Hemodialysis patients (HDP) and kidney transplant recipients (KTR) have a high risk of infection with SARS-CoV-2 with poor clinical outcomes. Because of this, vaccination of these groups of patients against SARS-CoV-2 is particularly important. However, immune responses may be impaired in immunosuppressed and chronically ill patients. Here, our aim was to compare the efficacy of an mRNA-based vaccine in HDP, KTR, and healthy subjects. Design: In this prospective observational cohort study, the humoral and cellular response of prevalent 192 HDP, 50 KTR, and 28 healthy controls (HC) was assessed 1, 2, and 6 months after the first immunization with the BNT162b2 mRNA vaccine. Results: After 6 months, 97.5% of HDP, 37.9% of KTR, and 100% of HC had an antibody response. Median antibody levels were 1539.7 (±3355.8), 178.5 (±369.5), and 2657.8 (±2965.8) AU/mL in HDP, KTR, and HC, respectively ( p ≤ 0.05). A SARS-CoV-2 antigen-specific cell response to vaccination was found in 68.8% of HDP, 64.5% of KTR, and 90% of HC. Conclusion: The humoral response rates to mRNA-based vaccination of HDPs are comparable to HCs, but antibody titers are lower. Furthermore, HDPs have weaker T-cell response to vaccination than HCs. KTRs have very low humoral and antigen-specific cellular response rates and antibody titers, which requires other vaccination strategies in addition to booster vaccination.
【저자키워드】 COVID-19, Immunosuppression, end-stage kidney disease, transplantation, 【초록키워드】 SARS-CoV-2, Efficacy, immune response, vaccination, antibody, Antibody Response, T-cell Response, immunization, clinical outcomes, Patient, Antibody titer, group, Antibody titers, BNT162b2 mRNA vaccine, booster vaccination, kidney transplant recipient, cellular response, Immunosuppressed, Vaccination strategy, humoral, high risk, healthy control, healthy subjects, mRNA-based vaccine, Cell, prevalent, addition, comparable, HCs, ill patients, infection with SARS-CoV-2, mRNA-based, prospective observational cohort, response to vaccination, 【제목키워드】 SARS-CoV-2, Transplant, response, recipient,