key: cord-0811752-tixni8y9
authors: Ficociello, Linda H.; Willetts, Joanna; Mullon, Claudy; Mysayphonh, Chance; Dahne-Steuber, Ines A.; Johnson, Curtis; Pollan, Melanie; Alexander, Sandra; Mulhern, Jeffrey G.; Kossmann, Robert J.; Anger, Michael S.; Hymes, Jeffrey L.
title: Antibody Response Among Maintenance Dialysis Patients to the COVID-19 Ad26.COV2.S Vaccine
date: 2022-01-13
journal: Kidney Med
DOI: 10.1016/j.xkme.2022.100409
sha: 7d9ee5c9285ce6a683281577c210dd533f0ba949
doc_id: 811752
cord_uid: tixni8y9

nan

This quality improvement project aimed to determine whether dialysis patients on various dialysis modalities, vaccinated in dialysis clinics or the community, differed in antibody response to COVID-19 Ad26.COV2.S vaccine. All patients vaccinated with Ad26.COV2.S in twenty dialysis clinics selected in order to maximize patients with various dialysis modalities and vaccination setting, were eligible. Antibody response was measured in remnant blood samples from routine laboratory tests obtained July-August 2021. All patients allowed use of remnant blood samples collected for routine care for research purposes as part of the consent form signed upon receiving treatment. As such, no additional study-specific informed consent nor institutional review board approval was required. Average time between vaccination and sample draw was 95+12 days. Response was assessed using a semi-quantitative chemiluminescent assay for immunoglobulin-G directed against the receptor binding domain of the S1 subunit of SARS-CoV-2 spike antigen (ADVIA Centaur® XP/XPT sCOVG; Siemens Healthcare Diagnostics Inc.; Tarrytown). The index range is 0.5-750 and indices of >1 were considered reactive (1).

Although a relationship between index value and immunity has not been defined, indices >7 meet FDA requirement of an acceptable level of a neutralizing titer (2, 3) . Heparin is used in hemodialysis to prevent clotting and in vitro studies have revealed that adenovirus vectors utilizing CD46-dependent pathway and heparin sulfate proteoglycans cellular entry pathway are inhibited by heparin (6) . However, it is unknown whether heparin exposure in dialysis at the time of vaccination impacts antibody response.

We can assess the potential for heparin administration and its proximity to vaccination across modalities. Among G-HDclinic patients, 99% had dialysis on the same day as vaccination and 85% had documented heparin administration. Although the exact timing of vaccination in relation to the heparin administration is unknown, we may assume that this group has the highest degree of potential heparin exposure compared to other groups. G-HDcommunity or G-HHD patients may or may not have had dialysis or 

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