Humoral response after SARS-CoV-2 mRNA vaccine in a cohort of hemodialysis patients and kidney transplant recipients

Date:  June 17, 2021

Time: 11:00am PDT, 8:00pm CET

BACKGROUND Kidney transplant recipients and patients on hemodialysis are immunocompromised populations excluded from vaccine trials. Data are lacking regarding their humoral response to COVID vaccination. METHODS We investigated early serological response after COVID 19 vaccination with Pfizer/BioNTech (BNT162b2) mRNA vaccine in 78 patients undergoing hemodialysis, 74 kidney transplant recipients, and 7 healthy controls. Antibody titers against SARS-CoV-2 were measured at 0, 14, 28, 36 and 58 days after the first injection. RESULTS In controls, antibodies were detected at a positive level (>13 AU/ml) at day 14 post-injection, and increased progressively, to peak at day 36 (1082 AU/mL [IQR: 735.0-1662]). Patients undergoing hemodialysis had lower titers that peaked at day 58 (276 AU/mL [IQR 83.4-526.0]. A positive antibody level was detected in only 3 kidney transplant recipients. In hemodialysis patients, age, serum albumin and Kt/V were positively correlated with serological response (p< 0.043 and p<0.019 respectively); non responders to HBV vaccine had the lowest titers of anti-SARS-CoV-2 antibodies. CONCLUSIONS Our results suggest that the post-vaccine humoral response is strongly inhibited by immunosuppressant therapy in kidney transplant recipients, while it is lowered by the uremic condition in patients undergoing hemodialysis.

Learning Objectives

• Evaluate the humoral response after SARS-CoV-2 mRNA vaccine in a setting of fragile individuals
• To assess the performance of serology assay in post vaccination monitoring of fragile individuals
• To evaluate the clinical impact of serology test in monitoring humoral response of fragile individuals

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