Humoral Response to BNT162b2 and CoronaVac in Patients Undergoing Maintenance Hemodialysis: A Multicenter Prospective Cohort Study

Nephron. 2023;147(7):392-400. doi: 10.1159/000528170. Epub 2023 Jan 5.

Abstract

Introduction: Data regarding inactivated vaccines for SARS-CoV-2 in patients undergoing maintenance hemodialysis (MHD) are limited. We aimed to investigate humoral responses induced by CoronaVac compared to BNT162b2 in this population.

Methods: In this multicenter prospective cohort study, adult patients undergoing MHD who lacked a history of COVID-19 and decided to get vaccinated with BNT162b2 or CoronaVac were enrolled. Participants provided serum samples before, 1 and 3 months after 2 doses. Anti-SARS-CoV-2 IgG antibodies against receptor-binding domain of the virus were measured, and levels ≥50 AU/mL were considered as positive. Breakthrough infections and adverse events were recorded.

Results: Ninety-two patients were included, 68 (73.9%) of whom were seronegative at baseline. BNT162b2 and CoronaVac were administered in 38 (55.9%) and 30 (44.1%) patients. At 1 month, seropositivity was 93.1% in BNT162b2 and 88% in CoronaVac groups (p = 0.519). Quantitative antibody levels were significantly higher in BNT162b2 (p < 0.001). At 3 months, both seropositivity (96.4% and 78.3%, p = 0.045) and antibody levels (p = 0.001) remained higher in BNT162b2 compared to CoronaVac. Five patients (7.4%) experienced breakthrough COVID-19. Adverse events were more frequent with BNT162b2, although all of them were mild. Multiple linear regression model showed that only vaccine choice (BNT162b2) was related to the humoral response (β = 0.272, p = 0.038). Seropositive patients at baseline (n = 24) had higher antibody levels at any time point.

Conclusions: BNT162b2 and CoronaVac induced humoral responses in naïve patients undergoing MHD, which were more robust and durable for 3 months after BNT162b2. Both vaccines created high antibody levels in patients who were seropositive at baseline.

Keywords: COVID-19; Dialysis; Hemodialysis; SARS-CoV-2; Vaccine.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Viral
  • BNT162 Vaccine*
  • COVID-19 Vaccines
  • COVID-19*
  • Humans
  • Prospective Studies
  • Renal Dialysis
  • SARS-CoV-2

Substances

  • BNT162 Vaccine
  • sinovac COVID-19 vaccine
  • COVID-19 Vaccines
  • Antibodies, Viral

Grants and funding

This work was supported by Scientific Research Projects Coordination Unit of Bezmialem Vakif University with the project number 20210613. Funding source had no role in study design, execution, and reporting.