Decline of Humoral Responses 6 Months after Vaccination with BNT162b2 (Pfizer–BioNTech) in Patients on Hemodialysis

Jahn, Michael; Korth, Johannes; Dorsch, Oliver; Anastasiou, Olympia E.; Krawczyk, Adalbert; Brochhagen, Leonie; Sand, Lukas van de; Sorge-Hädicke, Burkhard; Tyczynski, Bartosz; Witzke, Oliver; Dittmer, Ulf; Dolff, Sebastian; Wilde, Benjamin; Kribben, Andreas

doi:10.3390/vaccines10020327

Cited by 8 publications

(10 citation statements)

References 77 publications

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“…9 In a study evaluating BNT162b2 response in HD patients, the seropositivity rate was detected to be 96.6% at 6 weeks after the first dose, 91.5% at week 12, and 79.7% at 6 months. 10 Similarly, in another study including HD and PD patients that had received the BNT162b2 vaccine, it was shown that the seroconversion rate was 78.8% in the HD group and 81.3% in the PD group at 6 months, and there was no difference in terms of antibody levels. 11 In the current study, when the patients that did not receive the booster dose were evaluated, the seropositivity rate at 6 months was 61.8% in the HD group and 58.3% in the PD group.…”

Section: Resultsmentioning

confidence: 89%

“…[6][7][8] Data from studies with a long-term follow-up suggest that antibody levels in the dialysis cohort decrease at 3-6 months after vaccination. [9][10][11] In light of these findings, the necessity of a booster dose started to be discussed, and the CoronaVac or BNT162b2 vaccine was made available for dialysis patients as a booster dose as of July 2021 in Turkey.…”

Section: Introductionmentioning

confidence: 99%

“…Conflicting results have been reported in studies evaluating haemodialysis (HD) and/or peritoneal dialysis (PD) patients that had been administered various types of vaccines 6–8 . Data from studies with a long‐term follow‐up suggest that antibody levels in the dialysis cohort decrease at 3–6 months after vaccination 9–11 . In light of these findings, the necessity of a booster dose started to be discussed, and the CoronaVac or BNT162b2 vaccine was made available for dialysis patients as a booster dose as of July 2021 in Turkey.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of homologous and heterologous inactivated and mRNA vaccination programme against SARS‐CoV‐2 in dialysis patients

Yasar,

Yildiz,

Ozturk

et al. 2024

Nephrology

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AimTo evaluate the vaccine response and the effect of the booster dose on COVID‐19 positivity in haemodialysis (HD) and peritoneal dialysis (PD) patients who received and did not receive BNT162b2 as a booster dose after two doses of CoronaVac.MethodsThe study included 80 PD and 163 HD patients, who had been administered two doses of the CoronaVac. Antibody levels were measured on Days 42 and 90 after the first dose. Measurements were repeated on Day 181 after the first dose in the patients that received two vaccine doses and on Day 28 after the third dose in those that also received the booster dose. Antibody levels below 50 AU/mL were considered negative.ResultsThe seropositivity rate was similar in the HD and PD group on Days 42 and 90 (p = 0.212 and 0.720). All patients were seropositive in the booster group. The antibody level was lower in the patients that received CoronaVac as the booster compared to those administered BNT162b2 in HD and PD groups (p < 0.001 and 0.002). COVID‐19 positivity was detected in 11 patients (7 = had not received the booster dose, 4 = had received third dose of CoronaVac). The multivariate analysis revealed that as age increased, COVID‐19 positivity also increased (OR: 1.080, 95% CI: 1.017 – 1.146, p = 0.012), while booster dose administration decreased this positivity (OR: 0.113, 95% CI: 0.028 – 0.457, p = 0.002).ConclusionOur results may indicate the need for additional vaccination doses in patients with HD and PD. Our findings indicate a higher antibody response in dialysis patients with heterologous BNT162b2 as a booster dose after two doses of CoronaVac compared to homologous CoronaVac.image

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Section: Resultsmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of homologous and heterologous inactivated and mRNA vaccination programme against SARS‐CoV‐2 in dialysis patients

Yasar,

Yildiz,

Ozturk

et al. 2024

Nephrology

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“…Another issue is the short duration of the anti-COVID-19 mRNA vaccine in dialysis patients. Studies reported that anti-SARS-CoV-2 antibody titres declined after 6 months [80][81][82], and a more recent report showed that vaccine-specific humoral and cellular immunity waned 4 months after two vaccine doses in dialysis patients [83]. More information is also needed to assess the durability of vaccine protection against new variants.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 Vaccination in Kidney Transplant Candidates and Recipients

Ponticelli¹,

Campise

2022

Vaccines

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Kidney transplant candidates and kidney transplant recipients (KTRs) are at particular risk of severe complications of COVID-19 disease. In Western countries, mortality in affected hospitalized KTRs ranges between 19% and 50%. COVID-19 vaccination remains the most important measure to prevent the severity of infection in candidates and recipients of kidney transplant. However, the uraemic condition may affect the vaccine-induced immunity in patients with advanced chronic kidney disease (CKD) and in KTRs. Retention of uraemic toxins, dysbiosis, dysmetabolism, and dialysis can diminish the normal response to vaccination, leading to dysfunction of inflammatory and immune cells. In KTRs the efficacy of vaccines may be reduced by the immunosuppressive medications, and more than half of kidney transplant recipients are unable to build an immune response even after four administrations of anti-COVID-19 vaccines. The lack of antibody response leaves these patients at high risk for SARS-CoV-2 infection and severe COVID-19 disease. The aim of the present review is to focus on the main reasons for the impaired immunological response among candidates and kidney transplant recipients and to highlight some of the present options available to solve the problem.

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“…Patients on hemodialysis who were vaccinated with mRNA vaccines induce anti-SARS-CoV-2 antibodies [ 8 ], although at lower concentrations than healthy volunteers [ 9 ]. In addition, they have an early decrease in antibody titers compared to the general population [ 10 , 11 , 12 ]. The causal mechanisms leading to the immune impairment of ESRD patients are not entirely understood.…”

Section: Introductionmentioning

confidence: 99%

High Plasma Levels of Fibroblast Growth Factor 23 Are Associated with Increased Risk of COVID-19 in End-Stage Renal Disease Patients on Hemodialysis: Results of a Prospective Cohort

Toro

Michea

Parra-Lucares

et al. 2023

Toxins

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End-stage renal disease (ESRD) patients are a population with high rates of COVID-19 and mortality. These patients present a low response to anti-SARS-CoV-2 immunization, which is associated with immune dysfunction. ESRD patients also present high plasma titers of Fibroblast Growth Factor 23 (FGF23), a protein hormone that reduces immune response in vivo and in vitro. Increased FGF23 levels associate with higher infection-related hospitalizations and adverse infectious outcomes. Thus, we evaluated whether ESRD patients with high FGF23 titers have an increased rate of SARS-CoV-2 infection. Methods: We performed a prospective cohort of ESRD patients in hemodialysis who had measurements of plasma intact FGF23 in 2019. We determined COVID-19 infections, hospitalizations, and mortality between January 2020 and December 2021. Results: We evaluated 243 patients. Age: 60.4 ± 10.8 years. Female: 120 (49.3%), diabetes: 110 (45.2%). During follow-up, 45 patients developed COVID-19 (18.5%), 35 patients were hospitalized, and 12 patients died (mortality rate: 26.6%). We found that patients with higher FGF23 levels (defined as equal or above median) had a higher rate of SARS-CoV-2 infection versus those with lower levels (18.8% versus 9.9%; Hazard ratio: 1.92 [1.03–3.56], p = 0.039). Multivariate analysis showed that increased plasma FGF23 was independently associated with SARS-CoV-2 infection and severe COVID-19. Discussion: Our results suggest that high plasma FGF23 levels are a risk factor for developing COVID-19 in ESRD patients. These data support the potential immunosuppressive effects of high circulating FGF23 as a factor implicated in the association with worse clinical outcomes. Further data are needed to confirm this hypothesis.

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Decline of Humoral Responses 6 Months after Vaccination with BNT162b2 (Pfizer–BioNTech) in Patients on Hemodialysis

Cited by 8 publications

References 77 publications

Comparison of homologous and heterologous inactivated and mRNA vaccination programme against SARS‐CoV‐2 in dialysis patients

Comparison of homologous and heterologous inactivated and mRNA vaccination programme against SARS‐CoV‐2 in dialysis patients

COVID-19 Vaccination in Kidney Transplant Candidates and Recipients

High Plasma Levels of Fibroblast Growth Factor 23 Are Associated with Increased Risk of COVID-19 in End-Stage Renal Disease Patients on Hemodialysis: Results of a Prospective Cohort

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