Diminishing Immune Responses against Variants of Concern in Dialysis Patients 4 Months after SARS-CoV-2 mRNA Vaccination
Alex Dulovic, Monika Strengert, Gema Morillas Ramos, Matthias Becker, Johanna Griesbaum, Daniel Junker, Karsten Lürken, Andrea Beigel, Eike Wrenger, Gerhard Lonnemann, Anne Cossmann, Metodi V. Stankov, Alexandra Dopfer‐Jablonka, Philipp D. Kaiser, Bjoern Traenkle, Ulrich Rothbauer, Gérard Krause, Nicole Schneiderhan‐Marra, Georg M. N. Behrens
Abstract
Patients undergoing chronic hemodialysis were among the first to receive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations because of their increased risk for severe coronavirus disease and high case-fatality rates. By using a previously reported cohort from Germany of at-risk hemodialysis patients and healthy donors, where antibody responses were examined 3 weeks after the second vaccination, we assessed systemic cellular and humoral immune responses in serum and saliva 4 months after vaccination with the Pfizer-BioNTech BNT162b2 vaccine using an interferon-γ release assay and multiplex-based IgG measurements. We further compared neutralization capacity of vaccination-induced IgG against 4 SARS-CoV-2 variants of concern (Alpha, Beta, Gamma, and Delta) by angiotensin-converting enzyme 2 receptor-binding domain competition assay. Sixteen weeks after second vaccination, compared with 3 weeks after, cellular and humoral responses against the original SARS-CoV-2 isolate and variants of concern were substantially reduced. Some dialysis patients even had no detectable B- or T-cell responses.