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Long-Term Dynamic Humoral Response to SARS-CoV-2 mRNA Vaccines in Patients on Peritoneal Dialysis.
Quiroga, Borja; Soler, María José; Ortiz, Alberto; Gansevoort, Ron T; Leyva, Alba; Rojas, José; de Sequera, Patricia.
  • Quiroga B; Nephrology Department, Hospital Universitario de la Princesa, 28006 Madrid, Spain.
  • Soler MJ; Nephrology Department, Vall d'Hebrón University Hospital, 08035 Barcelona, Spain.
  • Ortiz A; IIS-Fundación Jimenez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo-IRSIN, REDinREN, Instituto de Investigación Carlos III, 28040 Madrid, Spain.
  • Gansevoort RT; Dept. Internal Medicine, University Medical Center Groningen, University of Groningen, Postbus 30001, 9700 RB Groningen, The Netherlands.
  • Leyva A; R&D Department, VIRCELL SL, 18001 Granada, Spain.
  • Rojas J; R&D Department, VIRCELL SL, 18001 Granada, Spain.
  • de Sequera P; Nephrology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain.
Vaccines (Basel) ; 10(10)2022 Oct 18.
Article in English | MEDLINE | ID: covidwho-2071951
ABSTRACT

INTRODUCTION:

Patients on peritoneal dialysis (PD) present an impaired humoral response against SARS-CoV-2, at least after the initial vaccination and booster dose. Until now, the effect of a fourth dose has not been established. The aim of the present study is to evaluate the long-term dynamics of the humoral response of PD patients to multiple doses of SARS-CoV-2 vaccines, focusing on the effect of the fourth dose.

METHODS:

This is an analysis of the prospective and multicentric SENCOVAC study. We included patients on PD without additional immunosuppression that had received at least 3 SARS-CoV-2 mRNA vaccine doses. We evaluated anti-spike antibody titers after the initial vaccination, third and fourth doses, using prespecified fixed assessments (i.e., baseline, 28 days, 3, 6, and 12 months after completing the initial vaccine schedule). Breakthrough infections were also collected.

RESULTS:

We included 164 patients on PD (69% males, 62 ± 13 years old). In patients who had received only two doses, the rates of positive humoral response progressively decreased from 96% at 28 days to 80% at 6 months, as did with anti-spike antibody titers. At 6 months, 102 (62%) patients had received the third vaccine dose. Patients with the third dose had higher rates of positive humoral response (p = 0.01) and higher anti-spike antibody titers (p < 0.001) at 6 months than those with only 2 doses. At 12 months, the whole cohort had received 3 vaccine doses, and 44 (27%) patients had an additional fourth dose. The fourth dose was not associated to higher rates of positive humoral response (100 vs. 97%, p = 0.466) or to statistically significant differences in anti-spike antibody titers as compared to three doses (p = 0.371) at 12 months. Prior antibody titers were the only predictor for subsequent higher anti-spike antibody titer (B 0.53 [95%CI 0.27-0.78], p < 0.001). The 2 (1.2%) patients that developed COVID-19 during follow-up had mild disease.

CONCLUSIONS:

PD presents an acceptable humoral response with three doses of SARS-CoV-2 vaccines that improve the progressive loss of anti-spike antibody titers following two vaccine doses.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Vaccines10101738

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Vaccines10101738