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Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study

Publicated to:Clinical Kidney Journal. 15 (10): 1856-1864 - 2022-10-01 15(10), DOI: 10.1093/ckj/sfac169

Authors: Quiroga B; Soler MJ; Ortiz A; Jaravaca Mantecón CJ; Nava Pérez N; Serra Martín M; Sato Y; Marin Franco AJ; Pazmiño Zambrano DF; Lucena Valverde R; Ortega Diaz M; Calderón González C; Cazorla López JM; Pereira M; González Parra E; Sánchez Horrillo A; Sánchez González C; Toapanta N; Cigarrán Guldris S; Sánchez Hernández R; Pizarro Sánchez S; Muñiz Rincón M; Garcia-Fernández N; Blanco Castro N; Collantes Mateo R; Quiroz Morales MA; Escamilla-Cabrera B; Berdud Godoy I; Gil-Casares Casanova B; Leyva A; Rojas J; Gansevoort RT; De Sequera P; Carretero MP; Tocora DG; Rodríguez MTJ; Zanón TT; Suárez ER; Santolaya AJS; Calero RC; Cobo PA; Ramos PM; Gracia-Iguacel C; Martin-Cleary C; Sánchez-Rodríguez J; Ramos-Verde A; Giraldo YG; Suárez PR; Perpén AF; Ramos AF; Villanueva LS; Cortiñas A; Díez Arias PA; Cárdenas AC; De Santos A; Núñez A; Cuadrado GB; Repollet R; Moreso F; Azancot MA; Ramos N; Bestard O; Cidraque I; Bermejo S; Agraz I; Prat O; Medina C; Pardo E; Saiz A; Granados NM; Cabo MJC; Alarcón WL; Alexandru S; Suarez LGP; Saico SP; Tapia MP; Osorio LR; Zamora R; Moreno PLM; González NA; Ortiz AS; Iñarrea MNB; García T; Narváez C; Orellana C; León JLP; García MAM; Jiménez BG; Moya JDDR; Espinosa DL; Herrador AJ; Zurita MN; Álvarez LD; Martínez ÁG; Arroyo SB; Fernández RR; Vargas MJS; Casero RC; Useche G; De Miguel CS

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Abstract

Background: Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose. Methods: This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed. Results: A total of 711 patients [67% male, median age (range) 67 (20-89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P =. 001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P =. 693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P =. 001), lower time from booster (P =. 043) and past breakthrough SARS-CoV-2 infection (P <. 001). Conclusions: In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infection.

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