This means that even though people who have been vaccinated are much less likely to get sick, some people still will. Data shows that if a fully vaccinated person gets COVID-19, they are more likely to have illness that is less serious, less likely to require hospitalization and much less likely to die. This also includes sickness with new variants, such as the Delta variant.

While the COVID-19 vaccine is very effective, research now shows that people who are on treatments that weaken their immune system, such as transplant recipients or people on dialysis, may not have the same level of protection from COVID-19 as other people. Even if a transplant recipient is vaccinated, it is extremely important that they follow all guidelines to avoid being exposed to COVID-19. The FDA and CDC recommend a third dose of the vaccine for these people.

Does the COVID-19 vaccine work against new variants?

Yes. Current data shows that COVID-19 vaccines protect against variants that are spreading in the U.S. such as the Delta variant. If a fully vaccinated person gets sick from a COVID-19 variant, they are more likely to have illness that is less serious, less likely to require hospitalization and much less likely to die.

About the COVID-19 vaccine

How does the COVID-19 vaccine work?

The Pfizer and Moderna vaccines are called mRNA vaccines. An mRNA vaccine contains a harmless piece of protein from the virus called a "spike protein". When you get the vaccine, the spike protein tells your immune system to make antibodies to fight the COVID-19 virus.

Antibodies are what keep you from getting sick if you come into contact with the actual COVID-19 virus.

The Johnson & Johnson vaccine uses a harmless virus called an adenovirus. This virus is unrelated to COVID-19 but gives the same "spike protein" as the mRNA vaccines, which tells your body to make antibodies that protect you from COVID-19.

How was the COVID-19 vaccine tested to make sure it is safe and works?

Thousands of volunteers took part in COVID-19 vaccine clinical trials. Clinical trials for the vaccines compared results between people who were vaccinated and people who were not vaccinated (such as how many people got sick). Many different people took part in the clinical trials including people who are age 65 and older or who have a chronic (long-term) health problem that would make them more likely to get very sick from COVID-19. Each clinical trial was made up of people of different:

  • Ages
  • Sex
  • Race or ethnicity
  • Health status

Researchers do not yet know if there were any differences in how the vaccine worked in people with kidney disease compared to those without kidney disease.

Learn more about how the COVID-19 vaccines were tested

Can the vaccine cause COVID-19?

No. The vaccines that are available do not use the live virus that causes COVID-19 so they cannot make you sick with COVID-19.

How long does protection from the COVID-19 vaccine last?

Researchers do not yet know how long protection from COVID-19 will last after getting the vaccine. Experts are working to learn more about how long the vaccine will last and if people need future doses for continued protection against COVID-19.

Who should get the COVID-19 vaccine

If my family and people around me get the vaccine, do I still need to get it?

Yes. Even if your family had COVID-19 in the past and are vaccinated, they may still carry and spread the virus to others. People who are not vaccinated have a much higher risk of getting COVID-19 from vaccinated and unvaccinated people. The best way to make sure you are protected from COVID-19 is to get the vaccine yourself.

If I already had COVID-19, should I still get the vaccine?

Yes. Studies show that getting the vaccine after being sick with COVID-19 may give you added protection. Currently, there is not enough information to know how long someone is protected from getting COVID-19 again after infection. Also, even if a person had COVID-19 in the past and then got vaccinated, they may still carry and spread the virus to others. People who are not vaccinated have a much higher risk of getting COVID-19 from vaccinated and unvaccinated people. Getting vaccinated is the best way to protect yourself from COVID-19.

Are there certain people who should not get the vaccine?

Yes, you should not get the Pfizer or Moderna COVID-19 vaccine if you have ever had a severe allergic reaction (such as anaphylaxis) to any ingredients in the vaccines.

Find the list of ingredients in the vaccines here (in Appendix C).

Getting the COVID-19 vaccine

How can I get the vaccine?

People age 12 and older can get a COVID-19 vaccine in the U.S. Visit your local pharmacy, hospital or health department website to find out where you can get a vaccine in your area.

How much does the vaccine cost?

The vaccine is free to everyone in the U.S., even if you do not have insurance.

How many doses do I need of the COVID-19 vaccine?

The number of doses you need depends on the type of vaccine you get:

 PfizerModernaJohnson & Johnson
How many doses will I get?221
How far apart do I get the doses?21 days28 daysn/a
When am I fully protected?2 weeks after second dose2 weeks after second dose2 weeks after first dose
When can I get a third dose?8 months after second dose8 months after second doseUnknown at this time

Do I need a third dose of the COVID-19 vaccine?

Research has shown that people with a weakened immune system may not build the same protection as other people after two doses of the Pfizer or Moderna vaccines.

The CDC recommends a third dose of the Pfizer or Moderna vaccines for some people who are immunocompromised at least 28 days after their second dose. For people with kidney disease, this may include people who:

  • Have had a kidney transplant
  • Are on dialysis, which can weaken your immune system

Learn more about CDC guidance for people who are immunocompromised

A third dose of the COVID-19 vaccine is available to people who received the Pfizer or Moderna vaccines eight months after their second dose. Experts believe a third vaccine could help add protection against COVID-19 variants that are more easily spread, such as the Delta variant.

Learn more about a third dose of the COVID-19 vaccine

If you have questions, talk to your doctor about if you should get a third dose of the COVID-19 vaccine.

What are the possible side effects after getting the COVID-19 vaccine?

After getting the vaccine you may have some side effects, including:

  • Pain or bruising where you got the vaccine
  • Feeling weak and tired
  • Fever and chills
  • Feeling sick to your stomach or throwing up
  • Muscle or joint pain
  • Headache

These side effects are also common after getting many other vaccines, and do not mean that vaccines are unsafe. Side effects are signs that the vaccine is working to help your body build immunity.

Learn more about possible side effects from the COVID-19 vaccine

What if I have a bad reaction to the vaccine?

Right after you get the vaccine, a health care worker will monitor you for 15 minutes to make sure you do not have a bad reaction. If anything happens that is dangerous to your health, a health care worker will take steps to treat you and make sure you are safe. If you have a severe allergic reaction, called anaphylaxis, after getting your first COVID-19 vaccine, the CDC recommends that you do not get a second shot of any of the vaccines.

Talk to your doctor if you have questions about allergies or a bad reaction to the COVID-19 vaccine.

Learn more about what to do if you have a bad reaction to the COVID-19 vaccine

Why do I still need to wear a mask even after I get the vaccine?

Even if you have gotten the COVID-19 vaccine you can still carry and spread the COVID-19 virus to others. This is especially dangerous for people who cannot be vaccinated like young children or people with certain health conditions. To avoid the spread of COVID-19, the CDC recommends all people wear a mask when in public, indoor places.

Check your local government website to learn about mask requirements in your area.

Should I also get a flu shot?

The CDC still recommends everyone age six months and older get a flu shot, including people with kidney disease.

Where can I learn more about the vaccine?

The FDA:

The CDC:

American Society of Nephrology (ASN):

Your donation directly supports the fight against kidney disease

For 21 consecutive years Charity Navigator™ has rated us a Top Nonprofit. Your donations allow us to help more people than any other kidney organization – from making 150 kidney transplants possible every month to delivering financial relief to 1 in 7 dialysis patients. We also fund clinical research, provide financial assistance for kidney patients affected by natural disasters, and support a National virtual pediatric camp and a Kidney Health Coach community program.