Immune response to SARS-CoV-2 infection and vaccination in patients receiving kidney replacement therapy

Abstract

In this issue of Kidney International , the initial experience regarding the immunogenicity of prior coronavirus disease 2019 (COVID-19) infection and the response to the COVID-19 vaccines among patients on maintenance dialysis and kidney transplant recipients is summarized. Preliminary data suggest that there is reasonable durability of immune response after COVID-19 infection. Although immune response to first dose of vaccine is less than acceptable in both groups, a significant portion of maintenance dialysis patients develop robust antibody titers, whereas kidney transplant recipients show a less strong immune response even after the second vaccine dose.

Immunogenicity of a first dose of mRNA- or vector-based SARS-CoV-2 vaccination in dialysis patients: a multicenter prospective observational pilot study

“…Our study might point toward more rapid vaccination response in peritoneal dialysis patients. The high antibody levels in patients with prior COVID-19 infection confirms previous findings in patients on maintenance dialysis who recovered from COVID-19 [ 8 ]. Whether this persistent immunity may predispose dialysis patients to a similar triggering effect of a single vaccine dose as described for other populations, remains to be studied [ 9 ].…”

Reasons for COVID-19 vaccination hesitancy in hemodialysis patients

“…We read the excellent series of reports and editorial on the effectiveness of vaccination in patients on dialysis. 1 We would concur that although vaccination is less effective in these high-risk patients it remains critical to ensure our at-risk population remains as protected as possible. We would draw attention to the other significant challenge in such a population, namely hesitancy toward vaccination in patients on maintenance dialysis.…”

Neutralizing antibody response against variants of concern after vaccination of dialysis patients with BNT162b2

“…We and others showed high seroconversion rates after BNT162b2 mRNA vaccination in patients on hemodialysis, but still significantly lower rates as compared to those of healthy controls. 1 , 2 , 3 Variants of concern (VOCs) such as B.1.351 (beta variant) or B.1.617.2 (delta variant) partially escape from neutralizing antibodies (NAbs) and will probably replace wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or the B.1.1.7 (alpha) variant with increasing immunity in the population, induced by natural infection or vaccination. Wall et al.…”