Diminishing immune responses against variants of concern in dialysis patients four months after SARS-CoV-2 mRNA vaccination

Dulovic, A.; Strengert, M.; Morillas Ramos, G.; Becker, M.; Griesbaum, J.; Junker, D.; Luerken, K.; Beigel, A.; Wrenger, E.; Lonnemann, G.; Cossmann, A.; Stankov, M. V.; Dopfer-Jablonka, A.; Kaiser, P. D.; Traenkle, B.; Rothbauer, U.; Krause, G.; Schneiderhan-Marra, N.; Behrens, G. M. N.

Patients undergoing chronic hemodialysis were among the first to receive SARS-CoV-2 vaccinations due to their increased risk for severe COVID-19 disease and high case fatality rates. To date, there have been minimal longitudinal studies in hemodialysis patients to ascertain whether protection offered by vaccination is long-lasting. To assess how surrogates for protection changed over time, we examined both the humoral and cellular response in a previously reported cohort of at-risk hemodialysis patients and healthy donors, four months after their second dose of Pfizer BNT162b2. Compared to three weeks post-second vaccination, both cellular and humoral responses against the original SARS-CoV-2 isolate as well as variants of concern were significantly reduced, with some dialyzed individuals having no B- or T-cell response. Our data strongly support the need for a third booster in hemodialysis patients and potentially other at-risk individuals.