COVID-19 Vaccine and Chronic Kidney Disease: Frequently Asked Questions

What is important to know about the COVID-19 vaccines if you have chronic kidney disease

You may have many questions about the COVID-19 vaccines. This information will share what is currently known and will continue to be updated as we learn more. Please check back frequently.

What you should know:

• People with chronic kidney disease are at increased risk of severe outcomes including death if they get COVID-19.
• Health Canada only approves a vaccine if it is proven to be safe and effective through a rigorous scientific review system.
• A vaccine is currently the only foreseeable way to end the COVID-19 pandemic and allow Ontarians to return to normal life. 
• Since there is currently a limited supply of vaccines, the Government of Ontario has developed a phased approach to distributing the vaccines to ensure that the most vulnerable populations who need it the most, have the chance to receive it first.
• The second phase of Ontario’s vaccination plan includes individuals with high-risk chronic conditions. In this group are organ transplant recipients and people with kidney disease with estimated glomerular filtration rate (eGFR) under 30. This means people who have received a kidney transplant, people on chronic dialysis and people with chronic kidney disease stages 4 and 5. If you have kidney disease but are unclear at what stage or what your eGFR is, contact your kidney care or primary care team.
• As new vaccines are approved for use in Canada, they will be more widely available. Learn more about Ontario’s COVID-19 vaccine distribution plan: Getting a COVID-19 vaccine in Ontario.
• Although more research is needed to know how well the vaccine works for people with chronic kidney disease, it is recommended that people with chronic kidney disease and/or a kidney transplant be vaccinated for COVID-19 [1, 2].
• Even after you have received the vaccine it is important to continue to follow all public health advice including hand washing, mask wearing and physical distancing until infection rates have come down.

We encourage you to talk with your kidney care team about any concerns.

Should I get vaccinated against COVID-19?

Yes. The COVID-19 vaccines can help protect you, your family and your community from COVID-19. If a person with chronic kidney disease gets COVID-19 there is a higher chance that they will get very sick from the disease [3]. As such, the vaccine is an important part of protecting you from COVID-19. 

Is it safe for people with chronic kidney disease to take the vaccine?

Although further information is needed, based on expert opinion, people with chronic kidney disease, including those on dialysis or those that are pre- or post-transplant, should receive the vaccine. We encourage you to talk with your kidney care team about the potential risks and benefits of the vaccine so you can decide if the vaccine is appropriate for you. 

Health Canada has determined the Pfizer-BioNTech, Moderna, AstraZeneca and Jansen vaccines are safe and effective. Health Canada has one of the most rigorous scientific review systems in the world. Health Canada only approves a vaccine if it is safe, it works, it meets manufacturing standards, and the benefits of being vaccinated outweigh the risks.

How well does the vaccine work if I am on immunosuppressant medication for my kidney disease? 

We currently do not have research to tell us how different people with specific health conditions will respond to the vaccine. It is possible that you may not respond as well as other people if you are taking an immunosuppressant. This means that the vaccine may provide you with some but not full protection. Considering the high risk of COVID-19 to people with chronic kidney disease, it is still worthwhile to have the vaccine so you can have as much protection as possible, as some protection is better than no protection. 

If you are currently taking immunosuppressant medication, we encourage you to talk with your kidney care team about the potential risks and benefits of the vaccine so you can decide if the vaccine is appropriate for you and the best time to receive it. Do not stop taking your immunosuppressant medications without consulting your nephrologist.

Is the vaccine safe if I have had a kidney transplant?

Although further data is needed, based on expert opinion, people with a kidney transplant should receive the vaccine. There is no reason to believe that adverse events for people that have received a kidney transplant will be any different than that in the general population.  We encourage you to talk with your kidney care team about the potential risks and benefits of the vaccine so you can decide if the vaccine is appropriate for you and the best time to receive it.

What are the side-effects of the vaccine?

As with any vaccine, most side-effects of the COVID-19 vaccine are mild and should go away on their own. These types of side effects are expected and simply indicate the vaccine is working to produce protection. The most common side effects are:

• pain in your arm where the needle was given 
• fatigue (feeling very tired)
• headache
• muscle aches 
• fever (a temperature taken by mouth of 38.3◦C (100.9◦F) or higher one time or 38.0◦C (100.4◦F) for at least 1 hour)

Some people may also get chills, diarrhea or vomiting (throwing up). If side-effects last for more than 2 to 3 days, make sure you speak to your healthcare team. 
Serious side effects after receiving the vaccine are rare. However, should you develop any of the following reactions within 3 days of receiving the vaccine, seek medical attention right away or call 9-1-1:

• hives
• swelling of the face or mouth
• trouble breathing
• very pale colour and serious drowsiness
• high fever (over 40°C)
• convulsions or seizures
• other serious symptoms (e.g., “pins and needles” or numbness)

Which vaccine is best for people with chronic kidney disease?

There is no evidence that one vaccine is better than another for people with chronic kidney disease. We recommend that people who have access to the vaccine receive the first vaccine that is offered to them so that they can be protected as safely and as quickly as possible, and to slow the spread of the COVID-19 virus through the community. 

How is the vaccine given?

The vaccine is given by a needle (shot) into the muscle of your upper arm. Depending on which type of vaccine you are given you will need either 1 or 2 separate doses. It is important to continue to follow all public health guidelines even after being vaccinated. 

Can I stop wearing a mask and physical distancing after I am vaccinated?

Even after you have received the vaccine, it is important to continue to follow all public health advice including hand washing, mask wearing and keeping 6 feet apart from people you do not live with. This will help to keep you, your family and community safe, and end the pandemic. 

When can I be vaccinated?

As guided by the Ethical Framework for COVID-19 vaccine distribution, the Government of Ontario is taking a phased approach to distribute vaccines across the province to ensure the most vulnerable populations have the chance to receive the vaccine first. As Ontario gets more vaccine supply, the program will further expand to include additional groups.

The second phase of Ontario’s vaccination plan includes individuals with high-risk chronic conditions. In this group are organ transplant recipients and people with kidney disease with estimated glomerular filtration rate (eGFR) under 30. This means people who have received a kidney transplant, people on chronic dialysis and people with chronic kidney disease stages 4 and 5. If you have kidney disease but are unclear at what stage or what your eGFR is, contact your kidney care or primary care team.

We encourage you to talk with your kidney care team about whether the vaccine is appropriate for you to take once it is available for you.

You can find more details about Ontario’s COVID-19 vaccination program, including the various phases of the program, at Ontario’s COVID-19 vaccine web page.

For more information:

For more information on COVID-19 vaccines visit:

• Government of Ontario: covid-19.ontario.ca/covid-19-vaccines-ontario
• Health Canada: canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/vaccines.html

For more information on COVID-19 visit:

• Government of Ontario: covid-19.ontario.ca/
• Health Canada: canada.ca/covid-19
• Centers for Disease Control and Prevention: cdc.gov/coronavirus

For more information or to speak with someone about your emotional well-being or mental health contact:

• Bounceback Ontario (for help with managing low mood, mild to moderate depression, anxiety, stress or worry): Visit bouncebackontario.ca or call 1-866-345-0224
• ConnexOntario (Mental Health and Addictions Crisis Helpline): Visit connexontario.ca or call 1-866-531-2600
• Kidney Foundation of Canada: Visit kidney.ca or call 1-800-387-4474