SARS-CoV-2 spike protein antibody titers after the fourth dose of BNT162b2 vaccine among Japanese patients undergoing hemodialysis: a single-center study

Shun Watanabe; Toyoaki Sawano; Hiroaki Saito; Akihiko Ozaki; Masatoshi Wakui; Tianchen Zhao; Chika Yamamoto; Yurie Kobashi; Takeshi Kawamura; Akira Sugiyama; Aya Nakayama; Yudai Kaneko; Hiroaki Shimmura; Masaharu Tsubokura

doi:10.3389/fimmu.2024.1412918

SARS-CoV-2 spike protein antibody titers after the fourth dose of BNT162b2 vaccine among Japanese patients undergoing hemodialysis: a single-center study

Front Immunol. 2024 Aug 21:15:1412918. doi: 10.3389/fimmu.2024.1412918. eCollection 2024.

Authors

Shun Watanabe¹, Toyoaki Sawano^{2

3}, Hiroaki Saito^{3

4}, Akihiko Ozaki⁵, Masatoshi Wakui⁶, Tianchen Zhao³, Chika Yamamoto³, Yurie Kobashi^{3

7}, Takeshi Kawamura^{8

9}, Akira Sugiyama⁸, Aya Nakayama⁸, Yudai Kaneko^{9

10}, Hiroaki Shimmura¹, Masaharu Tsubokura³

Affiliations

¹ Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan.
² Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan.
³ Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan.
⁴ Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan.
⁵ Breast and Thyroid Center, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan.
⁶ Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan.
⁷ Department of Internal Medicine, Seireikai Group Hirata Central Hospital, Fukushima, Japan.
⁸ Isotope Science Center, The University of Tokyo, Tokyo, Japan.
⁹ Laboratory for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.
¹⁰ Medical and Biological Laboratories Co., Ltd, Tokyo, Japan.

Abstract

Patients undergoing hemodialysis are particularly vulnerable to severe outcomes of SARS-CoV-2 infection, with mortality rates higher than that of the general population. Vaccination reduces the risk of adverse outcomes, with booster doses being particularly beneficial. However, limited data are available on the effectiveness of subsequent vaccinations or their effect on increasing antibody levels. This single-center study aimed to investigate changes in SARS-CoV-2 IgG antibody titers following the fourth vaccination among 28 patients undergoing hemodialysis. Blood tests were conducted at various intervals post-vaccination, with a focus on identifying factors associated with antibody levels. The IgG antibody levels rapidly increased by Day 7 post-vaccination, with a median time to peak of 11 days. Antibody titers tended to be higher in male patients than in female patients. This study sheds light on the immune response to the fourth vaccination in patients undergoing hemodialysis. As this study included a small sample size, with a short observation period, further research is warranted to comprehensively understand the effectiveness of vaccination and the benefits of additional doses of vaccine.

Keywords: BNT162b2 vaccine; IgG antibody titers; SARS-CoV-2; chronic kidney failure; fourth dose of vaccine; hemodialysis.

MeSH terms

Aged
Antibodies, Viral* / blood
Antibodies, Viral* / immunology
BNT162 Vaccine* / administration & dosage
BNT162 Vaccine* / immunology
COVID-19* / immunology
COVID-19* / prevention & control
East Asian People
Female
Humans
Immunization, Secondary
Immunoglobulin G* / blood
Immunoglobulin G* / immunology
Japan / epidemiology
Male
Middle Aged
Renal Dialysis*
Spike Glycoprotein, Coronavirus / immunology
Vaccination

Substances

Antibodies, Viral
BNT162 Vaccine
Immunoglobulin G
Spike Glycoprotein, Coronavirus
spike protein, SARS-CoV-2

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was composed of two parts. The first part involved the collection of blood samples from study subjects and the acquisition of data. The second part analyzes the data and discusses the findings to compile the paper. The first part was primarily funded by the Japan Agency for Medical Research and Development (AMED) under the funding title “Development of Vaccines for the Novel Coronavirus Disease,” with a budget from Grant No. JP21nf0101638. The second part of the study was supported by Moderna, Inc. Additionally, this work was supported by JSPS KAKENHI Grant Number 23H00503, and by Medical & Biological Laboratories Co., Ltd. and Shenzhen YHLO Biotech Co., Ltd., the distributor and manufacturer of the antibody measurement system (iFlash 3000). This research was also supported by grants from the Kowa Co. and Research Center for Advanced Science and Technology at the University of Tokyo. It is important to note that none of the funding bodies are related in any capacity. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.