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Immunogenicity of COVID-19 Tozinameran Vaccination in Patients on Chronic Dialysis

Patients with kidney failure have notoriously weak responses to common vaccines. Thus, immunogenicity of novel SARS-CoV-2 vaccines might be impaired in this group. To determine immunogenicity of SARS-CoV-2 vaccination in patients with chronic dialysis, we analyzed the humoral and T-cell response aft...

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Autores principales: Schrezenmeier, Eva, Bergfeld, Leon, Hillus, David, Lippert, Joerg-Detlev, Weber, Ulrike, Tober-Lau, Pinkus, Landgraf, Irmgard, Schwarz, Tatjana, Kappert, Kai, Stefanski, Ana-Luisa, Sattler, Arne, Kotsch, Katja, Dörner, Thomas, Sander, Leif Erik, Budde, Klemens, Halleck, Fabian, Kurth, Florian, Corman, Victor Max, Choi, Mira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284337/
https://www.ncbi.nlm.nih.gov/pubmed/34276681
http://dx.doi.org/10.3389/fimmu.2021.690698
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author Schrezenmeier, Eva
Bergfeld, Leon
Hillus, David
Lippert, Joerg-Detlev
Weber, Ulrike
Tober-Lau, Pinkus
Landgraf, Irmgard
Schwarz, Tatjana
Kappert, Kai
Stefanski, Ana-Luisa
Sattler, Arne
Kotsch, Katja
Dörner, Thomas
Sander, Leif Erik
Budde, Klemens
Halleck, Fabian
Kurth, Florian
Corman, Victor Max
Choi, Mira
author_facet Schrezenmeier, Eva
Bergfeld, Leon
Hillus, David
Lippert, Joerg-Detlev
Weber, Ulrike
Tober-Lau, Pinkus
Landgraf, Irmgard
Schwarz, Tatjana
Kappert, Kai
Stefanski, Ana-Luisa
Sattler, Arne
Kotsch, Katja
Dörner, Thomas
Sander, Leif Erik
Budde, Klemens
Halleck, Fabian
Kurth, Florian
Corman, Victor Max
Choi, Mira
author_sort Schrezenmeier, Eva
collection PubMed
description Patients with kidney failure have notoriously weak responses to common vaccines. Thus, immunogenicity of novel SARS-CoV-2 vaccines might be impaired in this group. To determine immunogenicity of SARS-CoV-2 vaccination in patients with chronic dialysis, we analyzed the humoral and T-cell response after two doses of mRNA vaccine Tozinameran (BNT162b2 BioNTech/Pfizer). This observational study included 43 patients on dialysis before vaccination with two doses of Tozinameran 21 days apart. Overall, 36 patients completed the observation period until three weeks after the second dose and 32 patients were further analyzed at week 10. Serum samples were analyzed by SARS-CoV-2 specific IgG and IgA antibodies ~1, ~3–4 and ~10 weeks after the second vaccination. In addition, SARS-CoV-2-specific T-cell responses were assessed at ~3–4 weeks by an interferon-gamma release assay (IGRA). Antibody and T cell outcomes at this timepoint were compared to a group of 44 elderly patients not on dialysis, after immunization with Tozinameran. Median age of patients on chronic dialysis was 74.0 years (IQR 66.0, 82.0). The proportion of males was higher (69.4%) than females. Only 20/36 patients (55.6%, 95%CI: 38.29–71.67) developed SARS-CoV-2-IgG antibodies at the first sampling, whereas 32/36 patients (88.9%, 95%CI: 73.00–96.38) demonstrated IgG detection at the second sampling. In a longitudinal follow-up at ~10 weeks after the second dose, the proportion of dialysis patients reactive for anti-SARS-CoV-2-IgG decreased to 27/32 (84.37%, 95%CI: 66.46–94.10) The proportion of anti-SARS-CoV-2 S1 IgA decreased from 33/36 (91.67%; 95%CI: 76.41–97.82) at weeks 3–4 down to 19/32 (59.38; 95%CI: 40.79–75.78). Compared to a cohort of vaccinees with similar age but not on chronic dialysis seroconversion rates and antibody titers were significantly lower. SARS-CoV-2-specific T-cell responses 3 weeks after second vaccination were detected in 21/31 vaccinated dialysis patients (67.7%, 95%CI: 48.53–82.68) compared to 42/44 (93.3%, 95%CI: 76.49–98.84) in controls of similar age. Patients on dialysis demonstrate a delayed, but robust immune response three to four weeks after the second dose, which indicates effective vaccination of this vulnerable group. However, the lower immunogenicity of Tozinameran in these patients needs further attention to develop potential countermeasures such as an additional booster vaccination.
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spelling pubmed-82843372021-07-17 Immunogenicity of COVID-19 Tozinameran Vaccination in Patients on Chronic Dialysis Schrezenmeier, Eva Bergfeld, Leon Hillus, David Lippert, Joerg-Detlev Weber, Ulrike Tober-Lau, Pinkus Landgraf, Irmgard Schwarz, Tatjana Kappert, Kai Stefanski, Ana-Luisa Sattler, Arne Kotsch, Katja Dörner, Thomas Sander, Leif Erik Budde, Klemens Halleck, Fabian Kurth, Florian Corman, Victor Max Choi, Mira Front Immunol Immunology Patients with kidney failure have notoriously weak responses to common vaccines. Thus, immunogenicity of novel SARS-CoV-2 vaccines might be impaired in this group. To determine immunogenicity of SARS-CoV-2 vaccination in patients with chronic dialysis, we analyzed the humoral and T-cell response after two doses of mRNA vaccine Tozinameran (BNT162b2 BioNTech/Pfizer). This observational study included 43 patients on dialysis before vaccination with two doses of Tozinameran 21 days apart. Overall, 36 patients completed the observation period until three weeks after the second dose and 32 patients were further analyzed at week 10. Serum samples were analyzed by SARS-CoV-2 specific IgG and IgA antibodies ~1, ~3–4 and ~10 weeks after the second vaccination. In addition, SARS-CoV-2-specific T-cell responses were assessed at ~3–4 weeks by an interferon-gamma release assay (IGRA). Antibody and T cell outcomes at this timepoint were compared to a group of 44 elderly patients not on dialysis, after immunization with Tozinameran. Median age of patients on chronic dialysis was 74.0 years (IQR 66.0, 82.0). The proportion of males was higher (69.4%) than females. Only 20/36 patients (55.6%, 95%CI: 38.29–71.67) developed SARS-CoV-2-IgG antibodies at the first sampling, whereas 32/36 patients (88.9%, 95%CI: 73.00–96.38) demonstrated IgG detection at the second sampling. In a longitudinal follow-up at ~10 weeks after the second dose, the proportion of dialysis patients reactive for anti-SARS-CoV-2-IgG decreased to 27/32 (84.37%, 95%CI: 66.46–94.10) The proportion of anti-SARS-CoV-2 S1 IgA decreased from 33/36 (91.67%; 95%CI: 76.41–97.82) at weeks 3–4 down to 19/32 (59.38; 95%CI: 40.79–75.78). Compared to a cohort of vaccinees with similar age but not on chronic dialysis seroconversion rates and antibody titers were significantly lower. SARS-CoV-2-specific T-cell responses 3 weeks after second vaccination were detected in 21/31 vaccinated dialysis patients (67.7%, 95%CI: 48.53–82.68) compared to 42/44 (93.3%, 95%CI: 76.49–98.84) in controls of similar age. Patients on dialysis demonstrate a delayed, but robust immune response three to four weeks after the second dose, which indicates effective vaccination of this vulnerable group. However, the lower immunogenicity of Tozinameran in these patients needs further attention to develop potential countermeasures such as an additional booster vaccination. Frontiers Media S.A. 2021-06-30 /pmc/articles/PMC8284337/ /pubmed/34276681 http://dx.doi.org/10.3389/fimmu.2021.690698 Text en Copyright © 2021 Schrezenmeier, Bergfeld, Hillus, Lippert, Weber, Tober-Lau, Landgraf, Schwarz, Kappert, Stefanski, Sattler, Kotsch, Dörner, Sander, Budde, Halleck, Kurth, Corman and Choi https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Schrezenmeier, Eva
Bergfeld, Leon
Hillus, David
Lippert, Joerg-Detlev
Weber, Ulrike
Tober-Lau, Pinkus
Landgraf, Irmgard
Schwarz, Tatjana
Kappert, Kai
Stefanski, Ana-Luisa
Sattler, Arne
Kotsch, Katja
Dörner, Thomas
Sander, Leif Erik
Budde, Klemens
Halleck, Fabian
Kurth, Florian
Corman, Victor Max
Choi, Mira
Immunogenicity of COVID-19 Tozinameran Vaccination in Patients on Chronic Dialysis
title Immunogenicity of COVID-19 Tozinameran Vaccination in Patients on Chronic Dialysis
title_full Immunogenicity of COVID-19 Tozinameran Vaccination in Patients on Chronic Dialysis
title_fullStr Immunogenicity of COVID-19 Tozinameran Vaccination in Patients on Chronic Dialysis
title_full_unstemmed Immunogenicity of COVID-19 Tozinameran Vaccination in Patients on Chronic Dialysis
title_short Immunogenicity of COVID-19 Tozinameran Vaccination in Patients on Chronic Dialysis
title_sort immunogenicity of covid-19 tozinameran vaccination in patients on chronic dialysis
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284337/
https://www.ncbi.nlm.nih.gov/pubmed/34276681
http://dx.doi.org/10.3389/fimmu.2021.690698
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