Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients

Patrick Affeldt; Felix Carlo Koehler; Karl August Brensing; Martin Gies; Eva Platen; Vivien Adam; Linus Butt; Franziska Grundmann; Eva Heger; Steffen Hinrichs; Nils Kalisch; Simon Oehm; Gertrud Steger; Maike Wirtz; Thomas Benzing; Dirk Stippel; Florian Klein; Christine Kurschat; Roman-Ulrich Müller; Veronica Di Cristanziano

doi:10.3390/v14122646

Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients

Viruses. 2022 Nov 26;14(12):2646. doi: 10.3390/v14122646.

Authors

Patrick Affeldt^{1

2}, Felix Carlo Koehler^{1

3}, Karl August Brensing⁴, Martin Gies⁵, Eva Platen⁶, Vivien Adam¹, Linus Butt^{1

3}, Franziska Grundmann¹, Eva Heger², Steffen Hinrichs¹, Nils Kalisch¹, Simon Oehm¹, Gertrud Steger², Maike Wirtz², Thomas Benzing^{1

3}, Dirk Stippel⁷, Florian Klein², Christine Kurschat^{1

3}, Roman-Ulrich Müller^{1

3}, Veronica Di Cristanziano²

Affiliations

¹ Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
² Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany.
³ CECAD, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50931 Cologne, Germany.
⁴ Nierenzentrum Bonn, 53175 Bonn, Germany.
⁵ KfH-Nierenzentrum Köln-Longerich, 50737 Cologne, Germany.
⁶ Nierenzentrum Eifel, 53894 Mechernich, Germany.
⁷ Department of General, Visceral, Cancer and Transplant Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.

Abstract

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a serious hazard for hemodialysis (HD) patients and kidney transplant (KTX) recipients as they suffer from an impaired immune response to SARS-CoV-2 vaccination. In addition, a definition of SARS-CoV-2 IgG titer that indicates a sufficient immune response, especially against new omicron variants, is urgently needed. In the present study, the immune response to either a third or a fourth dose of a mRNA vaccine was investigated in 309 dialysis and 36 KTX patients. SARS-CoV-2 IgG titer thresholds indicating neutralizing activity against wild type (WT) and the omicron variant BA.1 were quantified. After four vaccine doses, a high-neutralizing activity against WT was evidenced in HD patients, whereas the neutralizing rate against BA.1 was significant lower. Concerning KTX recipients, humoral and cellular immune responses after a third vaccination were still highly impaired. This calls for modified omicron-targeting vaccines.

Keywords: BA.1; SARS-CoV-2; booster; dialysis; immunosuppression; kidney disease; neutralization; protection; surrogate; transplantation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Neutralizing
Antibodies, Viral
COVID-19 Vaccines
COVID-19* / prevention & control
Humans
Immunity
Immunoglobulin G
Kidney Transplantation*
Renal Dialysis
SARS-CoV-2
Transplant Recipients
Vaccination

Substances

COVID-19 Vaccines
Immunoglobulin G
Antibodies, Viral
Antibodies, Neutralizing

Supplementary concepts

SARS-CoV-2 variants

Grants and funding

The study at hand was supported by intramural funds. R.-U-M. received support from the Ministry of Science North Rhine-Westphalia and the German Research Foundation (DFG, DI 1501/9-2, MU 3629/6-1).