COVID19 vaccine type and humoral immune response in patients receiving dialysis

Garcia, Pablo; Anand, Shuchi; Han, Jialin; Montez-Rath, Maria; Sun, Sumi; Shang, Tiffany; Parsonnet, Julie; Chertow, Glenn M; Schiller, Brigitte; Abra, Graham

BACKGROUND: Patients on dialysis vaccinated with the attenuated adenovirus SARS-CoV-2 vaccine might mount an impaired response to vaccination. METHODS: We evaluated the humoral vaccination response among 2,099 fully vaccinated patients receiving dialysis. We used commercially available assays (Siemens) to assess prevalence of no response or diminished response to COVID-19 vaccination by vaccine type. We defined “no seroconversion” as lack of change from negative to positive in total RBD Ig antibody, no detectable response on semiquantitative RBD IgG antibody (index value <1) as “no RBD IgG response”, and a semiquantitative RBD IgG index value <10 as “diminished RBD IgG response” RESULTS: Of the 2,099 fully vaccinated patients on dialysis, the proportion receiving the mRNA1273, BNT162b2, and Ad26.COV2.S were 62% (n=1316), 20% (n=416) and 18% (n=367), respectively. A third (33.3%) of patients receiving the attenuated adenovirus Ad26.COV2.S vaccine failed to seroconvert and an additional 36% had no detectable or diminished IgG response even 28–60 days post vaccination. CONCLUSION: One in three fully vaccinated patients receiving dialysis had evidence of an impaired immune response to the attenuated adenovirus Ad26.COV2.S vaccine.