Dialysis patients do not develop adequate antibodies with one dose of SARS-CoV-2 vaccine
New research in CMAJ (Canadian Medical Association Journal) shows that most hemodialysis patients do not develop adequate antibodies after their first dose of SARS-CoV-2 vaccine.
“We advise that the second dose of the BNT162b2 [Pfizer] vaccine be administered to patients receiving hemodialysis at the recommended 3-week time interval, and that rigorous SARS-CoV-2 infection prevention and control measures be continued in hemodialysis units until vaccine efficacy is known,” writes Dr. Rita Suri, Director of the Division of nephrology at the McGill University Health Centre (MUHC) and an investigator at the Research Institute of the MUHC, with coauthors.
Patients receiving hemodialysis are especially vulnerable to COVID-19 as they must leave their homes three times a week for dialysis at a health care facility, and case fatality rates are 20%–30%, which is 10 times higher than in the general population.
The study included 154 patients receiving hemodialysis in Quebec (135 without and 19 with prior SARS-CoV-2 infection), 40 healthy volunteers (20 without and 20 with prior SARS-CoV2 infection) and convalescent plasma from 16 dialysis patients who survived COVID-19. Researchers measured antibody levels in the participants and found dialysis patients who were never previously exposed to COVID-19 had lower antibody levels than participants in the two control groups, even up to eight weeks later. Antibodies were undetectable in 57% of patients receiving hemodialysis. Of the 154 patients receiving dialysis, four developed COVID-19 after vaccination.
“Patients receiving hemodialysis who did not respond at four weeks remained non-responders at eight weeks, which is an argument against the possibility of a delayed response in these individuals. Older patients and those on immunosuppression had even lower seroconversion rates, but even younger patients not on immunosuppression had a significantly lower seropositivity rate than controls,” write the authors. How well dialysis patients respond to the second dose of vaccine is being studied.
About the study
The article “Short-term antibody response after 1 dose of BNT162b2 vaccine in patients receiving hemodialysis” is published May 12, 2021.
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