Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 21;15(9):1720-1726.
doi: 10.1093/ckj/sfac082. eCollection 2022 Sep.

Protective antibody response to mRNA-1273 and BNT162b2 vaccines in patients on maintenance haemodialysis: a prospective cohort study

Yves Dimitrov  1 , Thierry Krummel  2 , François Chantrel  3 , Anne-Laure Faller  3 , Julien Ott  1 , Daniela David  3 , Dorothée Bazin-Kara  2 , Thierry Hannedouche  2 , Claire Borni  3
Affiliations

Protective antibody response to mRNA-1273 and BNT162b2 vaccines in patients on maintenance haemodialysis: a prospective cohort study

Yves Dimitrov et al. Clin Kidney J. .

Abstract

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is more frequent and severe in patients with chronic kidney disease (CKD) on maintenance haemodialysis (HD). Vaccines are now available, but the protective response rates and determinants of humoral response to the vaccine are poorly described.

Methods: This prospective observational study describes the response rates of detectable and protective antibody titres 1 month after each dose of an mRNA vaccine in a cohort of 851 patients on maintenance HD.

Findings: Among naïve SARS-CoV-2 patients, a vast majority produced detectable (95.2%) or protective levels of antibodies (69.6%) 1 month after the second vaccine dose. In addition, the response rate was significantly higher with the mRNA-1273 than with the BNT162b2 vaccine 1 month after the second dose (79.8 versus 59.1%, respectively; P < 0.001). The main determinants for an inadequate humoral response were older age, treatment with immunosuppressants or oral anticoagulants and low serum albumin. All the patients who encountered coronavirus disease 2019 before vaccination also reached a highly protective humoral response.

Interpretation: We found an acceptable humoral response rate in patients on maintenance HD, much higher than in transplant recipients. Therefore the third dose of vaccine may be justified in those patients with an inadequate humoral response, particularly those with a history of organ transplantation or immunosuppressive treatment.

Keywords: COVID-19 mRNA vaccines; chronic kidney disease; haemodialysis.

PubMed Disclaimer

Figures

FIGURE 1:
FIGURE 1:
Flowchart.
FIGURE 2:
FIGURE 2:
Anti-spike antibody titres 1 month after the first (blue) and second (pink) vaccine doses. Values are represented separately for COVID-naïve patients (upper row) and those with a positive anti-NP test prior to vaccination (lower row). The left column shows the antibody response to the BNT162b2 vaccine and the right column the antibody response to the mRNA-1273 vaccine. Changes in antibody titres before and after each dose of vaccine were compared using a Wilcoxon rank sign test.
See this image and copyright information in PMC

References

    1. COVID-19 situation update for the EU/EEA, as of 24 June 2021. [Internet]. European Centre for Disease Prevention and Control. https://www.ecdc.europa.eu/en/cases-2019-ncov-eueea (24 June 2021, date last accessed)
    1. Scarpioni R, Manini A, Valsania Tet al. . Covid-19 and its impact on nephropathic patients: the experience at Ospedale “Guglielmo da Saliceto” in Piacenza. G Ital Nefrol 2020; 37: 2020-vol2 - PubMed
    1. Alberici F, Delbarba E, Manenti Cet al. . A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection. Kidney Int 2020; 98: 20–26 - PMC - PubMed
    1. Goicoechea M, Sánchez Cámara LA, Macías Net al. . COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int 2020; 98: 27–34 - PMC - PubMed
    1. Valeri AM, Robbins-Juarez SY, Stevens JSet al. . Presentation and outcomes of patients with ESKD and COVID-19. J Am Soc Nephrol 2020; 31: 1409–1415 - PMC - PubMed