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Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study

Autores: Quiroga, B.; Soler, M. J. (Autor de correspondencia); Ortiz, A. (Autor de correspondencia); Jaravaca Mantecón, C. J.; Nava Pérez, N.; Serra Martín, M.; Sato, Y.; Marín Franco, A. J.; Pazmiño Zambrano, D. F.; Lucena Valverde, R.; Ortega Díaz, M.; Calderón González, C.; Cazorla López, J. M.; Pereira, M.; González Parra, E.; Sánchez Horrillo, A.; Sánchez González, C.; Toapanta, N.; Cigarran Guldris, S.; Sánchez Hernández, R.; Pizarro Sánchez, S.; Muñiz Rincón, M.; García Fernández, Nuria; Blanco Castro, N.; Collantes Mateo, R.; Quiroz Morales, M. A.; Escamilla-Cabrera, B.; Berdud Godoy, I.; Gil-Casares Casanova, B.; Leyva, A.; Rojas, J.; Gansevoort, R. T.; de Sequera, P.
Título de la revista: CLINICAL KIDNEY JOURNAL
ISSN: 2048-8505
Volumen: 15
Número: 10
Páginas: 1856 - 1864
Fecha de publicación: 2022
Background Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose. Methods This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed. Results A total of 711 patients [67% male, median age (range) 67 (20-89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P = .001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P = .693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P = .001), lower time from booster (P = .043) and past breakthrough SARS-CoV-2 infection (P < .001). Conclusions In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infection. Lay Summary Patients on hemodialysis present higher rates of complications derived from SARS-CoV-2 infections. Initial vaccination schedules have demonstrated suboptimal responses in those patients. The aim of the present study is to evaluate the time-course of the humoral response after a booster dose of SARS-CoV-2 RNA-based vaccines (BNT162b2 or mRNA-1273) in patients on hemodialysis. We included 711 patients that had received a booster dose: 545 (77%) 6 months before the initial vaccination and 166 (23%) between 6 and 9 months from the initial vaccination. After the booster, only 6 (<1%) patients presented persistent negative humoral response. During follow-up from Month 6 to Month 9, 35 patients (5%) developed a SARS-CoV-2 infection. Patients that received the booster later, breakthrough SARS-CoV-2 infection and mRNA-1273 booster were associated with higher anti-Spike titers.