How Well Do Hemodialysis Patients Respond to the BNT162b2 mRNA COVID-19 Vaccine?

Fernando Carrera ,Belarmino Spencer ,Marco P.c Marques ,Luciano José Pereira ,Isabel Mafra ,Francisco Ferrer

doi:10.33696/nephrology.1.004

Abstract

Background: Hemodialysis patients as well as healthcare workers are considered to be in a high-risk category for SARS-CoV-2 infection and a priority for vaccination. Methods: In a single-center out-patient hemodialysis unit, 46 healthcare workers and 216 patients were vaccinated simultaneously with BNT162b2 (BioNTech-Pfizer) vaccine. They received two doses, 21 days apart. The primary objectives were to evaluate the safety and efficacy of the vaccine. Results: There were no major adverse events in either group. Lymphadenopathy was reported by some health workers. All (100%) individuals in the healthcare workers group developed a positive antibody response (anti-S IgG) after the second dose compared with 91.7% of patients. Among patients there was a significant negative correlation between anti-S levels and age after both, the first dose (R= -0.176, p=0.01) and the second dose (R= -0.193, p=0.005);there was also a significant negative correlation between anti-S and Charlson Comorbidity Index adjusted for age after both, the first dose (R= -0.150, p=0.028) and the second dose (R= -0.163, p=0.018). Finally, a negative correlation between anti-S and Body Mass Index was found after the first dose (R= -0.140, p=0.04). No correlations were found with dialysis vintage, Kt/V, or diabetes. Conclusions: Following vaccination, patients had a significantly lower anti-S response than healthcare workers. Age, Charlson Comorbidity Index and Body Mass Index negatively impacted the humoral response. However, with more than 91% response we believe that vaccination can be recommended strongly in the hemodialysis population.

Highlights

Hemodialysis patients as well as healthcare workers are considered to be in a high-risk category for SARS-CoV-2 infection and a priority for vaccination
This study aimed to evaluate the antibody response following a mRNA COVID-19 vaccination program in an in-center hemodialysis (ICHD) population
Systemic reactions within 7 days after each dose: Systemic reactions were reported more often by healthcare workers than by patients; in both groups, they were more prevalent after the second dose

Summary

Introduction

Hemodialysis patients as well as healthcare workers are considered to be in a high-risk category for SARS-CoV-2 infection and a priority for vaccination. Over one hundred and eighty-five million people have been infected by SARS-CoV-2 and roughly four million have died worldwide so far [2]. The range of effective therapeutics is broadening, vaccination has emerged as the best solution to ameliorate the severity of the disease and to achieve community immunity. A successfully implemented global vaccination program appears to offer the best chance for society to return to its pre-pandemic state. MRNA vaccines targeting SARS-CoV-2 became available with unprecedented speed [5], within a few months of the genomic identification of the virus [6] The development of a new vaccine, takes years. mRNA vaccines targeting SARS-CoV-2 became available with unprecedented speed [5], within a few months of the genomic identification of the virus [6]

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Methods

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Conclusion