Antibody response to the BNT162b2 vaccine in maintenance hemodialysis patients

Attias, Philippe; Sakhi, Hamza; Rieu, Philippe; Soorkia, Arvish; Assayag, David; Bouhroum, Sabrina; Nizard, Patrice; Karoui, Khalil El

doi:10.1016/j.kint.2021.04.009

Cited by 83 publications

(86 citation statements)

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“…The strongest predictors of humoral vaccine response and antibody levels seen in our results are concordant with those reported across other publications such as age, immunosuppressive treatment, and previous SARS-CoV-2 infection 22,35,36 . A correlation between seroconversion, its intensity, and patient age was seen in our findings, as also observed in other previously reported results on SARS-CoV-2 mRNA vaccines 28,31,37 . This was expected, given that age has been previously associated with an impaired ability to mount a robust immune humoral or cellular response 38 .…”

Section: Discussionsupporting

confidence: 92%

“…Our results confirm that seropositive patients at baseline produce a more intense humoral response 23,31,46 , reaching anti-S1-RBD IgG levels with the first dose as high as seronegative patients achieve after the second dose. However, findings regarding antibody levels must be interpreted carefully: even though there is evidence of a correlation between anti-S1-RBD IgG levels and viral neutralization 20 , their amount cannot be reliably correlated with higher protection because real-world information on prevention of severe COVID-19 after vaccination in hemodialysis patients is lacking.…”

Section: J O U R N a L P R E -P R O O Fsupporting

confidence: 81%

“…Emerging data on the humoral response of other hemodialysis cohorts have shown similar seroconversion results ranging from 82 to 96%. All but the Frantzen et al study (244 patients) 30 had a smaller number of participants than ours 21,22,[31][32][33][34] . Moreover, to our knowledge ours is the largest hemodialysis cohort to have evaluated the immune response to the mRNA-1273 vaccine 22 .…”

Section: Discussionmentioning

confidence: 51%

“…This was expected, given that age has been previously associated with an impaired ability to mount a robust immune humoral or cellular response 38 . However, when comparing agematched patients receiving maintenance hemodialysis with the general population, what stands out is that the former have a slower pace of seroconversion 31 . This may be related to the widely-described impaired immune response of maintenance hemodialysis patients found in other immunization programs 19,27,39 , though it seems not to be relevant when evaluating seroconversion after completing the vaccination scheme in the peritoneal dialysis population 40 .…”

Section: Discussionmentioning

confidence: 99%

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Humoral and Cellular Responses to mRNA-1273 and BNT162b2 SARS-CoV-2 Vaccines Administered to Hemodialysis Patients

Broseta

Rodríguez-Espinosa

Rodríguez³

et al. 2021

American Journal of Kidney Diseases

107

106

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Section: Discussionsupporting

confidence: 92%

Section: J O U R N a L P R E -P R O O Fsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Humoral and Cellular Responses to mRNA-1273 and BNT162b2 SARS-CoV-2 Vaccines Administered to Hemodialysis Patients

Broseta

Rodríguez-Espinosa

Rodríguez³

et al. 2021

American Journal of Kidney Diseases

107

106

View full text Add to dashboard Cite

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“…In comparison to these findings, the strong immunogenicity with the mRNA-BNT162b2 SARS-CoV-2 vaccine found in our study is encouraging and hopefully translates into the prevention of clinically important outcomes such as severe COVID-19, hospitalization and death. Our results confirm the recently published high antibody response rates from 90% to 96% in three dialysis cohorts from Israel (24)(25)(26), and show a better vaccine response compared to 56 French SARS-CoV-2 infection-naïve hemodialysis patients (82%) (27).…”

Section: Discussionsupporting

confidence: 91%

The Safety and Immunogenicity of the mRNA-BNT162b2 SARS-CoV-2 Vaccine in Hemodialysis Patients

et al. 2021

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BackgroundHemodialysis patients are at high risk for severe COVID-19. SARS-CoV-2 vaccination related safety and immunogenicity data in these patients are rare.MethodsIn this observational study SARS-CoV-2-seronegative hemodialysis patients were vaccinated with two doses of the Pfizer/BioNTech mRNA-BNT162b2 vaccine (COMIRNATY® 30 µg) and followed for 90 days. Local and systemic side effects were assessed at every dialysis session during the first post-vaccination week after the first and second vaccine dose. Immunogenicity was determined four weeks after vaccination by quantifying anti-SARS-CoV-2 spike protein IgG antibodies (LIAISON® SARS-CoV-2-TrimericS IgG chemiluminescent immunoassay) expressed in binding activity units per milliliter (BAU/mL) adapted to the WHO International standard.ResultsFifty patients (32% women, 68% men) with a mean (SD) age of 67.6 (14.8) years were included. Mild local reactions occurred in 38% after the first injection, and in 29.2% with mild, in 2.1% with moderate and in 2.1% with severe degree after the second injection. Systemic reactive events occurred less often, with diarrhea (4% mild, 4% moderate) and fatigue (8% mild) being the most frequent ones. After the first injection 42% of the patients developed a positive response using the assay specific cut-off value of 33.8 binding activity units per milliliter (BAU/mL) with a median (Q1, Q3) anti-SARS-CoV-2 spike IgG concentration of 20.0 (11.7, 51.0) BAU/mL. After the second injection the percentage of seropositive patients increased to 97.9% with an anti-SARS-CoV-2 spike IgG concentration of 1075 (290.8, 1735) BAU/mL. Higher age and immunosuppression were associated with lower, calcitriol treatment and prior seroconversion to hepatitis B vaccination with significantly higher antibody concentration.ConclusionsThe mRNA-BNT162b2 SARS-CoV-2 vaccine appears to be safe and well-tolerated and shows a high immunogenicity in hemodialysis patients.

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Immunogenicity Rates After SARS-CoV-2 Vaccination in People With End-stage Kidney Disease

et al. 2021

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IMPORTANCE Adults receiving dialysis treatment have a higher likelihood of death when infected with SARS-CoV-2 than adults not receiving dialysis treatment. To date, the immune response of people receiving dialysis after SARS-CoV-2 vaccination has not been systematically discussed.OBJECTIVE To assess immunogenicity rates in people with end-stage kidney disease (ESKD) receiving SARS-CoV-2 vaccines, explore postvaccination potential risk factors for nonresponse, and assess whether receiving dialysis is associated with different antibody response rates compared with the nondialysis population.DATA SOURCES This systematic review and meta-analysis used articles from PubMed, Medline, and Embase published before July 30, 2021, as well as articles in the medRxiv preprint server. STUDY SELECTIONStudies that evaluated the immunogenicity rate according to the postvaccine antibody response rate in patients with ESKD receiving dialysis were selected. DATA EXTRACTION AND SYNTHESISThe meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A random-effects model was used. Two independent reviewers conducted the literature search and extracted the data. MAIN OUTCOMES AND MEASURESThe primary outcome was the pooled antibody postvaccine response rates in individuals with ESKD. The secondary outcomes were pooled response rates in individuals receiving and not receiving dialysis. Subgroup analysis and meta-regression were conducted to identify the sources of heterogeneity. RESULTSA total of 32 studies were included. The overall immunogenicity rate of the dialysis group was 86% (95% CI, 81%-89%). Meta-regression showed a significant difference was detected in the postvaccine response rate on the basis of prevalence of diabetes (regression coefficient, −0.06; 95% CI, −0.10 to −0.02; P = .004). Compared with nondialysis controls, patients in the dialysis group had a lower response rate after the first (relative risk [RR], 0.61; 95% CI, 0.47-0.79; I 2 = 70.2%) and second (RR, 0.88; 95% CI, 0.82-0.93; I 2 = 72.2%) doses, with statistically significantly increased RR between first and second doses (P = .007). CONCLUSIONS AND RELEVANCEThese findings suggest that the immunogenicity rate among patients receiving dialysis was 41% after the first dose and 89% after the second dose. Diabetes might be a risk factor for nonresponse in the dialysis population. Patients receiving dialysis had a poorer antibody response rate than did individuals not receiving dialysis, particularly after the first dose.

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Antibody response to the BNT162b2 vaccine in maintenance hemodialysis patients

Cited by 83 publications

References 3 publications

Humoral and Cellular Responses to mRNA-1273 and BNT162b2 SARS-CoV-2 Vaccines Administered to Hemodialysis Patients

Humoral and Cellular Responses to mRNA-1273 and BNT162b2 SARS-CoV-2 Vaccines Administered to Hemodialysis Patients

The Safety and Immunogenicity of the mRNA-BNT162b2 SARS-CoV-2 Vaccine in Hemodialysis Patients

Immunogenicity Rates After SARS-CoV-2 Vaccination in People With End-stage Kidney Disease

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