BACKGROUND AND OBJECTIVES: Although most patients receiving maintenance dialysis exhibit initial seroresponse to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, concerns exist regarding the durability of this antibody response. This study evaluated seroresponse over time. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This retrospective cohort study included patients on maintenance dialysis, from a midsize national dialysis provider, who received a complete SARS-CoV-2 vaccine series and had at least one antibody titer checked after full vaccination. IgG spike antibodies (anti-spike IgG) titers were assessed monthly with routine laboratory tests after vaccination; the semiquantitative assay reported a range between zero and ≥20 Index. Descriptive analyses compared trends over time by history of coronavirus disease 2019 (COVID-19) and vaccine type. Time-to-event analyses examined the outcome of loss of seroresponse (anti-spike IgG <1 Index or development of COVID-19). Cox regression adjusted for additional clinical characteristics. RESULTS: Among 1870 patients receiving maintenance dialysis, 1569 had no prior COVID-19. Patients without prior COVID-19 had declining titers over time. Among 443 recipients of BNT162b2 (Pfizer), median (interquartile range) anti-spike IgG titer declined from ≥20 (5.89 to ≥20) in month 1 after full vaccination to 1.96 (0.60-5.88) by month 6. Among 778 recipients of mRNA-1273 (Moderna), anti-spike IgG titer declined from ≥20 (interquartile range, ≥20 to ≥20) in month 1 to 7.99 (2.61 to ≥20) by month 6. The 348 recipients of Ad26.COV2.S (Janssen) had a lower titer response than recipients of an mRNA vaccine over all time periods. In time-to-event analyses, recipients of Ad26.COV2.S and mRNA-1273 had the shortest and longest time to loss of seroresponse, respectively. The maximum titer reached in the first 2 months after full vaccination was associated with durability of the anti-spike IgG seroresponse; patients with anti-spike IgG titer 1-19.99 had a shorter time to loss of seroresponse compared with patients with anti-spike IgG titer ≥20 (hazard ratio, 15.5; 95% confidence interval, 11.7 to 20.7). CONCLUSIONS: Among patients receiving maintenance dialysis, vaccine-induced seroresponse wanes over time across vaccine types. Early titers after full vaccination are associated with the durability of seroresponse.
BACKGROUND AND OBJECTIVES: Although most patients receiving maintenance dialysis exhibit initial seroresponse to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, concerns exist regarding the durability of this antibody response. This study evaluated seroresponse over time. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This retrospective cohort study included patients on maintenance dialysis, from a midsize national dialysis provider, who received a complete SARS-CoV-2 vaccine series and had at least one antibody titer checked after full vaccination. IgG spike antibodies (anti-spike IgG) titers were assessed monthly with routine laboratory tests after vaccination; the semiquantitative assay reported a range between zero and ≥20 Index. Descriptive analyses compared trends over time by history of coronavirus disease 2019 (COVID-19) and vaccine type. Time-to-event analyses examined the outcome of loss of seroresponse (anti-spike IgG <1 Index or development of COVID-19). Cox regression adjusted for additional clinical characteristics. RESULTS: Among 1870 patients receiving maintenance dialysis, 1569 had no prior COVID-19. Patients without prior COVID-19 had declining titers over time. Among 443 recipients of BNT162b2 (Pfizer), median (interquartile range) anti-spike IgG titer declined from ≥20 (5.89 to ≥20) in month 1 after full vaccination to 1.96 (0.60-5.88) by month 6. Among 778 recipients of mRNA-1273 (Moderna), anti-spike IgG titer declined from ≥20 (interquartile range, ≥20 to ≥20) in month 1 to 7.99 (2.61 to ≥20) by month 6. The 348 recipients of Ad26.COV2.S (Janssen) had a lower titer response than recipients of an mRNA vaccine over all time periods. In time-to-event analyses, recipients of Ad26.COV2.S and mRNA-1273 had the shortest and longest time to loss of seroresponse, respectively. The maximum titer reached in the first 2 months after full vaccination was associated with durability of the anti-spike IgG seroresponse; patients with anti-spike IgG titer 1-19.99 had a shorter time to loss of seroresponse compared with patients with anti-spike IgG titer ≥20 (hazard ratio, 15.5; 95% confidence interval, 11.7 to 20.7). CONCLUSIONS: Among patients receiving maintenance dialysis, vaccine-induced seroresponse wanes over time across vaccine types. Early titers after full vaccination are associated with the durability of seroresponse.
Authors: Fernando P Polack; Stephen J Thomas; Nicholas Kitchin; Judith Absalon; Alejandra Gurtman; Stephen Lockhart; John L Perez; Gonzalo Pérez Marc; Edson D Moreira; Cristiano Zerbini; Ruth Bailey; Kena A Swanson; Satrajit Roychoudhury; Kenneth Koury; Ping Li; Warren V Kalina; David Cooper; Robert W Frenck; Laura L Hammitt; Özlem Türeci; Haylene Nell; Axel Schaefer; Serhat Ünal; Dina B Tresnan; Susan Mather; Philip R Dormitzer; Uğur Şahin; Kathrin U Jansen; William C Gruber Journal: N Engl J Med Date: 2020-12-10 Impact factor: 91.245
Authors: Amarendra Pegu; Sarah E O'Connell; Stephen D Schmidt; Sijy O'Dell; Chloe A Talana; Lilin Lai; Jim Albert; Evan Anderson; Hamilton Bennett; Kizzmekia S Corbett; Britta Flach; Lisa Jackson; Brett Leav; Julie E Ledgerwood; Catherine J Luke; Mat Makowski; Martha C Nason; Paul C Roberts; Mario Roederer; Paulina A Rebolledo; Christina A Rostad; Nadine G Rouphael; Wei Shi; Lingshu Wang; Alicia T Widge; Eun Sung Yang; John H Beigel; Barney S Graham; John R Mascola; Mehul S Suthar; Adrian B McDermott; Nicole A Doria-Rose; Jae Arega; John H Beigel; Wendy Buchanan; Mohammed Elsafy; Binh Hoang; Rebecca Lampley; Aparna Kolhekar; Hyung Koo; Catherine Luke; Mamodikoe Makhene; Seema Nayak; Rhonda Pikaart-Tautges; Paul C Roberts; Janie Russell; Elisa Sindall; Jim Albert; Pratap Kunwar; Mat Makowski; Evan J Anderson; Amer Bechnak; Mary Bower; Andres F Camacho-Gonzalez; Matthew Collins; Ana Drobeniuc; Venkata Viswanadh Edara; Srilatha Edupuganti; Katharine Floyd; Theda Gibson; Cassie M Grimsley Ackerley; Brandi Johnson; Satoshi Kamidani; Carol Kao; Colleen Kelley; Lilin Lai; Hollie Macenczak; Michele Paine McCullough; Etza Peters; Varun K Phadke; Paulina A Rebolledo; Christina A Rostad; Nadine Rouphael; Erin Scherer; Amy Sherman; Kathy Stephens; Mehul S Suthar; Mehgan Teherani; Jessica Traenkner; Juton Winston; Inci Yildirim; Lee Barr; Joyce Benoit; Barbara Carste; Joe Choe; Maya Dunstan; Roxanne Erolin; Jana Ffitch; Colin Fields; Lisa A Jackson; Erika Kiniry; Susan Lasicka; Stella Lee; Matthew Nguyen; Stephanie Pimienta; Janice Suyehira; Michael Witte; Hamilton Bennett; Nedim Emil Altaras; Andrea Carfi; Marjorie Hurley; Brett Leav; Rolando Pajon; Wellington Sun; Tal Zaks; Rhea N Coler; Sasha E Larsen; Kathleen M Neuzil; Lisa C Lindesmith; David R Martinez; Jennifer Munt; Michael Mallory; Caitlin Edwards; Ralph S Baric; Nina M Berkowitz; Eli A Boritz; Kevin Carlton; Kizzmekia S Corbett; Pamela Costner; Adrian Creanga; Nicole A Doria-Rose; Daniel C Douek; Britta Flach; Martin Gaudinski; Ingelise Gordon; Barney S Graham; LaSonji Holman; Julie E Ledgerwood; Kwanyee Leung; Bob C Lin; Mark K Louder; John R Mascola; Adrian B McDermott; Kaitlyn M Morabito; Laura Novik; Sarah O'Connell; Sijy O'Dell; Marcelino Padilla; Amarendra Pegu; Stephen D Schmidt; Wei Shi; Phillip A Swanson; Chloe A Talana; Lingshu Wang; Alicia T Widge; Eun Sung Yang; Yi Zhang; James D Chappell; Mark R Denison; Tia Hughes; Xiaotao Lu; Andrea J Pruijssers; Laura J Stevens; Christine M Posavad; Michael Gale; Vineet Menachery; Pei-Yong Shi Journal: Science Date: 2021-08-13 Impact factor: 63.714
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Authors: Hafsa Nazir Jatoi; Samina Abbas; Muhammad Saif Abbasi; Misha Asif Tauni; Shamas Ghazanfar; Mohammad Daniyal Zafar Malick; Muhammad Faiq Umar; Muhammad Junaid Tahir; Muhammad Sohaib Asghar; Ali Ahmed Journal: Ann Med Surg (Lond) Date: 2022-05-17
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