Abstract
Background: Patients with chronic kidney disease, dialysis patients and kidney transplant patients are at high risk of developing severe coronavirus disease 2019 (COVID-19). Data regarding the immunogenicity of anti-severe acute respiratory syndrome coronavirus 2 messenger RNA (anti-SARS-CoV-2 mRNA) vaccines in dialysis patients were published recently. We assessed the immunogenicity of anti-SARS-CoV-2 mRNA vaccine in dialysis patients.
Patients and methods: One hundred and nine patients on haemodialysis (n = 85) or peritoneal dialysis (n = 24) have received two injections of 30-μg doses of BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) that were administered intramuscularly 28 days apart. Those who were still seronegative after the second dose were given a third dose 1 month later. Anti-SARS-CoV-2 antibodies were tested before and after vaccination.
Results: Ninety-one out of the 102 patients who had at least a 1-month follow-up after the second (n = 97) or the third (n = 5) vaccine doses had anti-SARS-CoV-2 antibodies. The seroconversion rate was 88.7% (86 out of 97 patients) among SARS-CoV-2 seronegative patients at the initiation of vaccination. Receiving immunosuppressive therapy was an independent predictive factor for non-response to vaccination.
Conclusion: Due to high immunogenicity and safety of mRNA vaccines, we strongly recommend prioritizing a two-dose vaccination of dialysis patients. A third dose can be required in non-responders to two doses. When possible, patients waiting for a kidney transplantation should be offered the vaccine before transplantation.
Keywords: COVID-19; SARS-CoV-2; haemodialysis; immunosuppression; peritoneal dialysis.
【저자키워드】 COVID-19, SARS-CoV-2, Immunosuppression, Haemodialysis, Peritoneal dialysis, 【초록키워드】 Vaccine, coronavirus, COVID-19 vaccine, vaccination, therapy, antibody, mRNA vaccine, Chronic kidney disease, anti-SARS-CoV-2, dialysis, mRNA vaccines, kidney, vaccine dose, anti-SARS-CoV-2 antibodies, mRNA, Patient, Follow-up, Peritoneal dialysis, patients, Pfizer-BioNTech, seronegative, kidney transplant, dose, immunosuppressive, high risk, Predictive, Messenger RNA, acute respiratory syndrome, severe coronavirus disease, second dose, injection, seroconversion rate, doses, Administered, non-responder, independent, tested, required, nine, were given, the vaccine, intramuscularly, of BNT162b2, offered, seronegative patient, 【제목키워드】 Vaccine, dialysis, Patient,