key: cord-1047248-ivv64dcr
authors: Hasmann, Sandra; Paal, Michael; Füeßl, Louise; Fischereder, Michael; Schönermarck, Ulf
title: Humoral immunity to SARS-CoV-2 vaccination in haemodialysis patients: (Response to: Humoral and cellular immunity to SARS-CoV-2 vaccination in renal transplant versus dialysis patients: A prospective, multicenter observational study using mRNA-1273 or BNT162b2 mRNA vaccine.)
date: 2021-10-25
journal: Lancet Reg Health Eur
DOI: 10.1016/j.lanepe.2021.100237
sha: 682a84a03248d0223177fc49414d02809a026005
doc_id: 1047248
cord_uid: ivv64dcr

nan

In their prospective multicentre study Stumpf et al. report on the humoral and cellular immunity to SARS-CoV-2 vaccination in the so far largest cohort of dialysis patients [1] . mRNA-based COVID-19 vaccines elicit an antibody response in 80-96% of the dialysis population (Table 1) , which is substantially higher compared to hepatitis B or influenza vaccinations. Table 1 Comparison of SARS-CoV-2 S antibody response rate* and median antibody** titre after vaccination between haemodialysis*** patients and healthy controls**** using the median and the interquartile range. However, when looking in detail at the quantity of the antibody titre their humoral response is significantly lower than in health care workers or non-dialysis patients (Table 1 ). More than half of the haemodialysis patients develop a titre below the lowest Anti-SARS-CoV-2 S titre in the control group [2] . In contrast, haemodialysis patients with a prior infection mount a substantially higher antibody response [3] comparable to nondialysis individuals [2, 4] .

In addition to this apparent diminished antibody response in dialysis patients, concerns also remain about faster waning of antibody levels after vaccination in this group, as is described after natural infection [5] . Given that neutralizing antibody levels have been shown to be highly predictive of immune protection from symptomatic SARS-CoV-2 infection [6] , dialysis patients may benefit from regular antibody testing and intensified vaccine schedules. Therefore further studies should establish antibody thresholds predictive of protection from severe disease, and clarify the role and timing of booster vaccinations in this group.

Sandra Hasmann and Ulf Sch€ onermarck designed the letter; all authors contributed significantly to the content of the letter and have accepted the final version.

This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

The authors have nothing to disclose.

Humoral and cellular immunity to SARS-CoV-2 vaccination in renal transplant versus dialysis patients: a prospective, multicenter observational study using mRNA-1273 or BNT162b2 mRNA vaccine

Antibody response to mRNA SARS-CoV-2 vaccines in hemodialysis patients

Antibody response to mRNA-1273 SARS-CoV-2 vaccine in hemodialysis patients with and without prior COVID-19

Antibody response to the BNT162b2 vaccine in maintenance hemodialysis patients

Kinetics of antiÀSARS-CoV-2 IgG antibodies in hemodialysis patients six months after infection

Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection