BACKGROUND: The real-world protection provided by SARS-CoV-2 messenger RNA (mRNA) vaccines to kidney transplant recipients (KTRs) remains uncertain. OBJECTIVE: To study the association between mRNA vaccination and SARS-CoV-2 infection rate in KTRs. DESIGN: Retrospective observational cohort study. SETTING: The Czech Republic (17 February to 16 May 2021). PATIENTS: 2101 KTRs followed in the Department of Nephrology at the Institute for Clinical and Experimental Medicine. MEASUREMENTS: Positive result for SARS-CoV-2 on polymerase chain reaction test and vaccination status of KTRs. RESULTS: The incidence rate in the vaccinated group was 0.474 per 1000 person-days (33 cases in 69 672 days at risk). The incidence rate in the unvaccinated group was 1.370 per 1000 person-days (79 cases in 57 658 days at risk). The unadjusted incidence rate ratio (IRR; incidence rate of vaccinated/incidence rate of unvaccinated) for KTRs was 0.346 (95% CI, 0.227 to 0.514). The multivariable adjusted IRR for KTRs was 0.544 (CI, 0.324 to 0.876). LIMITATION: Retrospective observational design, uneven follow-up of patient groups, and different exposition to SARS-CoV-2 stemming from strong temporal trends and differences in clinical and probably behavioral characteristics. CONCLUSION: Vaccination of KTRs is associated with lower risk for SARS-CoV-2 infection. PRIMARY FUNDING SOURCE: The Ministry of Health of the Czech Republic.

Department of Nephrology Institute for Clinical and Experimental Medicine Prague Czech Republic

Information Technology Department Institute for Clinical and Experimental Medicine Prague Czech Republic

Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic

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