Risk of strong antibody decline in dialysis and transplant patients after SARS-CoV-2mRNA vaccination: Six months data from the observational Dia-Vacc study

Julian Stumpf, Jörg Schwöbel, Tom Lindner, Leona Anders, Torsten Siepmann, Claudia Karger, Jan Hüther, Heike Martin, Petra Müller, Robert Faulhaber-Walter, Torsten Langer, Holger Schirutschke, Thomas Stehr, Frank Meistring, Annegret Pietzonka, Kirsten Anding-Rost, Katja Escher, Frank Pistrosch, Jens Schewe, Harald SeidelKerstin Barnett, Thilo Pluntke, Simon Cerny, Alexander Paliege, Ingolf Bast, Anne Steglich, Florian Gembardt, Friederike Kessel, Hannah Kröger, Patrick Arndt, Jan Sradnick, Kerstin Frank, Anna Klimova, René Mauer, Xina Grählert, Torsten Tonn, Christian Hugo

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


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.

Original languageEnglish (US)
Article number100371
JournalThe Lancet Regional Health - Europe
StatePublished - Jun 2022
Externally publishedYes

Bibliographical note

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)


  • Antibody fading
  • Dialysis patients
  • Kidney transplant recipients
  • Medical personnel
  • SARS-CoV-2mRNA vaccination

PubMed: MeSH publication types

  • Journal Article


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