key: cord-0908656-5vlc3g6b
authors: Ducloux, D.; Colladant, M.; Chabannes, M.; Yannaraki, M.; Courivaud, C.
title: Humoral response after three doses of BNT162b2 mRNA COVID-19 vaccine in patients on hemodialysis
date: 2021-06-30
journal: Kidney Int
DOI: 10.1016/j.kint.2021.06.025
sha: daf6ebdfb4badda033dd70c239691a65106b9b0f
doc_id: 908656
cord_uid: 5vlc3g6b

nan

Dear Sir, Dialysis patients are at increased risk of severe COVID-19 infections (1) . Therefore, there are considered as being a priority population for COVID-19 vaccination. Because immune responses against vaccines are considerably reduced in this population (2), a vaccination strategy including three doses of vaccine has been recommended for dialysis patients.

However, few data exist concerning humoral response to SARS-coV-2 vaccination with three doses of BNT162b2 (Pfizer-BioNTech) in patients on hemodialysis (HD). Moreover, about 90% of HD patients exhibit antibody positivity after two injections of vaccine (3) (4) (5) (6) and the relevance of a third dose is questionable. Nevertheless, only 75% exhibit robust responses after two doses and a vaccine booster may be useful (7) .

We studied vaccine response in 50 HD patients COVID-19 naïve (no clinical history, negative serology) having received the BNT162b2 mRNA COVID-19 vaccine and 15 HD patients with a history of COVID-19 infections. Three doses of vaccine were proposed for naïve patients and two for those previously exposed to COVID-19.

Forty-five naïve patients received three doses whereas five received only two doses (refusal of patients). Humoral response was studied using the SARS-Cov-2 immunoassay, Abbott® designed to detect IgG antibodies to the receptor-binding domain (RBD) of the S1 subunit of the spike protein of SARS-CoV-2. As a relevant threshold cannot be determined, we used that provided by the Manufacturer. We report in a single center study that 90% of dialysis patients have a vaccine response after two doses of BNT162b2 mRNA COVID-19 vaccine. A third dose enhances humoral response in almost all patients (Figure 3 ), but especially in those with lower antibody titers after two doses. Moreover, a fraction of non-responders after two doses develops a strong response after the third dose. Dialysis patients with low humoral response may benefit from a third dose of BNT162b2 mRNA COVID-19 vaccine.

J o u r n a l P r e -p r o o f

COVID-19 in dialysis patients: outlasting and outsmarting a pandemic

Impaired immune responses and antigen-specific memory CD4+ T cells in hemodialysis patients

Humoral Response to SARS-CoV-2-Vaccination with BNT162b2 (Pfizer-BioNTech) in Patients on Hemodialysis

Efficacy of the BNT162b2 mRNA COVID-19 vaccine in a hemodialysis cohort

Immunogenicity of SARS-CoV-2 Vaccine in Dialysis

Impaired Humoral Response in Renal Transplant Recipients to SARS-CoV-2 Vaccination with BNT162b2