Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1783723381915385856 |
---|---|
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. |
format | Online Article Text |
id | pubmed-8284337 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT schrezenmeiereva immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT bergfeldleon immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT hillusdavid immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT lippertjoergdetlev immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT weberulrike immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT toberlaupinkus immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT landgrafirmgard immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT schwarztatjana immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT kappertkai immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT stefanskianaluisa immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT sattlerarne immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT kotschkatja immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT dornerthomas immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT sanderleiferik immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT buddeklemens immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT halleckfabian immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT kurthflorian immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT cormanvictormax immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis AT choimira immunogenicityofcovid19tozinameranvaccinationinpatientsonchronicdialysis |