Infectious Disease

The study shows how patients on hemodialysis respond to Pfizer’s COVID-19 vaccine

April 13, 2021

2 min read

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Grupper reports that he is employed at the Tel Aviv Medical Center. In the study you will find all relevant financial information from all other authors.

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Research in Israel showed that although patients on maintenance hemodialysis had a “significant” antibody response to the COVID-19 vaccine from Pfizer and BioNTech, it was less than that in patients without kidney disease.

Age also appeared to play an important role in the humoral immune response of all participants.

COVID-19 vaccine antibody response

The data were provided by Grupper A et al. Clin J Am Soc Nephrol. 2021; doi: 10.2215 / CJN.03500321.

“The prioritization of dialysis patients for vaccination was at the top of the international SARS-CoV-2 vaccination programs.” Ayelet Groups, MD, of Tel Aviv Medical Center and colleagues, wrote. “Patients with CRF, particularly those with renal failure, were treated with maintenance therapy [hemodialysis] Huntington’s disease tends to have a decreased immune response to infection or vaccination, as shown with the hepatitis B virus vaccine. As a result, there is often a need for higher vaccine doses or planning changes in these patients.

This study aims to determine one aspect of the immune response, the humoral response to the BNT162b2 vaccine (PfizerBioNTech) in patients with renal failure at HD maintenance. “

The researchers compared the responses of 56 dialysis patients with that of 95 health care workers (who served as controls) a median 30 days after receiving the second dose of the vaccine.

All participants in the control group developed an antibody response to 96% of the dialysis patients.

Specific observations regarding differences in response between groups indicated that immunoglobulin G levels in patients in the dialysis group were significantly lower compared to controls (median of 2,900 versus 7,401), and the likelihood of being in the lower quartile of IgG Levels were 2.7 times higher for dialysis patients.

Within the dialysis group, those who were older or who had lower lymphocyte counts were most likely to have lower IgG levels (OR of 1.22 per 1 year older and 0.83 per 10-e3 / ml-higher lymphocyte count).

Age was significant for both groups, with the probability of being in the lower IgG quartile being 1.11 times higher per year.

According to Gupper and colleagues, this finding (which showed little difference in antibody response, especially in participants over 70 years of age) suggests that age is an important factor regardless of medical conditions.

The researchers also pointed out some limitations to the study, noting that their study population did not allow for consideration of the possible roles that race and ethnicity might play.

“In many countries, the incidence and / or severity of COVID-19 have varied by ethnicity, which we were unable to study due to the homogeneity of our HD maintenance population,” they wrote.

They also pointed out that the “significant age difference” between dialysis patients and healthcare workers is important, as the former had an average age of 74 versus 57.

Despite the limitations, the researchers highlighted how the study helps understand the vaccine effects for this patient population.

“Although the extent of humoral response in most patients on maintenance therapy was considered positive in our study, the weaker seroresponse (compared to controls and the populations in which the vaccine trials were conducted) may have consequences, including lower efficacy of the Vaccine for the parent strain or variants that develop and / or a shorter period of immune protection after vaccination, “they wrote.

In a related press release, co-investigators Moshe Shashar, MD, shared his point of view on how the results could be useful in the future.

“I believe our results should encourage dialysis-treated patients with kidney failure to get vaccinated as soon as they have a vaccine available, while we as caregivers should look for ways to improve its effectiveness in our patients “, he said.

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