Publication date: May 23, 2025

Vaccination rates for influenza and COVID-19 remain low among people with chronic kidney disease (CKD). Nephrology care offers an opportunity to boost vaccination rates. Understanding provider perceptions can be key to developing effective intervention programs. We conducted a nationwide survey among nephrology care providers. In a questionnaire, we assessed the providers’ agreement with potential barriers to recommending influenza and COVID-19 vaccines and perceptions of selected vaccination programs on their acceptability, appropriateness, and feasibility. Between February and June 2023, 312 providers responded to the survey. Most providers agreed that there is sufficient evidence for influenza vaccines (270/311, 86. 8%) and that vaccines reduce the risk of serious complications of influenza (277/310, 89. 4%). However, 40/312 (12. 8%) felt that recommending influenza vaccines is less important than other issues they must address. By profession, more physicians agreed with the evidence (112/123 or 91. 1% vs 39/49 or 79. 5% for NPs and 83/101 or 82. 2% for RNs, p = 0. 007) than nurse practitioners (NPs) or nurses (RNs). The most perceived barrier was lack of self-efficacy: 95/311 (30. 5%) felt that many patients will not get vaccinated even if they recommend it. Similar responses were seen for COVID-19 vaccines. Regarding vaccination programs, 209/235 (88. 9%), 197/224 (87. 9%), and 183/222 (82. 4%) providers considered provider reminders acceptable, appropriate, and feasible. 209/239 (87. 4%), 198/226 (87. 6%) and 187/224 (83. 5%) did so for standing orders. Onsite/walk-in vaccinations were viewed as acceptable by 192/242 (79. 3%) but less feasible (137/222 or 61. 7%). Fewer than 33% of providers perceived patient incentives as acceptable, appropriate, or feasible. Most nephrology care providers believe that influenza and COVID-19 vaccinations offer evidence-based benefits, with slightly higher belief among physicians compared to NPs or RNs. However, important barriers to vaccination remain. Standing orders, provider reminders, and onsite/walk-in vaccination are favorably perceived by providers.

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