tetano
Editor, Senior Moderator
Clin Kidney J
. 2021 Aug 13;14(11):2349-2355.
doi: 10.1093/ckj/sfab152. eCollection 2021 Nov.
Humoral response to a third injection of BNT162b2 vaccine in patients on maintenance haemodialysis
Marine Dekervel[SUP] 1 [/SUP], Nicolas Henry[SUP] 1 [/SUP], Massimo Torreggiani[SUP] 2 [/SUP], Lise-Marie Pouteau[SUP] 3 [/SUP], Jean-Paul Imiela[SUP] 4 [/SUP], Chloé Mellaza[SUP] 3 [/SUP], Anne-Sophie Garnier[SUP] 1 [/SUP], Amaury Dujardin[SUP] 3 [/SUP], Marine Asfar[SUP] 5 [/SUP], Alexandra Ducancelle[SUP] 6 [/SUP], Axelle Paquin[SUP] 7 [/SUP], Sophie Blanchi[SUP] 8 [/SUP], Virginie Besson[SUP] 1 [/SUP], Giorgina Barbara Piccoli[SUP] 2 [/SUP], Jean-François Augusto[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Humoral response against sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after two doses of BNT162b2 (Pfizer-BioNTech) has been proven to be less intense in maintenance dialysis patients as compared with healthy subjects, leading the French authorities to recommend a third injection in this population. Here we investigated the response to the third injection in two cohorts of haemodialysis (HD) patients.
Methods: Data from two prospective observational cohorts were collected. In the first ('systematic') cohort, patients from two HD centres (n = 66) received a third injection of BNT162b2, regardless of the response after two injections. In the second ('conditional') cohort, the injection was only prescribed to patients (n = 34) with no or low response to the previous two doses. In both cohorts, the third dose was injected 1-2 months after the second dose. Serology was performed after the second and third doses to assess anti-Spike immunoglobulin G (S IgG) antibody titre.
Results: In the systematic cohort, anti-S IgG was found in 83.3 and 92.4% of patients after the second and third doses of BNT162b2, respectively. In this cohort, 6/11 (54.5%) and 20/21 (95.2%) patients switched from non-responder to low responder and from low responder to high responder, respectively. In low and high responders to two doses, 50/55 (90.9%) at least doubled their anti-S IgG titre. Similar trends were observed in the conditional cohort.
Conclusions: In maintenance HD patients, humoral response against SARS-CoV-2 was boosted after a third dose of BNT162b2, allowing seroconversion in more than half of non-responders. These data may support an intensified vaccination protocol with a third dose of BNT162b2 in dialysis patients.
Keywords: BNT162b2 vaccine; COVID-19; SARS-Cov-2; haemodialysis; immunogenicity.
. 2021 Aug 13;14(11):2349-2355.
doi: 10.1093/ckj/sfab152. eCollection 2021 Nov.
Humoral response to a third injection of BNT162b2 vaccine in patients on maintenance haemodialysis
Marine Dekervel[SUP] 1 [/SUP], Nicolas Henry[SUP] 1 [/SUP], Massimo Torreggiani[SUP] 2 [/SUP], Lise-Marie Pouteau[SUP] 3 [/SUP], Jean-Paul Imiela[SUP] 4 [/SUP], Chloé Mellaza[SUP] 3 [/SUP], Anne-Sophie Garnier[SUP] 1 [/SUP], Amaury Dujardin[SUP] 3 [/SUP], Marine Asfar[SUP] 5 [/SUP], Alexandra Ducancelle[SUP] 6 [/SUP], Axelle Paquin[SUP] 7 [/SUP], Sophie Blanchi[SUP] 8 [/SUP], Virginie Besson[SUP] 1 [/SUP], Giorgina Barbara Piccoli[SUP] 2 [/SUP], Jean-François Augusto[SUP] 1 [/SUP]
Affiliations
- PMID: 34754430
- PMCID: PMC8573007
- DOI: 10.1093/ckj/sfab152
Abstract
Background: Humoral response against sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after two doses of BNT162b2 (Pfizer-BioNTech) has been proven to be less intense in maintenance dialysis patients as compared with healthy subjects, leading the French authorities to recommend a third injection in this population. Here we investigated the response to the third injection in two cohorts of haemodialysis (HD) patients.
Methods: Data from two prospective observational cohorts were collected. In the first ('systematic') cohort, patients from two HD centres (n = 66) received a third injection of BNT162b2, regardless of the response after two injections. In the second ('conditional') cohort, the injection was only prescribed to patients (n = 34) with no or low response to the previous two doses. In both cohorts, the third dose was injected 1-2 months after the second dose. Serology was performed after the second and third doses to assess anti-Spike immunoglobulin G (S IgG) antibody titre.
Results: In the systematic cohort, anti-S IgG was found in 83.3 and 92.4% of patients after the second and third doses of BNT162b2, respectively. In this cohort, 6/11 (54.5%) and 20/21 (95.2%) patients switched from non-responder to low responder and from low responder to high responder, respectively. In low and high responders to two doses, 50/55 (90.9%) at least doubled their anti-S IgG titre. Similar trends were observed in the conditional cohort.
Conclusions: In maintenance HD patients, humoral response against SARS-CoV-2 was boosted after a third dose of BNT162b2, allowing seroconversion in more than half of non-responders. These data may support an intensified vaccination protocol with a third dose of BNT162b2 in dialysis patients.
Keywords: BNT162b2 vaccine; COVID-19; SARS-Cov-2; haemodialysis; immunogenicity.