Seroresponse to SARS-CoV-2 vaccines among maintenance dialysis patients

Abstract

ImportanceVaccines against SARS-CoV-2 are highly effective in the general population; however, their efficacy may be diminished in maintenance dialysis patients, a population particularly vulnerable to COVID-19 infection and morbidity.ObjectiveWe assessed vaccine response in a national sample of maintenance dialysis patients and identified predictors of response.DesignRetrospective cohort studySetting130 Dialysis Clinic, Inc (DCI) facilitiesParticipantsMaintenance dialysis patients without known prior COVID-19 or a positive baseline antibody titerExposure(s)Vaccine type and clinical characteristicsMain Outcome(s)Using a semi-quantitative assay for antibodies against SARS-CoV-2 spike antigen, vaccine response was defined as at least one titer ≥1 U/L between 14 and 74 days after completion of a SARS-CoV-2 vaccine series. Regression analysis was used to identify characteristics associated with response.ResultsAmong 1528 patients, 437 received BNT162b2/Pfizer vaccine, 766 received mRNA-1273/Moderna, and 325 received Ad26.COV2.S/Janssen. Serologic response differed significantly by vaccine type: 381/437 (87%) among BNT162b2/Pfizer recipients, 736/766 (96%) among mRNA-1273/Moderna recipients, and 119/325 (37%) among Ad26.COV2.S/Janssen recipients. Vaccine type, older age, immune-modulating medication, history of transplantation, and lower serum albumin were associated with vaccine non-response.Conclusions and RelevanceSerologic response to mRNA vaccines is robust among maintenance dialysis patients. Future research should evaluate durability of this response, correlation between seroresponse and protection from COVID-19, and the role of the AD26.COV2.S/Janssen vaccine in this vulnerable population.

Seroresponse to SARS-CoV-2 Vaccines among Maintenance Dialysis Patients over 6 Months

“…However, this association persisted when the analyses were restricted to only recipients of an mRNA vaccine. This association has been also observed in our prior work (38) and requires further investigation.…”

Seroresponse to Third Doses of SARS-CoV-2 Vaccine Among Patients Receiving Maintenance Dialysis

“…As previously described, beginning in January 2021, DCI physicians had the option of activating a SARS-CoV-2 vaccine protocol, in which anti-spike IgG antibodies were measured monthly with routine labwork. 4 The chemiluminescent assay ADVIA Centaur XP/XPT COV2G, which measures IgG antibodies against the receptor-binding domain of the S1 subunit of SARS-CoV-2 spike antigen, had received emergency use authorization (EUA) in July 2020. 5,6 This semi-quantitative assay reports a calibrator-established Index Value between 0 and 20 or of ≥20; per manufacturer specifications, titer ≥1 represents detectable antibodies, likely signifying seroresponse.…”

Antibody Response to the Coronavirus Disease 2019 Ad26.COV2.S Vaccine Among Maintenance Dialysis Patients

“…A recent publication showed a similar attenuated antibody response to Ad26.COV2.S vaccine in dialysis patients vaccinated in two dialysis clinics, where after an average follow up of 52 days, 62% of patients had undetected antibody response (<1) (4). A report by Hsu et al, observed 63% of patients vaccinated with Ad26.COV2.S undetected antibody response, however they found that only 7% of patients vaccinated with mRNA vaccines had undetected antibody response (5).…”

“…Mysayphonh PharmD 1 , Ines A Dahne-Steuber MA 3 , Curtis Johnson MS 4 , Melanie Pollan PhD 5 , Sandra Alexander BS 6 , Jeffrey G Mulhern MD 7 , Robert J Kossmann MD 1 , Michael S Anger MD 1,2 , Jeffrey L Hymes MD 1 .…”

“…Laboratories, Rockleigh, New Jersey4 Spectra Laboratories, Milpitas, California J o u r n a l P r e -p r o o f5 Siemens Healthcare Diagnostics Inc., Tarrytown, New York6 Fresenius Medical Care North America, Waltham, Massachusetts7 Baystate Medical Center, Springfield, Massachusetts Address for Correspondence: Jeffrey L Hymes, MD, 1000 Corporate Centre Drive, Suite 400, Franklin, TN 37067; 615-567-4821; jeffrey.hymesmd@fmc-na.com Authors' Contributions: Research idea and study design: JLH, C.Mysayph, JGM, LHF, C.Mullon; data acquisition: IADS, CJ, SA, MP; Laboratory methodology: CJ, MP; data analysis/interpretation: JW, LHF, JGM, RJK, MA; statistical analysis: JW, LHF; supervision: JLH, RJK, IADS. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.…”