Abstract
Rationale & objective: Recent studies showed that antibody titers after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the dialysis population are diminished as compared with the general population, suggesting the possible value of a third booster dose. We characterized the humoral response after 3 doses of the BNT162b2 vaccine in patients treated with either maintenance hemodialysis (HD) or peritoneal dialysis (PD).
Study design: Case series.
Setting & participants: 69 French patients (38 HD and 31 PD) treated at a single center who received 3 doses of the BNT162b2 vaccine.
Findings: Humoral response was evaluated using plasma levels of anti-SARS-CoV-2 spike protein S1 immunoglobulin measured after the second dose and at least 3 weeks after the third dose of the BNT162b2 vaccine. Patients (median age 68 years [interquartile range (IQR), 53-76 years], 65% men) had a median anti-S1 antibody level of 284 [IQR, 83-1190] AU/mL after the second dose, and 7,554 [IQR, 2,268-11,736] AU/mL after the third dose. Three patients were nonresponders (anti-S1 antibody level < 0.8 AU/mL), and 12 were weak responders (anti-S1 antibody level 0.8-50 AU/mL) after the second vaccine dose. After the third dose, 1 of the 3 initial nonresponders produced anti-spike antibody, and all the 12 initial weak responders increased their antibody levels. Patients with a greater increase in anti-S1 antibody levels after a third dose had lower antibody levels after the second dose, and a longer time interval between the second and the third dose. Adverse events did not seem to be more common or severe after a third vaccine dose.
Limitations: Observational study, small sample size. Relationship between antibody levels and clinical outcomes is not well understood.
Conclusions: A third dose of the BNT162b2 vaccine substantially increased antibody levels in patients receiving maintenance dialysis and appeared to be as well tolerated as a second dose.
Keywords: Antibody levels; BNT162b2; anti-spike serology; coronavirus disease 2019 (COVID-19); dialysis; end-stage renal disease (ESRD); immune response; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); third booster dose; vaccine; vaccine adverse effects.
【저자키워드】 Vaccine, immune response, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dialysis, Coronavirus disease 2019 (COVID-19), BNT162b2, antibody levels, End-stage renal disease (ESRD), Third booster dose, anti-spike serology, vaccine adverse effects., 【초록키워드】 coronavirus disease, SARS-CoV-2, BNT162b2 vaccine, coronavirus, vaccination, antibody, anti-SARS-CoV-2, observational study, immune, Spike protein, Clinical outcome, vaccine dose, adverse effects, Hemodialysis, Humoral response, Immunoglobulin, Patient, Antibody titer, End-stage renal disease, plasma, General population, Responder, Peritoneal dialysis, booster dose, booster, Anti-spike, anti-spike antibody, dose, humoral, acute respiratory syndrome, Adverse, second dose, median age, rationale, single center, small sample size, French, men, recent, relationship, setting, event, initial, greater, produced, evaluated, receiving, median, characterized, treated, increase in, IQR, patients treated, 【제목키워드】 SARS-CoV-2, response, maintenance,