Jens Van Praet1,2, Marijke Reynders3, Dirk De Bacquer4, Liesbeth Viaene5, Melanie K Schoutteten6,7, Rogier Caluwé8, Peter Doubel5, Line Heylen6,9, Annelies V De Bel10, Bruno Van Vlem8, Deborah Steensels11, An S De Vriese12,2. 1. Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge, Brugge, Belgium. 2. Department of Internal Medicine, Ghent University, Ghent, Belgium. 3. Division of Medical Microbiology, AZ Sint-Jan Brugge, Brugge, Belgium. 4. Department of Public Health and Primary Care, Ghent University, Belgium. 5. Division of Nephrology, AZ Groeninge, Kortrijk, Belgium. 6. Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. 7. Department of Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium. 8. Division of Nephrology, OLV Hospital Aalst, Aalst, Belgium. 9. Division of Nephrology, Ziekenhuis Oost-Limburg, Genk, Belgium. 10. Laboratory of Clinical Biology, Department of Microbiology, AZ Groeninge, Kortrijk, Belgium. 11. Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium. 12. Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge, Brugge, Belgium an.devriese@azsintjan.be.
Abstract
BACKGROUND: Preliminary evidence suggests patients on hemodialysis have a blunted early serological response to SARS-CoV-2 vaccination. Optimizing the vaccination strategy in this population requires a thorough understanding of predictors and dynamics of humoral and cellular immune responses to different SARS-CoV-2 vaccines. METHODS: This prospective multicenter study of 543 patients on hemodialysis and 75 healthy volunteers evaluated the immune responses at 4 or 5 weeks and 8 or 9 weeks after administration of the BNT162b2 or mRNA-1273 vaccine, respectively. We assessed anti-SARS-CoV-2 spike antibodies and T cell responses by IFN-γ secretion of peripheral blood lymphocytes upon SARS-CoV-2 glycoprotein stimulation (QuantiFERON assay) and evaluated potential predictors of the responses. RESULTS: Compared with healthy volunteers, patients on hemodialysis had an incomplete, delayed humoral immune response and a blunted cellular immune response. Geometric mean antibody titers at both time points were significantly greater in patients vaccinated with mRNA-1273 versus BNT162b2, and a larger proportion of them achieved the threshold of 4160 AU/ml, corresponding with high neutralizing antibody titers in vitro (53.6% versus 31.8% at 8 or 9 weeks, P<0.0001). Patients vaccinated with mRNA-1273 versus BNT162b2 exhibited significantly greater median QuantiFERON responses at both time points, and a larger proportion achieved the threshold of 0.15 IU/ml (64.4% versus 46.9% at 8 or 9 weeks, P<0.0001). Multivariate analysis identified COVID-19 experience, vaccine type, use of immunosuppressive drugs, serum albumin, lymphocyte count, hepatitis B vaccine nonresponder status, and dialysis vintage as independent predictors of the humoral and cellular responses. CONCLUSIONS: The mRNA-1273 vaccine's greater immunogenicity may be related to its higher mRNA dose. This suggests a high-dose vaccine might improve the impaired immune response to SARS-CoV-2 vaccination in patients on hemodialysis.
BACKGROUND: Preliminary evidence suggests patients on hemodialysis have a blunted early serological response to SARS-CoV-2 vaccination. Optimizing the vaccination strategy in this population requires a thorough understanding of predictors and dynamics of humoral and cellular immune responses to different SARS-CoV-2 vaccines. METHODS: This prospective multicenter study of 543 patients on hemodialysis and 75 healthy volunteers evaluated the immune responses at 4 or 5 weeks and 8 or 9 weeks after administration of the BNT162b2 or mRNA-1273 vaccine, respectively. We assessed anti-SARS-CoV-2 spike antibodies and T cell responses by IFN-γ secretion of peripheral blood lymphocytes upon SARS-CoV-2 glycoprotein stimulation (QuantiFERON assay) and evaluated potential predictors of the responses. RESULTS: Compared with healthy volunteers, patients on hemodialysis had an incomplete, delayed humoral immune response and a blunted cellular immune response. Geometric mean antibody titers at both time points were significantly greater in patients vaccinated with mRNA-1273 versus BNT162b2, and a larger proportion of them achieved the threshold of 4160 AU/ml, corresponding with high neutralizing antibody titers in vitro (53.6% versus 31.8% at 8 or 9 weeks, P<0.0001). Patients vaccinated with mRNA-1273 versus BNT162b2 exhibited significantly greater median QuantiFERON responses at both time points, and a larger proportion achieved the threshold of 0.15 IU/ml (64.4% versus 46.9% at 8 or 9 weeks, P<0.0001). Multivariate analysis identified COVID-19 experience, vaccine type, use of immunosuppressive drugs, serum albumin, lymphocyte count, hepatitis B vaccine nonresponder status, and dialysis vintage as independent predictors of the humoral and cellular responses. CONCLUSIONS: The mRNA-1273 vaccine's greater immunogenicity may be related to its higher mRNA dose. This suggests a high-dose vaccine might improve the impaired immune response to SARS-CoV-2 vaccination in patients on hemodialysis.
Authors: Arne Sattler; Eva Schrezenmeier; Ulrike A Weber; Alexander Potekhin; Friederike Bachmann; Henriette Straub-Hohenbleicher; Klemens Budde; Elena Storz; Vanessa Proß; Yasmin Bergmann; Linda Ml Thole; Caroline Tizian; Oliver Hölsken; Andreas Diefenbach; Hubert Schrezenmeier; Bernd Jahrsdörfer; Tomasz Zemojtel; Katharina Jechow; Christian Conrad; Sören Lukassen; Diana Stauch; Nils Lachmann; Mira Choi; Fabian Halleck; Katja Kotsch Journal: J Clin Invest Date: 2021-07-15 Impact factor: 14.808
Authors: Carolina Lucas; Jon Klein; Maria E Sundaram; Feimei Liu; Patrick Wong; Julio Silva; Tianyang Mao; Ji Eun Oh; Subhasis Mohanty; Jiefang Huang; Maria Tokuyama; Peiwen Lu; Arvind Venkataraman; Annsea Park; Benjamin Israelow; Chantal B F Vogels; M Catherine Muenker; C-Hong Chang; Arnau Casanovas-Massana; Adam J Moore; Joseph Zell; John B Fournier; Anne L Wyllie; Melissa Campbell; Alfred I Lee; Hyung J Chun; Nathan D Grubaugh; Wade L Schulz; Shelli Farhadian; Charles Dela Cruz; Aaron M Ring; Albert C Shaw; Adam V Wisnewski; Inci Yildirim; Albert I Ko; Saad B Omer; Akiko Iwasaki Journal: Nat Med Date: 2021-05-05 Impact factor: 53.440
Authors: Jonathan G Braun; Susan Cheng; Kimia Sobhani; Joseph E Ebinger; Justyna Fert-Bober; Ignat Printsev; Min Wu; Nancy Sun; John C Prostko; Edwin C Frias; James L Stewart; Jennifer E Van Eyk Journal: Nat Med Date: 2021-04-01 Impact factor: 53.440
Authors: Shuchi Anand; Maria E Montez-Rath; Jialin Han; Pablo Garcia; LinaCel Cadden; Patti Hunsader; Russell Kerschmann; Paul Beyer; Mary Dittrich; Geoffrey A Block; Scott D Boyd; Julie Parsonnet; Glenn M Chertow Journal: J Am Soc Nephrol Date: 2021-06-11 Impact factor: 14.978
Authors: Philippe Attias; Hamza Sakhi; Philippe Rieu; Arvish Soorkia; David Assayag; Sabrina Bouhroum; Patrice Nizard; Khalil El Karoui Journal: Kidney Int Date: 2021-04-20 Impact factor: 10.612
Authors: Johan De Meester; Dirk De Bacquer; Maarten Naesens; Bjorn Meijers; Marie M Couttenye; An S De Vriese Journal: J Am Soc Nephrol Date: 2020-11-05 Impact factor: 10.121
Authors: Chiara Cantarelli; Andrea Angeletti; Laura Perin; Luis Sanchez Russo; Gianmarco Sabiu; Manuel Alfredo Podestà; Paolo Cravedi Journal: Clin Kidney J Date: 2022-07-27
Authors: Bas Calcoen; Nico Callewaert; Aline Vandenbulcke; Winnie Kerstens; Maya Imbrechts; Thomas Vercruysse; Kai Dallmeier; Johan Van Weyenbergh; Piet Maes; Xavier Bossuyt; Dorinja Zapf; Kersten Dieckmann; Kim Callebaut; Hendrik Jan Thibaut; Karen Vanhoorelbeke; Simon F De Meyer; Wim Maes; Nick Geukens Journal: Viruses Date: 2022-06-09 Impact factor: 5.818
Authors: Louise Füessl; Tobias Lau; Isaac Lean; Sandra Hasmann; Bernhard Riedl; Florian M Arend; Johanna Sorodoc-Otto; Daniela Soreth-Rieke; Marcell Toepfer; Simon Rau; Haxhrije Salihi-Halimi; Michael Paal; Wilke Beuthien; Norbert Thaller; Yana Suttmann; Gero von Gersdorff; Ron Regenauer; Anke von Bergwelt-Baildon; Daniel Teupser; Mathias Bruegel; Michael Fischereder; Ulf Schönermarck Journal: Vaccines (Basel) Date: 2022-04-13
Authors: Steven M Brunelli; Scott Sibbel; Steph Karpinski; Gilbert Marlowe; Adam G Walker; Jeffrey Giullian; David Van Wyck; Tara Kelley; Rachael Lazar; Meredith L Zywno; Jeffrey J Connaire; Amy Young; Francesca Tentori Journal: J Am Soc Nephrol Date: 2022-02-08 Impact factor: 14.978
Authors: An S De Vriese; Jens Van Praet; Marijke Reynders; Line Heylen; Liesbeth Viaene; Rogier Caluwé; Melanie Schoutteten; Dirk De Bacquer Journal: Kidney Int Rep Date: 2022-02-22