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Antibody and T-Cell Responses 6 Months after Covid-19 mRNA-1273 Vaccination in Patients with Chronic Kidney Disease, on Dialysis, or Living with a Kidney Transplant

32 Pages Posted: 30 Mar 2022

See all articles by Jan-Stephan Sanders

Jan-Stephan Sanders

University of Groningen - Division of Nephrology

A. Lianne Messchendorp

University of Groningen - Division of Nephrology

Rory de Vries

Erasmus University Rotterdam (EUR) - Department of Viroscience

Carla C. Baan

Erasmus University Rotterdam (EUR) - Department of Internal Medicine, Nephrology and Transplantation; Erasmus University Rotterdam (EUR) - Department of Internal Medicine

Debbie van Baarle

University of Groningen - Department of Medical Microbiology and Infection Prevention

Robert Samuel van Binnendijk

National Institute for Public Health and the Environment (RIVM) - Department for Immunology of Infectious Diseases and Vaccination (IIV)

Dimitri A. Diavatopoulos

Radboud University Nijmegen - Radboud University Medical Center

Daryl Geers

Erasmus University Rotterdam (EUR) - Department of Viroscience

Katharina S. Schmitz

Erasmus University Rotterdam (EUR) - Department of Viroscience

Corine GeurtsvanKessel

Erasmus Medical Center - Viroscience Department

Gerco den Hartog

National Institute for Public Health and the Environment (RIVM) - Department of Immune Surveillance

Marcia ML Kho

Erasmus University Rotterdam (EUR) - Department of Internal Medicine, Nephrology and Transplantation

Marion Koopmans

Erasmus University Rotterdam (EUR) - Department of Viroscience

Renate Van der molen

Radboud University Nijmegen - Radboud University Medical Center

Ester Remmerswaal

University of Amsterdam - Department of Experimental Immunology

Nynke Rots

National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control

Ron T. Gansevoort

University of Groningen - Division of Nephrology

Frederike J. Bemelman

University of Amsterdam - Department of Internal Medicine

Luuk B. Hilbrands

Radboud University Nijmegen - Radboud University Medical Center

Marlies EJ Reinders

Erasmus University Rotterdam (EUR) - Department of Internal Medicine, Nephrology and Transplantation

RECOVAC Collaborators

Independent

More...

Abstract

Background: The i mmune response to COVID-19 vaccination is inferior in kidney transplant recipients (KTR), and to a lesser extent in patients on dialysis or with chronic kidney disease (CKD). We assessed the immune response 6 months after mRNA-1273 vaccination in kidney patients and compared this to controls.

Methods: 152 participants with CKD stages G4/5 (eGFR <30 mL/min/1.73m 2 ), 145 participants on dialysis, 267 KTR, and 181 controls were included. SARS-CoV-2 Spike S1-specific IgG antibodies were measured by fluorescent bead-based multiplex-immunoassay, neutralizing antibodies to ancestral, Delta and Omicron (BA.1) variants by plaque reduction, and T-cell responses by IFN-γ release assay.

Findings: At 6 months after vaccination S1-specific antibodies were detected in 100% of controls, 98.7% of CKD G4/5 patients, 95.1% of dialysis patients, and 56.6% of KTR. These figures were comparable to the response rates at 28 days, but antibody levels waned significantly. Neutralization of the ancestral and Delta variant was detected in most participants, whereas neutralization of Omicron was mostly absent. S-specific T-cell responses were detected 6 months in 75.0% of controls, 69.4% of CKD G4/5 patients, 52.6% of dialysis patients, and 12.9% of KTR. T-cell responses at 6 months were significantly lower than responses at 28 days.

Interpretation: Although seropositivity rates at 6 months were comparable to that at 28 days after vaccination, significantly decreased antibody levels and T-cell responses were observed. The combination of low antibody levels, reduced T-cell responses, and absent neutralization of the newly-emerging variants indicates the need for additional boosts or alternative vaccination strategies in KTR.

Trial Registration: This study was registered with number NCT04741386 (ClinicalTrials.gov).

Funding: The Dutch Renal patients COVID-19 VACcination (RECOVAC) study was funded by
the Netherlands Organization for Health Research and Development (ZonMw), project
number: 10430072010002). This organization had no role in the design of the study, data
interpretation, writing of the manuscript nor in the decision to submit the manuscript.

Declaration of Interest: None to declare.

Ethical Approval: Ethical approval was obtained from the Dutch Central Committee on Research Involving Human Subjects (CCMO, NL76215.042.21) and the local ethics committees of the participating centers.

Keywords: COVID-19, mRNA-1273, vaccine, chronic kidney disease, kidney transplantation, dialysis, immunogenicity

Suggested Citation

Sanders, Jan-Stephan and Messchendorp, A. Lianne and de Vries, Rory and Baan, Carla C. and van Baarle, Debbie and van Binnendijk, Robert Samuel and Diavatopoulos, Dimitri A. and Geers, Daryl and Schmitz, Katharina S. and GeurtsvanKessel, Corine and den Hartog, Gerco and Kho, Marcia ML and Koopmans, Marion and Van der molen, Renate and Remmerswaal, Ester and Rots, Nynke and Gansevoort, Ron T. and Bemelman, Frederike J. and Hilbrands, Luuk B. and Reinders, Marlies EJ and Collaborators, RECOVAC, Antibody and T-Cell Responses 6 Months after Covid-19 mRNA-1273 Vaccination in Patients with Chronic Kidney Disease, on Dialysis, or Living with a Kidney Transplant. Available at SSRN: https://ssrn.com/abstract=4070419 or http://dx.doi.org/10.2139/ssrn.4070419

Jan-Stephan Sanders (Contact Author)

University of Groningen - Division of Nephrology ( email )

Groningen
Netherlands

A. Lianne Messchendorp

University of Groningen - Division of Nephrology ( email )

Groningen
Netherlands

Rory De Vries

Erasmus University Rotterdam (EUR) - Department of Viroscience ( email )

Netherlands

Carla C. Baan

Erasmus University Rotterdam (EUR) - Department of Internal Medicine, Nephrology and Transplantation ( email )

Rotterdam
Netherlands

Erasmus University Rotterdam (EUR) - Department of Internal Medicine ( email )

Debbie Van Baarle

University of Groningen - Department of Medical Microbiology and Infection Prevention ( email )

Groningen
Netherlands

Robert Samuel Van Binnendijk

National Institute for Public Health and the Environment (RIVM) - Department for Immunology of Infectious Diseases and Vaccination (IIV) ( email )

Bilthoven
Netherlands

Dimitri A. Diavatopoulos

Radboud University Nijmegen - Radboud University Medical Center ( email )

Nijmegen
Netherlands

Daryl Geers

Erasmus University Rotterdam (EUR) - Department of Viroscience ( email )

Netherlands

Katharina S. Schmitz

Erasmus University Rotterdam (EUR) - Department of Viroscience ( email )

Netherlands

Corine GeurtsvanKessel

Erasmus Medical Center - Viroscience Department ( email )

Netherlands

Gerco Den Hartog

National Institute for Public Health and the Environment (RIVM) - Department of Immune Surveillance ( email )

Marcia ML Kho

Erasmus University Rotterdam (EUR) - Department of Internal Medicine, Nephrology and Transplantation ( email )

Rotterdam
Netherlands

Marion Koopmans

Erasmus University Rotterdam (EUR) - Department of Viroscience ( email )

Netherlands

Renate Van der molen

Radboud University Nijmegen - Radboud University Medical Center ( email )

Ester Remmerswaal

University of Amsterdam - Department of Experimental Immunology ( email )

Netherlands

Nynke Rots

National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control ( email )

Bilthoven
Netherlands

Ron T. Gansevoort

University of Groningen - Division of Nephrology ( email )

Groningen
Netherlands

Frederike J. Bemelman

University of Amsterdam - Department of Internal Medicine ( email )

Luuk B. Hilbrands

Radboud University Nijmegen - Radboud University Medical Center ( email )

Nijmegen
Netherlands

Marlies EJ Reinders

Erasmus University Rotterdam (EUR) - Department of Internal Medicine, Nephrology and Transplantation ( email )

Rotterdam
Netherlands

RECOVAC Collaborators

Independent