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BMC Nephrol . Response to three doses of the Pfizer/BioNTech BNT162b2 COVID-19 vaccine: a retrospective study of a cohort of haemodialysis patients

tetano

Editor, Senior Moderator
BMC Nephrol


. 2022 May 18;23(1):189.
doi: 10.1186/s12882-022-02751-5.
Response to three doses of the Pfizer/BioNTech BNT162b2 COVID-19 vaccine: a retrospective study of a cohort of haemodialysis patients in France


Jean-François Verdier[SUP] 1 [/SUP], Sonia Boyer[SUP] 2 [/SUP], Florence Chalmin[SUP] 2 [/SUP], Ahmed Jeribi[SUP] 2 [/SUP], Caroline Egasse[SUP] 2 [/SUP], Marie France Maggi[SUP] 3 [/SUP], Philippe Auvray[SUP] 2 [/SUP], Tarik Yalaoui[SUP] 4 [/SUP]



Affiliations

Abstract

Background: The mortality rate associated with coronavirus disease 2019 (COVID-19) is high among haemodialyzed patients. We sought to describe the serological status of haemodialysis patients having received up to three doses of BNT162b2 mRNA vaccine, and to identify factors associated with a poor humoral response.
Methods: We performed a retrospective, observational study of patients attending a dialysis centre in Antibes, France. One or two of each patient's monthly venous blood samples were assayed for anti-spike (S1) immunoglobulin G (IgG).
Results: We included 142 patients, of whom 124 remained COVID-19-negative throughout the study. Among these COVID-19-negative patients, the humoral immune response rate (defined as an anti-S1 IgG titre ≥1.2 U/ml) was 82.9% after two injections and 95.8% after three injections, and the median [interquartile range] titre increased significantly from 7.09 [2.21; 19.94] U/ml with two injections to 93.26 [34.25; 176.06] U/ml with three. Among patients with two injections, the mean body mass index and serum albumin levels were significantly higher in responders than in non-responders (26.5 kg/m[SUP]2[/SUP] vs. 23.2 kg/m[SUP]2[/SUP], p = 0.0392; and 41.9 g/l vs. 39.0 g/l, p = 0.0042, respectively). For the study population as a whole at the end of the study, a history of COVID-19, at least two vaccine doses, and being on the French national waiting list for kidney transplantation were the only factors independently associated with the anti-S1 IgG titre.
Conclusions: Dialysis patients vaccinated with two doses of BNT162b2 might not be sufficiently protected against SARS-CoV-2 and so should receive a third (booster) dose.
Trial registration: The present retrospective study of clinical practice was not interventional and so was not registered.

Keywords: COVID-19; Comirnaty; Haemodialysis; SARS-CoV-2; Vaccine.
 
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