*Purpose: Kidney transplant recipients are at high risk for complications from COVID-19 infection and prevention is important. We studied attitudes toward vaccines including willingness to take a COVID-19 vaccine in a population of inner-city KTx.

*Methods: A telephone survey was conducted in summer 2020 in a random sample of 34 KTx patients regarding attitudes and knowledge about vaccines and compared with data that were collected from 28 pts in 2019. Statistics were by t-test or Pearson r as appropriate.

*Results: In 2020 mean age was 57.5 ± 10.8 yrs, 18 (55%) males and 15 (46%) females, 21 (66%) black, 5 (16%) Hispanic, 3 (9%) white, 3 (9%) other. 4 (12%) did not finish high school, 14 (43%) completed high school, 15 (35%) finished some college or more. Time since transplant was 8.3 ± 6.5 yrs. 14 (41%) had diabetes. There were no differences between 2019 and 2020 for age, gender, race, time since txp or education. Compared to 2019, KTx in 2020 were more likely to agree that vaccines prevent severe illness (p=0.001) but were more concerned that vaccines could have serious side effects (p=0.023) and reported feeling more comfortable discussing concerns with doctors (p=0.016). For 2020 education level inversely correlated with belief that vaccines prevent severe illness (r = -0.41, p = 0.019). Patients with diabetes expressed less concern about vaccines than those without (p = 0.013). There were no differences in vaccine attitudes with respect to age, gender, or race. When asked if they would take a COVID-19 vaccine 12 (36%) responded “yes” and 21 (64%) responded “no”. Education level inversely correlated with agreement (r = -0.45, p = 0.010). There were no differences with respect to age, gender, or race. When asked about primary sources of information on vaccines 21 (66%) said health professionals, 9 (28%) said their own research, 1 (3%) said news, and 1 (3%) said religion. Compared to patients who said health professionals, pts who reported own research had a higher level of education (p = 0.039), believed themselves to be more knowledgeable about vaccines (p = 0.031), and expressed more concern that vaccines can lead to serious side effects (p = 0.030).

*Conclusions: In our population: 1) Compared to 2019, KTx in 2020 were more likely to believe that vaccines prevent illness, were more concerned with vaccine safety but felt more comfortable expressing their concern to their doctor. 2) Pts with diabetes had fewer concerns about vaccines. 3) Pts with higher education were more likely to question and express concern about vaccines. 4) The majority of pts would not accept a COVID-19 vaccine at this time, especially those with higher education who report doing their own research to find information. 5) Once the vaccine becomes available, an intensive education program will have to be created so that vaccine acceptance rises in this vulnerable, inner-city population.

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