Results of an Academic Dialysis Program-Wide SARS-CoV-2 Vaccination Effort

Bowman, Brendan; Lobo, Benjamin J.; Jennie, Z.; Sharma, Binu

doi:10.1101/2021.05.07.21256841

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Peritoneal and home dialysis clinics are co‐located at select sites. In January 2021, the UVA Health System undertook a dialysis program‐wide vaccination effort in partnership with the Virginia Department of Health's Blue Ridge Health District (BRHD) 22 . UVA Health mobile vaccination clinics offered patients a two‐shot series of the Pfizer‐ BioNTech COVID‐19 vaccine (BNT162b2).…”

Section: Methodsmentioning

confidence: 99%

“…In January 2021, the UVA Health System undertook a dialysis program-wide vaccination effort in partnership with the Virginia Department of Health's Blue Ridge Health District (BRHD). 22 UVA Health mobile vaccination clinics offered patients a two-shot series of the Pfizer-BioNTech COVID-19 vaccine (BNT162b2). Vaccinations were administered by dialysis pharmacists, nurses, and advanced practice nurses.…”

Section: Study Settingmentioning

confidence: 99%

“…Beginning in January of 2021, the University of Virginia began a dialysis program-wide vaccination campaign using BNT162b2. 22 We followed a cohort of these dialysis patients and reported their longterm humoral responses to two doses of BNT162b2 for 6 months after full vaccination. 6 A subset of these patients received a third dose of BNT162b2 and their short-term antibody response was reported.…”

mentioning

confidence: 99%

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Humoral immunity trends in a hemodialysis cohort following SARS‐CoV‐2 mRNA booster: A cohort study

Goggins,

Sharma,

et al. 2024

Health Science Reports

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Background and AimsPatients with end stage kidney disease on hemodialysis are vulnerable to SARS‐CoV‐2 infection. Current guidelines recommend boosters of SARS‐CoV‐2 mRNA‐based vaccines. The long‐term humoral response of hemodialysis patients infected with SARS‐CoV‐2 after receiving a booster of SARS‐CoV‐2 mRNA‐based vaccines has been incompletely characterized. Here, we determined the long‐term humoral response of hemodialysis patients to two and three doses of the Pfizer BioNTech (BNT162b2) mRNA SARS‐CoV‐2 vaccine and investigated the effect of postbooster SARS‐CoV‐2 infection on antibody levels over time.MethodsSamples were collected on a monthly basis and tested for anti‐SARS‐CoV‐2 antibodies against anti‐spike S1 domain. Thirty‐five hemodialysis patients were enrolled in the original study and 27 of these received a booster. Patients were followed up to 6 months after the first two doses and an additional 7 months after the third BNT162b2 dose. Results are presented as the internationally harmonized binding antibody units (BAU/mL).ResultsAntibody level significantly increased from prebooster to 2 weeks postbooster, with a median [25th, 75th percentile] rise from 52.72 [28.55, 184.7] to 6216 [3806, 11,730] BAU/mL in the total population. Of patients with a negative or borderline detectable antibody level 6 months after vaccination who received a third dose, 89% developed positive antibody levels 2 weeks postbooster. Postbooster antibody levels declined an average rate of 29% per month in infection‐naïve patients. Antibody levels spiked in patients infected with SARS‐CoV‐2 after receiving a booster but declined rapidly. No patients infected postbooster required hospitalization.ConclusionsA third dose of BNT162b2 restores antibody levels to high levels in dialysis patients but levels decline over time. A third dose did not necessarily prevent infection, but no patients suffered severe infection or required hospitalization. SARS‐CoV‐2 recovered patients appear to have a blunted rise in antibody levels after a third dose. Although patients infected with SARS‐CoV‐2 postbooster had an immediate spike in antibody levels, these declined over time.

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Section: Methodsmentioning

confidence: 99%

Section: Study Settingmentioning

confidence: 99%

mentioning

confidence: 99%

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Humoral immunity trends in a hemodialysis cohort following SARS‐CoV‐2 mRNA booster: A cohort study

Goggins,

Sharma,

et al. 2024

Health Science Reports

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“…In January 2021, the University of Virginia began a program‐wide vaccination campaign for dialysis patients exclusively using BNT162b2 (courtesy of the Virginia Department of Health) and achieved an 80% vaccination rate among prevalent dialysis patients. 8 From this cohort, a subset of patients was selected to prospectively study serial antibody levels from 2 to 6 months following full vaccination. Here, the results of serial monthly antibody levels, slope of antibody decline, and qualitative population loss of detectable humoral antibody response in this selected subset are reported.…”

Section: Introductionmentioning

confidence: 99%

Long‐term humoral immunity decline in hemodialysis patients following severe acute respiratory syndrome coronavirus 2 vaccination: A cohort study

Goggins

Sharma

Jennie

et al. 2022

Health Science Reports

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Background and Aims Dialysis patients are extremely vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection with high rates of hospitalization and mortality rates. In January 2021, the University of Virginia Dialysis Program initiated a program‐wide vaccination campaign to administer the Pfizer BioNTech messenger RNA SARS‐CoV‐2 (BNT162b2) vaccine. The aim of this study was to characterize the long‐term time‐dependent decline in humoral immunity in hemodialysis patients. Methods A prospective cohort study measuring serial monthly semiquantitative IgG antibody levels to the SARS‐CoV‐2 spike protein receptor binding domain in fully vaccinated in‐center hemodialysis patients. Samples were collected monthly and tested for anti‐SARS‐CoV‐2 antibodies against the anti‐spike S1 domain for 2–6 months post full vaccination. Results were presented as internationally harmonized binding antibody units (BAU/ml). To analyze the change in antibody levels over time, a linear mixed model with random intercept and random slope was used for longitudinal antibody levels. A multivariable model was used to estimate the slope of antibody levels by adjusting for selected patient characteristics. Based on the estimated intercepts and slopes for each subject from the unadjusted model, 10‐month antibody levels were projected. Results The mean baseline antibody level was 647.59 BAU/ml and 87.88% (29/33) of patients were considered qualitatively positive. Two patients were negative at baseline and an additional two had borderline results. Patient antibody levels declined at an adjusted average rate of 31% per month. At 6 months postvaccination, 40% of patients remaining in the cohort possessed either negative or borderline IgG antibody levels. Projecting future antibody levels suggests that 65% of the cohort will progress to borderline or negative antibody levels at 10 months post full vaccination. Conclusion The long‐term vaccine response following vaccination with the BNT162b2 in hemodialysis patients was characterized. Our data add to the limited pool of data in this patient population and emphasize the critical need for vaccine boosters.

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Long Term Humoral Immunity Decline in Hemodialysis Patients Following SARS-CoV-2 Vaccination

Goggins

Sharma

Jennie

et al. 2021

Preprint

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Dialysis patients are extremely vulnerable to SARS-CoV-2 infection with high rates of hospitalization and mortality rates estimated at 20-30%. In January of 2021, the University of Virginia Dialysis Program initiated a program wide vaccination campaign administering Pfizer BioNTech mRNA SARS-CoV-2 (BNT162b2) vaccine. To characterize the time-dependent decline in humoral immunity, we performed a prospective cohort study measuring serial monthly semi quantitative IgG antibody levels to the SARS-CoV-2 spike protein receptor binding domain in fully vaccinated in-center hemodialysis patients. Measurements were taken beginning at 2 months post full vaccination through 6 months after full vaccination. Early results showed similar seroconversion rates as prior studies with 88% obtaining positive antibody levels. Those with prior infection obtained the highest antibody levels. Over the ensuing months, patient antibody levels declined at an adjusted average rate of 31% per month. At the conclusion of the study, 40% of patients remaining in the cohort possessed either negative or borderline IgG antibody levels. Projecting future antibody levels based on the slopes of antibody level decay suggests 65% of the cohort will progress to borderline or negative antibody levels at 10 months post full vaccination. In summary, we studied long term vaccine response following vaccination with the BNT162b2 mRNA vaccine in hemodialysis patients. Our data adds to the limited pool of data in this patient population and will help to inform the discussion about vaccine booster needs and frequency.

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Results of an Academic Dialysis Program-Wide SARS-CoV-2 Vaccination Effort

Cited by 3 publications

References 6 publications

Humoral immunity trends in a hemodialysis cohort following SARS‐CoV‐2 mRNA booster: A cohort study

Humoral immunity trends in a hemodialysis cohort following SARS‐CoV‐2 mRNA booster: A cohort study

Long‐term humoral immunity decline in hemodialysis patients following severe acute respiratory syndrome coronavirus 2 vaccination: A cohort study

Long Term Humoral Immunity Decline in Hemodialysis Patients Following SARS-CoV-2 Vaccination

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