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SARS-CoV-2 vaccine antibody response and breakthrough infections in patients receiving dialysis (preprint)
medrxiv; 2021.
Preprint Dans Anglais | medRxiv | ID: ppzbmed-10.1101.2021.10.12.21264860
ABSTRACT

Background:

Patients receiving dialysis are a sentinel population for groups at high risk for death and disability from COVID-19. Understanding correlates of protection post-vaccination can inform immunization and mitigation strategies.

Methods:

Monthly since January 2021, we tested plasma from 4791 patients receiving dialysis for antibodies to the receptor-binding domain (RBD) of SARS-CoV-2 using a high-throughput assay. We qualitatively assessed the proportion without a detectable RBD response and among those with a response, semiquantitative median IgG index values. Using a nested case-control design, we matched each breakthrough case to five controls by age, sex, and vaccination-month to determine whether peak and pre-breakthrough RBD IgG index values were associated with risk for infection post-vaccination.

Results:

Among 2563 vaccinated patients, the proportion without a detectable RBD response increased from 6.6% [95% CI 5.5-8.1] in 14-30 days post-vaccination to 20.2% [95% CI 17.1-23.8], and median index values declined from 92.7 (95% CI 77.8-107.5) to 3.7 (95% CI 3.1-4.3) after 5 months. Persons with SARS-CoV-2 infection prior-to-vaccination had higher peak index values than persons without prior infection, but values equalized by 5 months (p=0.230). Breakthrough infections occurred in 56 patients, with samples collected a median of 21 days pre-breakthrough. Peak and pre-breakthrough RBD values <23 (equivalent to <506 WHO BAU/mL) were associated with higher odds for breakthrough infection (OR 3.7 [95% CI 2.0-6.8] and 9.8 [95% CI 2.9-32.8], respectively).

Conclusions:

The antibody response to SARS-CoV-2 vaccination wanes rapidly, and in persons receiving dialysis, the persisting antibody response is associated with risk for breakthrough infection.
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Texte intégral: Disponible Collection: Preprints Base de données: medRxiv Sujet Principal: Mort / Douleur paroxystique / COVID-19 / Infections langue: Anglais Année: 2021 Type de document: Preprint

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Texte intégral: Disponible Collection: Preprints Base de données: medRxiv Sujet Principal: Mort / Douleur paroxystique / COVID-19 / Infections langue: Anglais Année: 2021 Type de document: Preprint