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Biedunkiewicz B, Tylicki L, Ślizień W, Lichodziejewska-Niemierko M, Dąbrowska M, Kubanek A, Rodak S, Polewska K, Tylicki P, Renke M, Dębska-Ślizień A. Waning Humoral Response after COVID-19 mRNA Vaccination in Maintenance Dialysis Patients and Recovery after a Complementary Third Dose. Vaccines (Basel) 2022; 10:vaccines10030433. [PMID: 35335065 PMCID: PMC8950255 DOI: 10.3390/vaccines10030433] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to analyze the waning of anti-spike (S) antibodies after mRNA vaccination against COVID-19 in maintenance dialysis patients, and to assess the safety and effectiveness of the complementary third dose. This was a prospective, longitudinal study in which we analyzed the kinetics of antibodies up to six months after a two-dose vaccination (first protocol) in infection-naïve dialysis patients (IN-Ds), previously infected dialysis patients (PI-Ds) and subjects without chronic kidney disease (the controls), as well as their humoral response to the third dose of the same mRNA vaccine (second protocol). The respective reduction in antibody titer after 3 and 6 months by 82.9% and 93.03% in IN-Ds (n = 109), 73.4% and 93.36% in PI-Ds (n = 32) and 75.5% and 88.8% in the controls (n = 20) was demonstrated. Consequently, a protective antibody titer above 141 BAU/mL was found in only 47.7% and 23.8% of IN-Ds after 3 and 6 months, respectively. After the third vaccine dose, a significant increase in antibody titer was observed in all groups, with increases by a factor of ×51.6 in IN-Ds, ×30.1 in the controls and ×8.4 in PI-Ds. The median antibody titer after the third dose differed significantly between groups, and was the highest in PI-Ds: PI-Ds, 9090 (3300−15,000) BAU/mL; the controls, 6945 (2130−11,800); IN-Ds, 3715 (1470−7325) (p < 0.001). In conclusion, we observed similar degrees of antibody waning in all patients. After 3 months, over half of the infection-naïve dialysis patients had a very low antibody titer, and almost twenty percent of them had no antibodies at all. The humoral response to the third dose was very good, raising their titer of antibodies to a higher level than those in the general population who have received the primary two-dose scheme. The results support the administration of a complementary third dose of the mRNA vaccine for dialysis patients as soon as possible.
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Affiliation(s)
- Bogdan Biedunkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
| | - Leszek Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
- Correspondence: ; Tel.: +48-58-5844700
| | | | - Monika Lichodziejewska-Niemierko
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
| | | | - Alicja Kubanek
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, 81-519 Gdynia, Poland; (A.K.); (M.R.)
| | - Sylwia Rodak
- NZOZ Diaverum, 81-519 Gdynia, Poland; (W.Ś.); (S.R.)
| | - Karolina Polewska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
| | - Piotr Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, 81-519 Gdynia, Poland; (A.K.); (M.R.)
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
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