tetano
Editor, Senior Moderator
Scand J Immunol
. 2022 Mar 4;e13152.
doi: 10.1111/sji.13152. Online ahead of print.
Improved immunologic response to COVID-19 vaccine with prolonged dosing interval in hemodialysis patients
Mathias Haarhaus[SUP] 1 2 [/SUP], Monica Duhanes[SUP] 1 [/SUP], Nataša Leševic[SUP] 1 [/SUP], Bogdan Matei[SUP] 1 [/SUP], Bernd Ramsauer[SUP] 1 [/SUP], Rui Da Silva Rodrigues[SUP] 3 [/SUP], Jun Su[SUP] 3 [/SUP], Michael Haase[SUP] 1 4 [/SUP], Carla Santos-Araújo[SUP] 1 5 [/SUP], Fernando Macario[SUP] 1 [/SUP]
Affiliations
Abstract
Vaccination against 2019 coronavirus disease (COVID-19) can reduce disease incidence and severity. Dialysis patients demonstrate a delayed immunologic response to vaccines. We determined factors affecting the immunologic response to COVID-19 vaccines in hemodialysis patients. All patients within a Swedish hemodialysis network, vaccinated with two doses of COVID-19 vaccine 2-8 weeks before inclusion, were eligible for this cross-sectional study. Severe adult respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein antibody levels were determined by EliA SARS-CoV-2-Sp1 IgG test (Thermo Fisher Scientific, Phadia AB) and related to clinical and demographic parameters. Eighty-nine patients were included. Patients were vaccinated with two doses of Comirnaty (BNT162b2, 73%) or Spikevax (mRNA-1273, 23,6%). Three patients received combinations of different vaccines. Response rate (antibody titres > 7 U/mL) was 89.9%, while 39.3% developed high antibody titres (> 204 U/mL), 47 (43-50) days after the second dose. A previous COVID-19 infection associated with higher antibody titres (median (25[SUP]th[/SUP] - 75[SUP]th[/SUP] percentile) 1,558.5 (814.5-3,763.8) U/mL vs. 87 (26-268) U/mL, p=0.002), while time between vaccine doses did not differ between groups (p=0.7). Increasing SARS-CoV-2 antibody titres were independently associated with increasing time between vaccine doses (B 0.241, P=0.02), decreasing serum calcium levels (B -0.233, P=0.007), and previous COVID-19 (B 1.078, P<0.001). In conclusion, a longer interval between COVID-19 mRNA vaccine doses, lower calcium, and a previous COVID-19 infection were independently associated with a stronger immunologic vaccination response in hemodialysis patients. While the response rate was good, only a minority developed high antibody titres, 47 (43-50) days after the second vaccine dose.
Keywords: COVID-19; Coronavirus; SARS-CoV-2; anti-SARS-CoV-2 spike protein IgG antibodies; hemodialysis; vaccination.
. 2022 Mar 4;e13152.
doi: 10.1111/sji.13152. Online ahead of print.
Improved immunologic response to COVID-19 vaccine with prolonged dosing interval in hemodialysis patients
Mathias Haarhaus[SUP] 1 2 [/SUP], Monica Duhanes[SUP] 1 [/SUP], Nataša Leševic[SUP] 1 [/SUP], Bogdan Matei[SUP] 1 [/SUP], Bernd Ramsauer[SUP] 1 [/SUP], Rui Da Silva Rodrigues[SUP] 3 [/SUP], Jun Su[SUP] 3 [/SUP], Michael Haase[SUP] 1 4 [/SUP], Carla Santos-Araújo[SUP] 1 5 [/SUP], Fernando Macario[SUP] 1 [/SUP]
Affiliations
- PMID: 35244289
- DOI: 10.1111/sji.13152
Abstract
Vaccination against 2019 coronavirus disease (COVID-19) can reduce disease incidence and severity. Dialysis patients demonstrate a delayed immunologic response to vaccines. We determined factors affecting the immunologic response to COVID-19 vaccines in hemodialysis patients. All patients within a Swedish hemodialysis network, vaccinated with two doses of COVID-19 vaccine 2-8 weeks before inclusion, were eligible for this cross-sectional study. Severe adult respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein antibody levels were determined by EliA SARS-CoV-2-Sp1 IgG test (Thermo Fisher Scientific, Phadia AB) and related to clinical and demographic parameters. Eighty-nine patients were included. Patients were vaccinated with two doses of Comirnaty (BNT162b2, 73%) or Spikevax (mRNA-1273, 23,6%). Three patients received combinations of different vaccines. Response rate (antibody titres > 7 U/mL) was 89.9%, while 39.3% developed high antibody titres (> 204 U/mL), 47 (43-50) days after the second dose. A previous COVID-19 infection associated with higher antibody titres (median (25[SUP]th[/SUP] - 75[SUP]th[/SUP] percentile) 1,558.5 (814.5-3,763.8) U/mL vs. 87 (26-268) U/mL, p=0.002), while time between vaccine doses did not differ between groups (p=0.7). Increasing SARS-CoV-2 antibody titres were independently associated with increasing time between vaccine doses (B 0.241, P=0.02), decreasing serum calcium levels (B -0.233, P=0.007), and previous COVID-19 (B 1.078, P<0.001). In conclusion, a longer interval between COVID-19 mRNA vaccine doses, lower calcium, and a previous COVID-19 infection were independently associated with a stronger immunologic vaccination response in hemodialysis patients. While the response rate was good, only a minority developed high antibody titres, 47 (43-50) days after the second vaccine dose.
Keywords: COVID-19; Coronavirus; SARS-CoV-2; anti-SARS-CoV-2 spike protein IgG antibodies; hemodialysis; vaccination.