High immunogenicity of a messenger RNA-based vaccine against SARS-CoV-2 in chronic dialysis patients

• Published in: Nephrology Dialysis Transplantation 2021-09, Vol.36 (9), p.1704-1709
• Main Authors: Longlune, Nathalie, Nogier, Marie Béatrice, Miedougé, Marcel, Gabilan, Charlotte, Cartou, Charles, Seigneuric, Bruno, Del Bello, Arnaud, Marion, Olivier, Faguer, Stanislas, Izopet, Jacques, Kamar, Nassim
• Format: Article
• Language: English
• Subjects: Antibodies, Viral - blood; BNT162 Vaccine; COVID-19 - prevention & control; COVID-19 Vaccines - immunology; Human health and pathology; Humans; Immunogenicity, Vaccine; Infectious diseases; Life Sciences; mRNA Vaccines; Original - Dialysis; Renal Dialysis; Vaccines, Synthetic - immunology
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfab193

Abstract Background Patients with chronic kidney disease, dialysis patients and kidney transplant patients are at high risk of developing severe coronavirus disease 2019 (COVID-19). Data regarding the immunogenicity of anti-severe acute respiratory syndrome coronavirus 2 messenger RNA (anti-SARS-CoV-2 mRNA) vaccines in dialysis patients were published recently. We assessed the immunogenicity of anti-SARS-CoV-2 mRNA vaccine in dialysis patients. Patients and methods One hundred and nine patients on haemodialysis (n = 85) or peritoneal dialysis (n = 24) have received two injections of 30-μg doses of BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) that were administered intramuscularly 28 days apart. Those who were still seronegative after the second dose were given a third dose 1 month later. Anti-SARS-CoV-2 antibodies were tested before and after vaccination. Results Ninety-one out of the 102 patients who had at least a 1-month follow-up after the second (n = 97) or the third (n = 5) vaccine doses had anti-SARS-CoV-2 antibodies. The seroconversion rate was 88.7% (86 out of 97 patients) among SARS-CoV-2 seronegative patients at the initiation of vaccination. Receiving immunosuppressive therapy was an independent predictive factor for non-response to vaccination. Conclusion Due to high immunogenicity and safety of mRNA vaccines, we strongly recommend prioritizing a two-dose vaccination of dialysis patients. A third dose can be required in non-responders to two doses. When possible, patients waiting for a kidney transplantation should be offered the vaccine before transplantation.