The Humoral Immune Response of the ChAdOx1 nCoV-19 Vaccine in Maintenance Dialysis Patients without Prior COVID-19 Infection

Abstract

Background: Chronic kidney disease (CKD) patients tend to have a reduced immune response to infection and vaccination. The efficacy of current available COVID-19 vaccines in CKD patients has not been widely evaluated. Methods: In the present study, three hundred and eight chronic dialysis patients received ChAdOx1 nCoV-19 (Oxford-AstraZeneca, AZ). Blood tests using an antibody against the receptor-binding domain (RBD) of the S1 subunit of the SARS-CoV-2 spike protein had performed at four designed time points before and after the first and second vaccine. Results: The mean age of patients was 65.5 ± 12.38 years, and the male/female ratio was 61.4%:38.6% (189/119). Two weeks after the first vaccination, only 37.66% of patients had a positive antibody response (>50 AU/mL). However, 65.58% of the participants showed a delayed antibody response ten weeks after the first vaccine. Four weeks after the second vaccine, 94.16% of participants had positive antibody levels. Age was the most significant factor associated with antibody response. Flow cytometry analysis revealed that immune-naïve patients had significantly lower early active B cells and proliferative B cells than the age- and sex-matched immune responders. Conclusion: Despite a delayed response, 94.16% of chronic dialysis patients achieved a positive antibody response after two doses of the AZ vaccine. Age is the most significant factor associated with antibody response.

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

“…Rates of 73%-92%, 2-4 weeks following 2 doses of Pfizer-BioNTech (BNT162b2) in HD patients (lower than healthy controls) have been shown in multiple studies [21,38,[44][45][46][47]. 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].…”

SARS-CoV2 antibody response after a third dose of heterologous ChAdOx1 nCoV-19 and Moderna vaccine in chronic dialysis patients

“…The present study is a successive cohort of our recently published study ( 8 ). The Abbott IgG II method was used to quantify antibodies against the spike protein's receptor-binding domain (RBD).…”

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

“…[ 15 ] It has also been reported that low hemoglobin or a history of diabetes is associated with a poor antibody response to SARS-CoV-2 vaccination. [ 16 ] The reason that there were no significant factors related to the presence or absence of antibody production in the present study is thought to be related to the fact that 63 out of 70 patients exhibited a positive antibody response; therefore, the number of patients may not have provided sufficient power to observe a statistically significant effect. To address this possibility, further studies involving a larger number of patients would be required.…”