Predictors of response to SARS-CoV-2 vaccines among maintenance dialysis patients
Journal of the American Society of Nephrology
; 32:96, 2021.
Article
in English
| EMBASE | ID: covidwho-1489700
ABSTRACT
Background:
Vaccines against SARS-CoV-2 are highly effective in the general population;however, their efficacy may be diminished in maintenance dialysis patients, a population particularly vulnerable to COVID-19. We assessed vaccine response in a national sample of maintenance dialysis patients.Methods:
Using retrospective clinical data, we assessed seroresponse to vaccine among maintenance dialysis patients cared for at 130 Dialysis Clinic, Inc (DCI) facilities. Via a clinical protocol available to early vaccinating facilities, antibodies against SARSCoV-2 spike antigen were semi-quantitatively assessed beginning with the monthly blood draw at least two weeks after completion of a SARS-CoV-2 vaccine series. Vaccine response was defined as a titer ≥2 U/L, and logistic regression analysis was used to identify characteristics associated with response. Patients with history of COVID-19 prior to antibody assessment were excluded.Results:
Among 1,352 patients, 996 (74%) had a serologic response. Serologic response differed significantly by vaccine type 314/386 (81%) among BNT162b2/ Pfizer recipients, 615/655 (94%) among mRNA-1273/Moderna recipients, and 67/311 (22%) among Ad26.COV2.S/Janssen recipients. Age greater than 75, lack of hepatitis B immunity, immune-modulating medication, lower serum albumin, and COPD were associated with vaccine non-response (Figure).Conclusions:
Serologic response to mRNA vaccines is robust among chronic dialysis patients, and the use of mRNA vaccines should be promoted aggressively in this vulnerable population. High rates of non-response to the Janssen vaccine warrant further study. Future research should evaluate the potential role for boosters and whether seroresponse corresponds with protection from COVID-19.
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Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Topics:
Vaccines
Language:
English
Journal:
Journal of the American Society of Nephrology
Year:
2021
Document Type:
Article
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