Humoral response to vaccination against SARS-CoV-2 in patients undergoing dialysis

Abstract

Patients undergoing maintenance dialysis have a higher mortality rate associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and response rates to vaccination against SARS-CoV-2 vary from 29.6% to 96.4% in such patients. This study aimed to assess the immunogenicity of SARS-CoV-2 vaccination in Korean patients undergoing dialysis. We enrolled 70 SARS-CoV-2-vaccinated patients undergoing dialysis, with 11 healthcare workers serving as healthy control subjects. Thirty-two patients had received a third vaccination, whereas 38 had received 2 vaccinations. The healthy control subjects completed the second vaccination. Immunoglobulin G (IgG) antibodies targeting the receptor-binding domain of the S1 subunit of the SARS-CoV-2 spike protein were measured The vaccination responder rates were 86% (37/43), 96% (26/27), and 91% (10/11) in the patients undergoing hemodialysis and peritoneal dialysis and healthy controls, respectively. IgG antibody levels were significantly higher when a third dose was administered, independent of the type of vaccine or the time interval between vaccination and the subsequent blood sampling date. When a third dose of vaccine was administered, there was no difference in IgG antibody levels between those receiving cross-vaccination or a single vaccine. There was no significant difference in IgG antibodies between healthy controls and patients undergoing dialysis. Patients on dialysis exhibited a sufficient antibody-related response to vaccination against SARS-CoV-2, even in those receiving cross-vaccination, and the antibody titer was higher after a third vaccination. Therefore, it is necessary to administer a third vaccine dose to Korean patients undergoing dialysis.

Antibody response in patients undergoing chronic hemodialysis post-severe acute respiratory syndrome coronavirus 2 vaccination: A prospective observational study

“…However, this result differs from those of previous studies. Several studies [16][17][18][19] showed that the third dose of vaccine substantially increased antibody levels in patients receiving maintenance dialysis, and its effect was particularly noticeable in those with a lower response to the previous 2 doses of vaccine. Precisely pinpointing the reasons for the disparity between our findings and those of prior studies presents a challenge.…”

“…We compared how the antibody responses of patients undergoing HD differ according to the third vaccination dose and the antibody responses of patients undergoing HD with those of the healthy population. Since COVID- 19 is not yet over, we believe this study can help plan future vaccine administration strategies in patients undergoing HD.…”