Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients

Viruses. 2022 Nov 26;14(12):2646. doi: 10.3390/v14122646.

Abstract

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a serious hazard for hemodialysis (HD) patients and kidney transplant (KTX) recipients as they suffer from an impaired immune response to SARS-CoV-2 vaccination. In addition, a definition of SARS-CoV-2 IgG titer that indicates a sufficient immune response, especially against new omicron variants, is urgently needed. In the present study, the immune response to either a third or a fourth dose of a mRNA vaccine was investigated in 309 dialysis and 36 KTX patients. SARS-CoV-2 IgG titer thresholds indicating neutralizing activity against wild type (WT) and the omicron variant BA.1 were quantified. After four vaccine doses, a high-neutralizing activity against WT was evidenced in HD patients, whereas the neutralizing rate against BA.1 was significant lower. Concerning KTX recipients, humoral and cellular immune responses after a third vaccination were still highly impaired. This calls for modified omicron-targeting vaccines.

Keywords: BA.1; SARS-CoV-2; booster; dialysis; immunosuppression; kidney disease; neutralization; protection; surrogate; transplantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • COVID-19 Vaccines
  • COVID-19* / prevention & control
  • Humans
  • Immunity
  • Immunoglobulin G
  • Kidney Transplantation*
  • Renal Dialysis
  • SARS-CoV-2
  • Transplant Recipients
  • Vaccination

Substances

  • COVID-19 Vaccines
  • Immunoglobulin G
  • Antibodies, Viral
  • Antibodies, Neutralizing

Supplementary concepts

  • SARS-CoV-2 variants

Grants and funding

The study at hand was supported by intramural funds. R.-U-M. received support from the Ministry of Science North Rhine-Westphalia and the German Research Foundation (DFG, DI 1501/9-2, MU 3629/6-1).