ChAdOx1 nCoV-19 Immunogenicity and Immunological Response Following COVID-19 Infection in Patients Receiving Maintenance Hemodialysis

Abstract

Patients with end-stage renal disease (ESRD) receiving hemodialysis (HD) were found to have a decreased immune response following mRNA COVID-19 immunization. ChAdOx1 nCoV-19 was a promising COVID-19 vaccine that performed well in the general population, but the evidence on immunogenicity in ESRD with HD patients was limited. Moreover, the immunological response to COVID-19 infection was inconclusive in patients with ESRD and HD. The aim of this study was to investigate the immunogenicity of ChAdOx1 nCoV-19 vaccination and the immunological response after COVID-19 infection in ESRD patients with HD. The blood samples were obtained at baseline, 1-month, and 3-month follow-up after each shot or recovery. All participants were measured for anti-spike IgG by the ELISA method, using Euroimmun. This study found a significant increase in anti-spike IgG after 1 month of two-shot ChAdOx1 nCoV-19 vaccination, followed by a significant decrease after 3 months. On the other hand, the anti-spike IgG was maintained in the post-recovery group. There was no significant difference in the change of anti-spike IgG between the one-shot ChAdOx1 nCoV-19-vaccinated and post-recovery groups for both 1-month and 3-month follow-ups. The seroconversion rate for the vaccinated group was 60.32% at 1 month after one-shot vaccination and slightly dropped to 58.73% at the 3-month follow-up, then was 92.06% at 1 month after two-shot vaccination and reduced to 82.26% at the 3-month follow-up. For the recovered group, the seroconversion rate was 95.65% at 1 month post-recovery and 92.50% at 3-month follow-up. This study demonstrated the immunogenicity of two-dose ChAdOx1 nCoV-19 in ESRD patients with HD for humoral immunity. After COVID-19 infection, the humoral immune response was strong and could be maintained for at least three months.

18-month longitudinal SARS COV-2 neutralizing antibody dynamics in haemodialysis patients receiving heterologous 3-dose vaccination (AZD-1222- AZD-1222- BNT162b2) in a lower middle income setting

“…The post 2nd dose seroconversion rate of HD patients, in our study (83.7% with MAB 450 IU/ml) was comparable with other work on similarly vaccinated HD cohorts (seroconversion 71.4% (MAB:345.1 BAU/ml) to 94.16% (MAB:1342 BAU/ml) [22,[48][49][50][51]. At four months post 2nd dose, the seroconversion rate in HD patients had dropped to 71.4% with MAB level of 235.4 IU/ml, similar to findings from Thailand where 2-dose AZD1222 in HD patients showed reducing seroconversion(92.06% to 82.26%) and MAB (anti-spike IgG, from 435.96 BAU/mL to 260.74 BAU/ mL) in HD patients in 3 months post 2nd dose [51]. At 6 months post 2nd dose, though seropositivity in HDs Fig.…”

“…The post 2nd dose seroconversion rate of HD patients, in our study (83.7% with MAB 450 IU/ml) was comparable with other work on similarly vaccinated HD cohorts (seroconversion 71.4% (MAB:345.1 BAU/ml) to 94.16% (MAB:1342 BAU/ml) [ 22 , 48 – 51 ]. At four months post 2nd dose, the seroconversion rate in HD patients had dropped to 71.4% with MAB level of 235.4 IU/ml, similar to findings from Thailand where 2-dose AZD1222 in HD patients showed reducing seroconversion(92.06% to 82.26%) and MAB (anti-spike IgG, from 435.96 BAU/mL to 260.74 BAU/mL) in HD patients in 3 months post 2nd dose [ 51 ]. At 6 months post 2nd dose, though seropositivity in HDs dropped further to 66.7%, MAB level of patients who remained seropositive had not changed significantly as those with low antibody levels had become seronegative while those with moderate to high antibody appeared able to maintain levels.…”

Humoral Immune Response of BNT162b2 and CoronaVac Vaccinations in Hemodialysis Patients: A Multicenter Prospective Cohort

“…This is one of the first studies to compare the humoral immune response of CoronaVac and an RNA vaccine such as BNT162b2 in patients undergoing chronic hemodialysis. To date, most of the studies that have evaluated the effects of anti-SARS-CoV-2 vaccinations in hemodialysis patients (including humoral and cellular immune response and clinical efficacy to prevent COVID-19 and COVID-19-related adverse outcomes) have analyzed RNA vaccines such as BNT162b2 (Pfizer-BioNTech) [20], ChAdOx1 nCoV-19 (Oxford-AstraZeneca) [21], and mRNA-1273 (Moderna) [22].…”

SARS-CoV-2 Vaccination: What Can We Expect Now?

“…In humans, a second generation of vaccines against COVID-19 is coming, and in June 2022 the pediatric version of the anti-COVID-19 vaccine has been approved for children in the USA [ 30 ]. Age-specific [ 30 ] and medical condition-specific vaccination procedures and formulations [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] definitely constitute a new paradigm in the “vaccine world”. Major developments are expected in the near future.…”