Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study
Borja Quiroga, María José Soler, Alberto Ortíz, Carlos Jesús Jaravaca Mantecón, Nathasha Nava Pérez, Marta Serra Martín, Yurika Sato, Antonio Franco, Diana Flor Pazmiño Zambrano, Rafael Lucena Valverde, Mayra Ortega Díaz, Carmen Calderón González, Juan Manuel Cazorla López, Mónica Pereira, Emilio González Parra, Ana Sánchez Horrillo, Sánchez González, Néstor Toapanta, Secundino Cigarrán Guldris, Rosa Sánchez Hernández, Soledad Pizarro Sánchez, María Muñiz Rincón, Nuria Garcı́a-Fernández, Natalia Blanco Castro, Rocío Collantes Mateo, Manuel Augusto Quiroz Morales, Beatriz Escamilla-Cabrera, Isabel Berdud Godoy, Beatriz Gil-Casares Casanova, Alba Leyva, José Antonio Muñoz Rojas, Ron T. Gansevoort, Patricia de Sequera, SENCOVAC collaborative network, Marta Puerta Carretero, Daniel Gaitán Tocora, Ma Teresa Jaldo Rodríguez, Tamar Talaván Zanón, Esther Rodriguez Suárez, Alfredo José Sáenz Santolaya, Raquel Cerrajero Calero, Patricia Arribas Cobo, Patricia Muñoz Ramos, Carolina Gracia-Iguacel, Catalina Martín-Cleary, Jinny Sánchez-Rodríguez, Ana Ramos-Verde, Yohana Gil Giraldo, Pablo Ruano Suárez, Antonio Fernández Perpén, Andrés Fernández-Ramos, Laura Salanova Villanueva, Alejandra Cortiñas, Pablo A Díez Arias, Alicia Cabrera Cárdenas, Antonio de Santos, Almudena Hernández Núñez, Guillermina Barril, Raquel Repollet, Francesc Moreso, María Azancot, Natália Ramos, Oriol Bestard, Ignacio Cidraque, Sheila Bermejo, Irene Agraz, Oreto Prat, Carlota Medina, Emma Pardo, A. Sáiz, Nicolás Menéndez Granados, María Jesús Corton Cabo, Walter López Alarcón, Simona Alexandru, Laura García Puente Suarez, Saúl Pampa Saico, Marisol Poma Tapia, Laura Rodríguez Osorio, Rocío Zamora, Paloma Leticia Martin Moreno, Noelia Ania González, Ana Sabalza Ortiz, María Nieves Bastida Iñarrea, Teresa Garcı́a, Carlos F. Narváez, Cristhian Orellana, José Luis Pizarro León, Manuel Antonio Martínez García, Benaldina García Jiménez, Juan de Dios Ramiro Moya, Diana López Espinosa, Alejandro Jiménez Herrador, Manuel Navarro Zurita, Leonardo Díaz Álvarez, Álvaro González Martínez, Sandra Báez Arroyo, Raquel Reina Fernández, Marlyn Janella Suárez Vargas, Rocío Calurano Casero, Gustavo Useche
Abstract
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.