SARS-CoV-2 Neutralization Capacity in Hemodialysis Patients with and without a Fifth Vaccination with the Updated Comirnaty Original/Omicron BA.4-5 Vaccine
Bo-Hung Liao,
Louise Platen,
Myriam Grommes,
Cho-Chin Cheng,
Christopher Holzmann-Littig,
Catharina Christa,
Bernhard Haller,
Verena Kappler,
Romina Bester,
Maia Lucia Werz,
Eva Platen,
Peter Eggerer,
Laëtitia Tréguer,
Claudius Küchle,
Christoph Schmaderer,
Uwe Heemann,
Lutz Renders,
Ulrike Protzer,
Matthias Christoph Braunisch
Affiliations
Bo-Hung Liao
Institute of Virology, TUM School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany
Louise Platen
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Myriam Grommes
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Cho-Chin Cheng
Institute of Virology, TUM School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany
Christopher Holzmann-Littig
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Catharina Christa
Institute of Virology, TUM School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany
Bernhard Haller
Institute of AI and Informatics in Medicine, TUM School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany
Verena Kappler
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Romina Bester
Institute of Virology, TUM School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany
Maia Lucia Werz
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Eva Platen
Kidney Center Eifel Dialyse, 53894 Mechernich, Germany
Peter Eggerer
KfH Kidney Center Harlaching, Munich-Harlaching, 81545 Munich, Germany
Laëtitia Tréguer
KfH Kidney Center, 83278 Traunstein, Germany
Claudius Küchle
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Christoph Schmaderer
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Uwe Heemann
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Lutz Renders
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Ulrike Protzer
Institute of Virology, TUM School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany
Matthias Christoph Braunisch
Department of Nephrology, TUM School of Medicine and Health, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Background: Hemodialysis patients have reduced serologic immunity after SARS-CoV-2 vaccination compared to the general population and an increased risk of morbidity and mortality when exposed to SARS-CoV-2. Methods: Sixty-six hemodialysis patients immunized four times with the original SARS-CoV-2 vaccines (BNT162b2, mRNA-1273) either received a booster with the adapted Comirnaty Original/Omicron BA.4-5 vaccine 8.3 months after the fourth vaccination and/or experienced a breakthrough infection. Two months before and four weeks after the fifth vaccination, the live-virus neutralization capacities of Omicron variants BA.5, BQ.1.1, and XBB.1.5 were determined, as well as neutralizing and quantitative anti-SARS-CoV-2 spike-specific IgG antibodies. Results: Four weeks after the fifth vaccination with the adapted vaccine, significantly increased neutralizing antibodies and the neutralization of Omicron variants BA.5, BQ.1.1, and XBB.1.5 were observed. The increase was significantly higher than after the fourth vaccination for variants BQ.1.1 and BA.5. Of all analyzed variants, BA.5 was neutralized best after the fifth vaccination. We did not see a difference in humoral immunity between the group with an infection and the group with a vaccination as a fifth spike exposure. Fivefold-vaccinated patients with a breakthrough infection showed a significantly higher neutralization capacity of XBB.1.5. Conclusion: A fifth SARS-CoV-2 vaccination with the adapted vaccine improves both wild-type specific antibody titers and the neutralizing capacity of the current Omicron variants BA.5, BQ.1.1, and XBB.1.5 in hemodialysis patients. Additional booster vaccinations with adapted vaccines will likely improve immunity towards current and original SARS-CoV-2 variants and are, therefore, recommended in hemodialysis patients. Further longitudinal studies must show the extent to which this booster vaccination avoids a breakthrough infection.
