Diminishing mRNA Vaccine Responses in Dialysis Patients

Diminishing Immune Responses Against Variants of Concern in Dialysis Patients 4 Months After SARS-CoV-2 mRNA Vaccination

Alex Dulovic; Monika Strengert; Gema Morillas Ramos; Matthias Becker; Johanna Griesbaum; Daniel Junker; Karsten Lürken; Andrea Beigel; Eike Wrenger; Gerhard Lonnemann; Anne Cossmann; Metodi V. Stankov; Alexandra Dopfer-Jablonka; Philipp D. Kaiser; Bjoern Traenkle; Ulrich Rothbauer; Gérard Krause; Nicole Schneiderhan-Marra; Georg M.N. Behrens

Disclosures

Emerging Infectious Diseases. 2022;28(4):743-750. 

In This Article

Abstract and Introduction

Abstract

Patients undergoing chronic hemodialysis were among the first to receive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations because of their increased risk for severe coronavirus disease and high case-fatality rates. By using a previously reported cohort from Germany of at-risk hemodialysis patients and healthy donors, where antibody responses were examined 3 weeks after the second vaccination, we assessed systemic cellular and humoral immune responses in serum and saliva 4 months after vaccination with the Pfizer-BioNTech BNT162b2 vaccine using an interferon-γ release assay and multiplex-based IgG measurements. We further compared neutralization capacity of vaccination-induced IgG against 4 SARS-CoV-2 variants of concern (Alpha, Beta, Gamma, and Delta) by angiotensin-converting enzyme 2 receptor-binding domain competition assay. Sixteen weeks after second vaccination, compared with 3 weeks after, cellular and humoral responses against the original SARS-CoV-2 isolate and variants of concern were substantially reduced. Some dialysis patients even had no detectable B- or T-cell responses.

Introduction

Persistence of vaccination-induced cellular and humoral immune responses is crucial to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or at least provide protection against severe coronavirus disease (COVID-19) that requires hospitalization. As in many other countries, the SARS-CoV-2 vaccination strategy in Germany was based on prioritization by occupation, underlying medical conditions, or advanced age.

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