TY - JOUR
T1 - Risk of strong antibody decline in dialysis and transplant patients after SARS-CoV-2mRNA vaccination
T2 - Six months data from the observational Dia-Vacc study
AU - Stumpf, Julian
AU - Schwöbel, Jörg
AU - Lindner, Tom
AU - Anders, Leona
AU - Siepmann, Torsten
AU - Karger, Claudia
AU - Hüther, Jan
AU - Martin, Heike
AU - Müller, Petra
AU - Faulhaber-Walter, Robert
AU - Langer, Torsten
AU - Schirutschke, Holger
AU - Stehr, Thomas
AU - Meistring, Frank
AU - Pietzonka, Annegret
AU - Anding-Rost, Kirsten
AU - Escher, Katja
AU - Pistrosch, Frank
AU - Schewe, Jens
AU - Seidel, Harald
AU - Barnett, Kerstin
AU - Pluntke, Thilo
AU - Cerny, Simon
AU - Paliege, Alexander
AU - Bast, Ingolf
AU - Steglich, Anne
AU - Gembardt, Florian
AU - Kessel, Friederike
AU - Kröger, Hannah
AU - Arndt, Patrick
AU - Sradnick, Jan
AU - Frank, Kerstin
AU - Klimova, Anna
AU - Mauer, René
AU - Grählert, Xina
AU - Tonn, Torsten
AU - Hugo, Christian
N1 - Funding Information:
We acknowledge the support from the DIA-VACC Investigators (see full list in Appendix). D. Michael Albrecht, Medizinischer Vorstand (Sprecher), Universitätsklinikum Carl Gustav Carus Dresden, Thomas Grünewald, Chemnitz, Vorsitzender Sächsische Impfkommission, Patricia Klein, Ärztliche Geschäftsführerin, Sächsische Landesärztekammer Körperschaft des öffentlichen Rechts, Marcus Strotkötter, Senior Operations Officer for Vaccination Center and Mobile Vaccination Teams at DRK Landesverband Sachsen e.V. EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany provided antibody ELISAs and interferon-gamma release assays for this study.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/6
Y1 - 2022/6
N2 - Background: Vulnerable dialysis and kidney transplant patients show impaired seroconversion rates compared to medical personnel eight weeks after SARS-CoV-2mRNA vaccination. Methods: We evaluated six months follow up data in our observational Dia-Vacc study exploring specific cellular (interferon-γ release assay) or/and humoral immune responses after 2x SARS-CoV-2mRNA vaccination in 1205 participants including medical personnel (125 MP), dialysis patients (970 DP) and kidney transplant recipients (110 KTR) with seroconversion (de novo IgA or IgG antibody positivity by ELISA) after eight weeks. Findings: Six months after vaccination, seroconversion remained positive in 98% of MP, but 91%/87% of DP/KTR (p = 0·005), respectively. Receptor binding domain-IgG (RBD-IgG) antibodies were positive in 98% of MP, but only 68%/57% of DP/KTR (p < 0·001), respectively. Compared to MP, DP and KTR were at risk for a strong IgG or RBD-IgG decline (p < 0·001). Within the DP but not KTR group male gender, peritoneal dialysis, short time on dialysis, BNT162b2mRNA vaccine, immunosuppressive drug use and diabetes mellitus were independent risk factors for a strong decline of IgG or RBD antibodies. The percentage of cellular immunity decline was similar in all groups. Interpretation: Both vulnerable DP and KTR groups are at risk for a strong decline for IgG and RBD antibodies. In KTR, antibody titres peak at a markedly lower level and accelerated antibody decline is mixed with a delayed/increasing IgG, RBD-IgG, or cellular immune response in a 16% fraction of patients. In both populations, immune monitoring should be used for early timing of additional booster vaccinations. Funding: This study was funded by the Else Kröner Fresenius Stiftung, Bad Homburg v. d. H., grant number Fördervertrag EKFS 2021_EKSE.27.
AB - Background: Vulnerable dialysis and kidney transplant patients show impaired seroconversion rates compared to medical personnel eight weeks after SARS-CoV-2mRNA vaccination. Methods: We evaluated six months follow up data in our observational Dia-Vacc study exploring specific cellular (interferon-γ release assay) or/and humoral immune responses after 2x SARS-CoV-2mRNA vaccination in 1205 participants including medical personnel (125 MP), dialysis patients (970 DP) and kidney transplant recipients (110 KTR) with seroconversion (de novo IgA or IgG antibody positivity by ELISA) after eight weeks. Findings: Six months after vaccination, seroconversion remained positive in 98% of MP, but 91%/87% of DP/KTR (p = 0·005), respectively. Receptor binding domain-IgG (RBD-IgG) antibodies were positive in 98% of MP, but only 68%/57% of DP/KTR (p < 0·001), respectively. Compared to MP, DP and KTR were at risk for a strong IgG or RBD-IgG decline (p < 0·001). Within the DP but not KTR group male gender, peritoneal dialysis, short time on dialysis, BNT162b2mRNA vaccine, immunosuppressive drug use and diabetes mellitus were independent risk factors for a strong decline of IgG or RBD antibodies. The percentage of cellular immunity decline was similar in all groups. Interpretation: Both vulnerable DP and KTR groups are at risk for a strong decline for IgG and RBD antibodies. In KTR, antibody titres peak at a markedly lower level and accelerated antibody decline is mixed with a delayed/increasing IgG, RBD-IgG, or cellular immune response in a 16% fraction of patients. In both populations, immune monitoring should be used for early timing of additional booster vaccinations. Funding: This study was funded by the Else Kröner Fresenius Stiftung, Bad Homburg v. d. H., grant number Fördervertrag EKFS 2021_EKSE.27.
KW - Antibody fading
KW - Dialysis patients
KW - Kidney transplant recipients
KW - Medical personnel
KW - SARS-CoV-2mRNA vaccination
UR - http://www.scopus.com/inward/record.url?scp=85127864616&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85127864616&partnerID=8YFLogxK
U2 - 10.1016/j.lanepe.2022.100371
DO - 10.1016/j.lanepe.2022.100371
M3 - Article
C2 - 35434688
AN - SCOPUS:85127864616
SN - 2666-7762
VL - 17
JO - The Lancet Regional Health - Europe
JF - The Lancet Regional Health - Europe
M1 - 100371
ER -
