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BMC Immunol ; 22(1): 70, 2021 10 19.
Article in English | MEDLINE | ID: covidwho-1477260


BACKGROUND: Hemodialysis (HD) patients have an increased risk of acquiring infections due to many health care contacts and may, in addition, have a suboptimal response to vaccination and a high mortality from Covid-19 infection. METHODS: In 50 HD patients (mean age 69.4 years, 62% men) administration of SARS-CoV-2BNT162b2 mRNA vaccine began in Dec 2020 and the immune response was evaluated 7-15 weeks after the last dose. Levels of Covid-19 (SARS-CoV-2) IgG antibody against the nucleocapsid antigen (anti-N) and the Spike antigen (anti-S) and T-cell reactivity testing against the Spike protein using ELISPOT technology were evaluated. RESULTS: Out of 50 patients, anti-S IgG antibodies indicating a vaccine effect or previous Covid-19 infection, were detected in 37 (74%), 5 (10%) had a borderline response and 8 (16%) were negative after two doses of vaccine. T-cell responses were detected in 29 (58%). Of the 37 patients with anti-S antibodies, 25 (68%) had a measurable T-cell response. 2 (40%) out of 5 patients with borderline anti-S and 2 (25%) without anti-S had a concomitant T-cell response. Twenty-seven (54%) had both an antibody and T-cell response. IgG antibodies to anti-N indicating a previous Covid-19 disease were detected in 7 (14%) patients. CONCLUSIONS: Most HD patients develop a B- and/or T-cell response after vaccination against Covid-19 but approx. 20% had a limited immunological response. T-cell reactivity against Covid-19 was only present in a few of the anti-S antibody negative patients.

Antibodies, Viral/blood , COVID-19 Vaccines/immunology , Coronavirus Nucleocapsid Proteins/immunology , Renal Dialysis , Spike Glycoprotein, Coronavirus/immunology , T-Lymphocytes/immunology , Adult , Aged , Aged, 80 and over , Antibodies, Viral/immunology , COVID-19/prevention & control , Female , Humans , Immunoglobulin G/blood , Male , Middle Aged , Phosphoproteins/immunology , SARS-CoV-2/immunology , Uremia/immunology , Uremia/pathology , Vaccination
Dtsch Med Wochenschr ; 146(7): 466-470, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1155718


Only fifteen months after the beginning of the COVID-19 pandemic, several vaccines are already available for clinical use. While the spike protein of SARS-CoV-2 constitutes the main target of all predominant SARS-CoV-2 vaccines, they work by different mechanisms (mRNA-based vaccines vs. vector-based vaccines vs. protein-based vaccines).Though there are slight differences regarding the level of protection against mild COVID-19, all five vaccines that have been through phase 3 trials were nearly 100 % effective in preventing severe or fatal cases of COVID-19. The side effects were of short duration.Patients with chronic kidney disease (or other significant comorbidities) were largely excluded from Phase 3 trials, which makes definite recommendations concerning their vaccination difficult. The vaccine's effectiveness may be reduced in that population due to a uremic immune defect and/or immunosuppressive medication. However, these patients have an increased risk for severe or fatal COVID-19, so that they may particularly benefit from the vaccine.

COVID-19 Vaccines/standards , COVID-19/complications , COVID-19/prevention & control , Renal Insufficiency, Chronic/complications , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/immunology , Clinical Trials, Phase III as Topic , Humans , Immunosuppressive Agents/therapeutic use , RNA, Messenger/immunology , Renal Insufficiency, Chronic/immunology , Uremia/complications , Uremia/immunology , Vaccines, Synthetic/adverse effects , Vaccines, Synthetic/immunology , Vaccines, Synthetic/standards