The Lancet Regional Health. Europe (Jun 2022)
Risk of strong antibody decline in dialysis and transplant patients after SARS-CoV-2mRNA vaccination: Six months data from the observational Dia-Vacc study
- Julian Stumpf,
- Jörg Schwöbel,
- Tom Lindner,
- Leona Anders,
- Torsten Siepmann,
- Claudia Karger,
- Jan Hüther,
- Heike Martin,
- Petra Müller,
- Robert Faulhaber-Walter,
- Torsten Langer,
- Holger Schirutschke,
- Thomas Stehr,
- Frank Meistring,
- Annegret Pietzonka,
- Kirsten Anding-Rost,
- Katja Escher,
- Frank Pistrosch,
- Jens Schewe,
- Harald Seidel,
- Kerstin Barnett,
- Thilo Pluntke,
- Simon Cerny,
- Alexander Paliege,
- Ingolf Bast,
- Anne Steglich,
- Florian Gembardt,
- Friederike Kessel,
- Hannah Kröger,
- Patrick Arndt,
- Jan Sradnick,
- Kerstin Frank,
- Anna Klimova,
- René Mauer,
- Xina Grählert,
- Torsten Tonn,
- Christian Hugo
Affiliations
- Julian Stumpf
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; KfH-Nierenzentrum Dresden, Dresden, Germany
- Jörg Schwöbel
- Dialysezentrum Chemnitz, Chemnitz, Germany
- Tom Lindner
- Division of Nephrology, University Hospital Leipzig, Leipzig, Germany
- Leona Anders
- Dialysepraxis Leipzig, Leipzig, Germany
- Torsten Siepmann
- KfH-Nierenzentrum am Klinikum Chemnitz, Krankenhaus Küchwald, Chemnitz, Germany
- Claudia Karger
- KfH-Nierenzentrum am Klinikum St. Georg, Leipzig, Germany
- Jan Hüther
- Nephrocare GmbH Döbeln, Döbeln, Germany
- Heike Martin
- Nephrologisches Zentrum Zwickau, Zwickau, Germany
- Petra Müller
- PHV Dialysezentrum Dresden-Johannstadt, Dresden, Germany
- Robert Faulhaber-Walter
- Nephrologisches Zentrum Freiberg, Freiberg, Germany
- Torsten Langer
- Dialysezentrum Annaberg, Annaberg-Buchholz, Germany
- Holger Schirutschke
- PHV Dialysezentrum Dresden Friedrichstadt, Dresden, Germany
- Thomas Stehr
- KfH-Nierenzentrum Bautzen, Bautzen, Germany
- Frank Meistring
- KfH-Nierenzentrum am Städtischen Klinikum Görlitz, Görlitz, Germany
- Annegret Pietzonka
- Via medis Nierenzentrum Dresden MVZ GmbH, Dresden, Germany
- Kirsten Anding-Rost
- KfH-Nierenzentrum Bischofswerda, Bischofswerda, Germany
- Katja Escher
- KfH-Gesundheitszentrum Aue, Aue-Bad-Schlema, Germany
- Frank Pistrosch
- Nephrologisches Zentrum Hoyerswerda, Hoyerswerda, Germany
- Jens Schewe
- Dialyse- und Nierenambulanz Sebnitz, Sebnitz, Germany
- Harald Seidel
- KfH-Nierenzentrum am Vogtland Krankenhaus Plauen, Plauen, Germany
- Kerstin Barnett
- Dialyse Heidenau, Heidenau, Germany
- Thilo Pluntke
- KfH-Nierenzentrum Grimma, Grimma, Germany
- Simon Cerny
- ELBLAND Dialyse Großenhain, Großenhain, Germany
- Alexander Paliege
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Ingolf Bast
- Dialysepraxis Leipzig, Leipzig, Germany
- Anne Steglich
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Florian Gembardt
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Friederike Kessel
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Hannah Kröger
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Patrick Arndt
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Jan Sradnick
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Kerstin Frank
- Institut für Transfusionsmedizin Plauen, DRK-Blutspendedienst Nord-Ost Gemeinnützige GmbH, Plauen, Germany
- Anna Klimova
- National Center for Tumor Diseases (NCT) Partner Site Dresden, Dresden, Germany
- René Mauer
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry (IMB), Technische Universität, Dresden, Germany
- Xina Grählert
- Coordinating Centre for Clinical Trials, Dresden, Germany
- Torsten Tonn
- Institute for Transfusion Medicine, German Red Cross Blood Donation Service North-East, Dresden, Germany; Faculty of Medicine Carl Gustav Carus, Transfusion Medicine, Technische Universität, Dresden, Germany
- Christian Hugo
- Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; KfH-Nierenzentrum Dresden, Dresden, Germany; Corresponding author at: Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
- Journal volume & issue
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Vol. 17
p. 100371
Abstract
Summary: Background: Vulnerable dialysis and kidney transplant patients show impaired seroconversion rates compared to medical personnel eight weeks after SARS-CoV-2mRNA vaccination. Methods: We evaluated six months follow up data in our observational Dia-Vacc study exploring specific cellular (interferon-γ release assay) or/and humoral immune responses after 2x SARS-CoV-2mRNA vaccination in 1205 participants including medical personnel (125 MP), dialysis patients (970 DP) and kidney transplant recipients (110 KTR) with seroconversion (de novo IgA or IgG antibody positivity by ELISA) after eight weeks. Findings: Six months after vaccination, seroconversion remained positive in 98% of MP, but 91%/87% of DP/KTR (p = 0·005), respectively. Receptor binding domain-IgG (RBD-IgG) antibodies were positive in 98% of MP, but only 68%/57% of DP/KTR (p < 0·001), respectively. Compared to MP, DP and KTR were at risk for a strong IgG or RBD-IgG decline (p < 0·001). Within the DP but not KTR group male gender, peritoneal dialysis, short time on dialysis, BNT162b2mRNA vaccine, immunosuppressive drug use and diabetes mellitus were independent risk factors for a strong decline of IgG or RBD antibodies. The percentage of cellular immunity decline was similar in all groups. Interpretation: Both vulnerable DP and KTR groups are at risk for a strong decline for IgG and RBD antibodies. In KTR, antibody titres peak at a markedly lower level and accelerated antibody decline is mixed with a delayed/increasing IgG, RBD-IgG, or cellular immune response in a 16% fraction of patients. In both populations, immune monitoring should be used for early timing of additional booster vaccinations. Funding: This study was funded by the Else Kröner Fresenius Stiftung, Bad Homburg v. d. H., grant number Fördervertrag EKFS 2021_EKSE.27.
