Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients
Patrick Affeldt, Felix C. Koehler, Karl August Brensing, Martin Gies, Eva Platen, Vivien Adam, Linus Butt, Franziska Grundmann, Eva Heger, Steffen Hinrichs, Nils Kalisch, Simon Oehm, Gertrud Steger, Maike Wirtz, Thomas Benzing, Dirk L. Stippel, Florian Klein, Christine Kurschat, Roman‐Ulrich Müller, Veronica Di Cristanziano
Abstract
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a serious hazard for hemodialysis (HD) patients and kidney transplant (KTX) recipients as they suffer from an impaired immune response to SARS-CoV-2 vaccination. In addition, a definition of SARS-CoV-2 IgG titer that indicates a sufficient immune response, especially against new omicron variants, is urgently needed. In the present study, the immune response to either a third or a fourth dose of a mRNA vaccine was investigated in 309 dialysis and 36 KTX patients. SARS-CoV-2 IgG titer thresholds indicating neutralizing activity against wild type (WT) and the omicron variant BA.1 were quantified. After four vaccine doses, a high-neutralizing activity against WT was evidenced in HD patients, whereas the neutralizing rate against BA.1 was significant lower. Concerning KTX recipients, humoral and cellular immune responses after a third vaccination were still highly impaired. This calls for modified omicron-targeting vaccines.