Clin Exp Vaccine Res.  2023 Jul;12(3):249-259. 10.7774/cevr.2023.12.3.249.

Antibody response to COVID-19 vaccination in patients on chronic hemodialysis

• Choi H
• Han S
• Kim JS
• Park B
• Lee MJ
• Shin GT
• Kim H
• Kim K
• Park AY
• Shin HJ
• Park I

• KMID: 2545222
• DOI: http://doi.org/10.7774/cevr.2023.12.3.249

Abstract

Purpose
Since patients on hemodialysis (HD) are known to be vulnerable to coronavirus disease 2019 (COVID-19), many studies were conducted regarding the effectiveness of the COVID-19 vaccine in HD patients in Western countries. Here, we assessed antibody response of HD patients for 6 months post-vaccination to identify the duration and effectiveness of the COVID-19 vaccine in the Asian population.
Materials and Methods
We compared antibody response of the COVID-19 vaccine in HD patients with healthy volunteers. Patient and control groups had two doses of ChAdOx1 nCoV-19 and mRNA-1273, respectively. Immunoglobulin G (IgG) was measured before vaccination, 2 weeks after the first dose, 2 and 4 weeks, 3 and 6 months after the second dose. Neutralizing antibody was measured before vaccination and at 2 weeks, 3 and 6 months after second dose. Since the third dose was started in the middle of the study, we analyzed the effect of the third dose as well.
Results
Although antibody production was weaker than the control group (n=22), the patient group (n=39) showed an increase in IgG and neutralizing antibody after two doses. And, 21/39 patients and 14/22 participants had a third dose (BNT162b2 or mRNA-1273 in the patient group, mRNA-1273 in the control group), and it did not affect antibody response in both group. Trend analysis showed IgG and neutralizing antibody did not decrease over time. Age, sex, and HD vintage did not affect antibody production in HD patients. Patients with higher body mass index displayed better seroresponse, while those on immunosuppressants showed poor seroresponse.
Conclusion
Two doses of vaccination led to significant antibody response in HD patients, and the antibody did not wane until 6 months.

Keyword

Antibody formation; COVID-19; COVID-19 vaccines; Neutralizing antibodies; Renal dialysis