Experience with SARS-CoV-2 BNT162b2 mRNA vaccine in dialysis patients

Yanay, Noa Berar; Freiman, Sarit; Shapira, Maanit; Wishahi, Samar; Hamze, Munir; Elhaj, Mohamad; Zaher, Maha; Armaly, Zaher

doi:10.1016/j.kint.2021.04.006

Cited by 115 publications

(122 citation statements)

References 9 publications

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“…In comparison to these findings, the strong immunogenicity with the mRNA-BNT162b2 SARS-CoV-2 vaccine found in our study is encouraging and hopefully translates into the prevention of clinically important outcomes such as severe COVID-19, hospitalization and death. Our results confirm the recently published high antibody response rates from 90% to 96% in three dialysis cohorts from Israel (24)(25)(26), and show a better vaccine response compared to 56 French SARS-CoV-2 infection-naïve hemodialysis patients (82%) (27).…”

Section: Discussionsupporting

confidence: 91%

The Safety and Immunogenicity of the mRNA-BNT162b2 SARS-CoV-2 Vaccine in Hemodialysis Patients

et al. 2021

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BackgroundHemodialysis patients are at high risk for severe COVID-19. SARS-CoV-2 vaccination related safety and immunogenicity data in these patients are rare.MethodsIn this observational study SARS-CoV-2-seronegative hemodialysis patients were vaccinated with two doses of the Pfizer/BioNTech mRNA-BNT162b2 vaccine (COMIRNATY® 30 µg) and followed for 90 days. Local and systemic side effects were assessed at every dialysis session during the first post-vaccination week after the first and second vaccine dose. Immunogenicity was determined four weeks after vaccination by quantifying anti-SARS-CoV-2 spike protein IgG antibodies (LIAISON® SARS-CoV-2-TrimericS IgG chemiluminescent immunoassay) expressed in binding activity units per milliliter (BAU/mL) adapted to the WHO International standard.ResultsFifty patients (32% women, 68% men) with a mean (SD) age of 67.6 (14.8) years were included. Mild local reactions occurred in 38% after the first injection, and in 29.2% with mild, in 2.1% with moderate and in 2.1% with severe degree after the second injection. Systemic reactive events occurred less often, with diarrhea (4% mild, 4% moderate) and fatigue (8% mild) being the most frequent ones. After the first injection 42% of the patients developed a positive response using the assay specific cut-off value of 33.8 binding activity units per milliliter (BAU/mL) with a median (Q1, Q3) anti-SARS-CoV-2 spike IgG concentration of 20.0 (11.7, 51.0) BAU/mL. After the second injection the percentage of seropositive patients increased to 97.9% with an anti-SARS-CoV-2 spike IgG concentration of 1075 (290.8, 1735) BAU/mL. Higher age and immunosuppression were associated with lower, calcitriol treatment and prior seroconversion to hepatitis B vaccination with significantly higher antibody concentration.ConclusionsThe mRNA-BNT162b2 SARS-CoV-2 vaccine appears to be safe and well-tolerated and shows a high immunogenicity in hemodialysis patients.

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Section: Discussionsupporting

confidence: 91%

The Safety and Immunogenicity of the mRNA-BNT162b2 SARS-CoV-2 Vaccine in Hemodialysis Patients

et al. 2021

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“…Emerging data on the humoral response of other hemodialysis cohorts have shown similar seroconversion results ranging from 82 to 96%. All but the Frantzen et al study (244 patients) 30 had a smaller number of participants than ours 21,22,[31][32][33][34] . Moreover, to our knowledge ours is the largest hemodialysis cohort to have evaluated the immune response to the mRNA-1273 vaccine 22 .…”

Section: Discussionmentioning

confidence: 52%

Humoral and Cellular Responses to mRNA-1273 and BNT162b2 SARS-CoV-2 Vaccines Administered to Hemodialysis Patients

Broseta

Rodríguez-Espinosa

Rodríguez³

et al. 2021

American Journal of Kidney Diseases

109

120

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“…Jahn et al compared the titer of anti-spike protein glycoprotein IgG antibody two weeks after the second dose of BNT162b2 between 72 patients with MHD and 16 healthy healthcare workers and found that the seroresponses were significantly lower in MHD patients aged over 60 years [ 37 ]. Yanay et al conducted a similar experiment of 127 MHD patients and 132 controls, and reported lower anti-spike antibody levels 21 to 35 days following two-dose BNT162b2 vaccinations in the dialysis group, particularly in those aged over 75 years [ 38 ]. Another experiment of 56 patients on MHD and 95 healthcare workers by Grupper et al reported a significant inverse correlation between age and antibody levels in both groups 30 days following the second dose of BNT162b2 [ 39 ].…”

Section: Effectiveness Of Covid-19 Vaccines In Hemodialysis Patientsmentioning

confidence: 99%

COVID-19 Vaccines in Patients with Maintenance Hemodialysis

Yen

Lin

Chen

et al. 2021

JPM

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The COVID-19 pandemic has infected more than 180 million people and caused more than 3.95 million deaths worldwide. In addition to personal hygiene, augmented cleaning, social distancing, and isolation, vaccine development and immunization are essential for this highly contagious disease. Patients with maintenance hemodialysis (MHD) have a greater risk of COVID-19 infection owing to their comorbidities, defective immunity, and repeated crowded in-center dialysis settings. However, many patients hesitate to get vaccinated because of their misunderstandings. The Efficacy of COVID-19 vaccination has been intensively discussed in the general population, whereas the data concerning the effectiveness of vaccination in MHD patients are relatively scanty. Nevertheless, those limited publications can provide some valuable information. Overall, lower and more delayed antibody responses following COVID-19 vaccination were observed in patients with MHD than in healthy controls in the settings of different populations, vaccines and dosage, definitions of the immune response, and antibody detection timepoints. Younger age, previous COVID-19 infection, and higher serum albumin level were positively associated with antibody formation, whereas older age and receiving immunosuppressive therapy were unfavorable factors. However, it remains uncertain between the elicited antibodies following vaccination and the genuine protection against COVID-19 infection. Patients with MHD should make their COVID-19 vaccination a priority in addition to other protective measures. More studies focusing on different vaccines, non-humoral immune responses, and risk-benefit analyses are warranted.

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Experience with SARS-CoV-2 BNT162b2 mRNA vaccine in dialysis patients

Cited by 115 publications

References 9 publications

The Safety and Immunogenicity of the mRNA-BNT162b2 SARS-CoV-2 Vaccine in Hemodialysis Patients

The Safety and Immunogenicity of the mRNA-BNT162b2 SARS-CoV-2 Vaccine in Hemodialysis Patients

Humoral and Cellular Responses to mRNA-1273 and BNT162b2 SARS-CoV-2 Vaccines Administered to Hemodialysis Patients

COVID-19 Vaccines in Patients with Maintenance Hemodialysis

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