Content written on and updated on April 16, 2021 - Medically reviewed by Medical Advisory Committee

The U.S. Food and Drug Administration (FDA) has provided Emergency Use Authorization for three* vaccines to prevent COVID-19. These vaccines are now being widely distributed across the United States and more vaccines are likely to be approved over the coming months. Here are answers to some common questions people who have kidney disease or who are living with a kidney transplant may have about the COVID-19 vaccine.

The American Kidney Fund will provide updates as new information about the COVID-19 vaccines becomes available. It is important to keep in mind the answers to these common questions are general. You should always make sure to talk to your doctor about any questions you may have about the COVID-19 vaccine.

*Although the FDA has provided Emergency Use Authorization of the Johnson & Johnson vaccine, it has paused its use out of an abundance of caution. The Pfizer and Moderna vaccines continue to be widely available across the country. More information can be found on the Centers for Disease Control  (CDC) website here

COVID-19 Vaccine FAQs

Is the COVID-19 vaccine safe for me if I have chronic kidney disease (CKD)?

There is no information about the safety of the vaccine specific to people with chronic kidney disease. However, the vaccine clinical trials included participants who are living with other health conditions, called comorbidities. The COVID-19 vaccine was tested on people who have diabetes, high blood pressure, heart disease, liver disease, lung disease, asthma, and HIV. The results of the clinical trials showed that the vaccine can be safely given to people who have these health conditions. Check with your doctor to know if the COVID-19 vaccine is safe for you.

Is the COVID-19 vaccine safe for me if I am on dialysis?

Patients on dialysis are at a greater risk for severe complications for COVID-19.

There is no information about the safety of the vaccine specific to people on dialysis. However, the vaccine clinical trials included participants who are living with other health conditions, called comorbidities. The COVID-19 vaccine was tested on people who have diabetes, high blood pressure, heart disease, liver disease, lung disease, asthma, and HIV. The results of the clinical trials showed that the vaccine can be safely given to people who have these health conditions. Check with your doctor to know if the COVID-19 vaccine is safe for you.

Is the vaccine safe for me if I am living with a kidney transplant?

Kidney transplant patients and other immunocompromised patients are at a greater risk for severe complications for COVID-19.

Unfortunately, there was not enough information from results of the COVID-19 vaccine clinical trials on the safety of the vaccines specifically for people who take immunosuppressive drugs, such as kidney transplant recipients. However, vaccines that do not involve giving a patient a living virus are generally safe. The Pfizer and Moderna vaccines do not involve giving a patient a living virus, so they are expected to be safe to give to transplant recipients unless the transplant recipient has a different health reason not to be vaccinated.

Because not enough transplant patients were included in the trials, we do not know how effective the vaccine may be in transplanted patients. Even if a transplant patient is vaccinated, it is extremely important that transplant patients continue to follow all guidelines to avoid being exposed to COVID-19.

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

Is the vaccine safe for me if I am a living kidney donor?

There is no specific information from the COVID-19 vaccine clinical trials about the effect on people who have donated their kidney in the past. However, if a living donor is in good health and does not have a history of severe side effects from vaccines, there would not be any special safety concerns based on the information about the COVID-19 vaccine at this time. Talk to your doctor if you have questions about the COVID-19 vaccine and being an organ donor.

If I am planning on donating my kidney in the future, is the vaccine safe for me?

There is no specific information from the COVID-19 vaccine clinical trials about the effect on people who have donated their kidney in the past. However, if a donor is in good health and does not have a history of bad side effects from vaccines, there would not be any special safety concerns based on the information about the COVID-19 vaccine at this time. Talk to your doctor if you have questions about the COVID-19 vaccine and being an organ donor.

Did the COVID-19 vaccine clinical trials include people with kidney disease or a kidney transplant?

People with kidney disease were enrolled in both the Pfizer and Moderna trials, but we do not know yet whether there were any differences in how the vaccine worked in those with kidney disease compared to those without kidney disease.

How does the COVID-19 vaccine work?

Many vaccines for other diseases work by getting a shot that has some of the virus that has been weakened or inactivated. However, because the Pfizer and Moderna COVID-19 vaccines are a new kind of vaccine called an mRNA vaccine, it does not work the same way as other vaccines. Like other vaccines, the COVID-19 vaccine is given as a shot, but instead of the shot containing a small amount of the virus like other vaccines, the COVID-19 shot contains a harmless piece of protein from the virus called a “spike protein.” When you get the COVID-19 vaccine, the spike proteins trigger your body’s immune system to make antibodies. Antibodies are what keep you from getting sick if you come into contact with the actual COVID-19 virus. The COVID-19 vaccine needs to be given in two doses. If you get the first shot of the COVID-19 vaccine made by Pfizer, you will need to get the second one 21 days later. If you get the first shot of the vaccine made by Moderna, you will need to get the second one 28 days later.

The latest COVID-19 vaccine approved by the FDA is the Johnson & Johnson vaccine. This vaccine only requires one dose and works as many other traditional vaccines do. It works by using a harmless virus (called an adenovirus) that is unrelated to the coronavirus, to deliver the same “spike protein” as the mRNA vaccines.

How effective is the COVID-19 vaccine?

Right now, there are three companies that have a vaccine for COVID-19: Pfizer, Moderna and Johnson & Johnson. Results from the Pfizer clinical trial showed their COVID-19 vaccine is 95% effective. The Moderna vaccine showed it is 94.1% effective in preventing COVID-19. The Johnson & Johnson vaccine showed it is 85% effective against severe complications from COVID-19 and 100% effective against hospitalizations and deaths without significant geographical differences.

If I have kidney disease, when will I be able to get the COVID-19 vaccine?

There were not enough vaccines in the first batches for everyone to get the vaccine at the same time. For this reason, federal and state governments have made plans for who would get the vaccine in order, based on certain factors that the Centers for Disease Control and Prevention (CDC) recommended. Here are the groups who will get the vaccine in order of priority:

Group 1a:

  • Health care workers
  • Residents of long-term care facilities

Group 1b:

  • People age 75 years and older
  • Essential frontline workers. Essential frontline workers are defined as people who work in these types of jobs:
    • Food production and farming
    • Manufacturing
    • Law enforcement
    • Education
    • Public transportation
    • Corrections (jails, prisons)
    • Emergency response (firefighters, EMS)

Group 1c:

  • Senior citizens under age 75
  • People between the ages of 16-64 with high-risk health conditions
  • Other essential workers (food services workers, grocery store workers, etc.)

Then, after the high-risk priority groups, the general adult public may be able to get a vaccine by the spring, if things go according to plan.

The CDC has stated that kidney disease is considered a high-risk health condition. This includes people who are living with a kidney transplant. This means that a person at any age who has kidney disease or is living with a transplant is considered to be someone with a high-risk health condition and would be vaccinated with Group 1b if they are 75 years of age or older, or Group 1c if they are under 75.

Although the federal government has provided guidance on how the vaccine should be given out to people, it is mostly up to each state government to decide how the vaccine will be given out to people who live in their state. Each state gave the federal government their vaccine distribution plans.

The CDC will be providing more guidance soon on high-risk medical conditions and children that will help states plan how they will give out the vaccine. Ask your doctor if you have questions about when you will be able to get the COVID-19 vaccine.

How long does the COVID-19 vaccine last?

Because the COVID-19 vaccine was just recently developed, scientists do not yet know how long the protection from COVID-19 will last after getting the vaccine.

How can I get the vaccine?

Plans are being rolled out at state, county and city levels. Once vaccines are more widely available, it is anticipated that people will be able to get them in doctors' offices, pharmacies, hospitals, and community health clinics.

How many doses do I have to get of the COVID-19 vaccine?

The Pfizer vaccine requires two doses, 21 days apart. The Moderna vaccine requires two doses, 28 days apart. The Johnson & Johnson vaccine requires only a single dose.

Can I get COVID-19 from taking the vaccine?

No, because the vaccine only includes a small part of protein made by the virus and not the virus itself.

Should I also get a flu shot?

Even during the COVID-19 pandemic, the CDC still recommends everyone age six months and older get a flu shot, including people with kidney disease.

How much does the vaccine cost? Is it covered by insurance?

The federal government bought of millions of doses of the COVID-19 vaccine and may buy more. Because of laws and government rules, vaccines bought by the federal government do not have an out-of-pocket cost. You will not have to pay anything for the vaccine.

Should children who have kidney disease get the vaccine?

At this time, the Pfizer vaccine is only for people age 16 and older, and the Moderna and Johnson & Johnson vaccines are only for people age 18 and older.

Does the COVID-19 vaccine have any side effects?

Participants in both trials did have some side effects that lasted a few days, including site injection site pain, fatigue, fever, muscle pain, joint pain, and headache. Some people who received the Pfizer vaccine have reported severe allergic reactions that were able to be treated. These side effects are commonly seen with many other vaccines and do not mean that the vaccines are unsafe. These are signs that the vaccine is working to build immunity.

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

The vaccine prevents people from developing severe illness from COVID-19. Experts are not yet sure if people who have the vaccine can spread COVID-19 to others even if they are protected from getting the virus themselves. Until scientists can be sure whether vaccinated people can spread COVID-19, the CDC says even vaccinated people should wear a mask, wash hands often, and stay at least six feet away from others.

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

The CDC says there is not enough information right now to say if or for how long after infection someone is protected from getting COVID-19 again; this is called acquired immunity. Early testing shows that acquired immunity from COVID-19 may not last very long, but more studies are needed to better understand this.

What if I have bad reaction to the vaccine?

At the time you get the vaccine, the health care worker who gave it to you will watch you for 15 minutes to make sure you do not have a bad reaction. If anything happens that is dangerous to your health, the health care worker will take emergency steps to make sure you are safe.

Health care workers who give the vaccine will be required to report certain adverse events following vaccination to a national system that tracks any bad reaction to the vaccine called the Vaccine Adverse Event Reporting System (VAERS). VAERS collects information on adverse events that are unexpected, appear to happen more often than expected, or have unusual patterns of how they happen. Health care providers also have to follow all safety reporting requirements according to FDA’s conditions of authorized use throughout the duration of any Emergency Use Authorization. Reports to VAERS help the CDC monitor the safety of vaccines. Safety is a top priority.

The CDC is also starting a new smartphone tool called v-safe to check-in on people’s health after they receive a COVID-19 vaccine. When you receive your vaccine, you should also receive a v-safe information sheet telling you how to enroll in v-safe. If you enroll, you will receive regular text messages directing you to surveys where you can report any problems or adverse reactions you have after receiving a COVID-19 vaccine. You do not have to enroll in v-safe if you do not want to.

Are there certain people who should NOT get the vaccine?

The Pfizer and Moderna COVID-19 vaccines should not be given to people with a known history of severe allergic reaction (e.g., anaphylaxis) to any ingredients in the vaccines. The list of ingredients in the vaccines can be found here.

Where can I learn more about the vaccine?

The FDA:

The CDC:

Is it true that the clinical trial only included healthy young people?

No. In the Pfizer clinical trial, 21.6% of participants are 65 years of age and older, and 20.3% of participants have some kind of health condition. In the Moderna clinical trial, 25.3% of participants are 65 years of age and older, and 22.3% of participants have at least one high-risk health condition for severe COVID-19. In the Johnson & Johnson clinical trial, 34% were 60 years of age or older.

Did the vaccine clinical trials include people of different races and genders?

Yes. The Pfizer clinical trials had 44,000 people. At first, the Pfizer clinical trials only included adults age 18 and older, but in September 2020 they started including teenagers as young as 16. Half of the participants were male, half were female; 83.1% white, 9.1% Black, 4.3% Asian, and less than 3% from other racial groups; 28% of participants were Hispanic/Latino.

The Moderna clinical trial included 30,000 participants age 18 and older across the United States. 52.6% of the participants are male and 47.3% are female. 36.5% of participants considered to be representing communities of color with 9.7% Black, 4.7% Asian, and less than 3% from other racial groups; 20% of participants were Hispanic/Latino.

While the FDA’s emergency use authorization is not the same as full approval, the FDA has carefully reviewed all safety data from clinical trials and it authorizes emergency vaccine use only when the expected benefits outweigh potential risks. During the emergency use authorization, more information is collected to apply for full approval, and the FDA and CDC will continue to monitor the safety of the vaccines to make sure even very rare side effects are identified.

The Johnson & Johnson clinical trial included 45,000 participants age 18 and older across eight countries. The trial makeup was 59% white, 19% Black, 9% Native American and 3% Asian; 45% of participants were Hispanic/Latino.

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

Yes, that is the best way to make sure you are protected.

If the vaccine keeps people from getting COVID-19, does it also keep them from spreading it to other people?

It is not clear if people vaccinated for COVID-19 might still be able to spread the virus, so it is important to continue to wear a mask, wash your hands often, and stay at least 6 feet apart from other people.

References

The FDA gave emergency permission for a vaccine from Pfizer and BioNTech that was authorized on December 11, and a vaccine developed by Moderna in collaboration with the National Institutes of Health that was authorized on December 18.