1. Humoral and cellular response after BNT162b2 vaccine booster in hemodialysis patients and kidney transplant recipients.
- Author
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De Cagna MR, Colucci V, Di Maggio A, Notaristefano N, Cianciotta F, Danza K, Salvatore F, Santoniccolo A, Lanzillotta SG, Perniola MA, Marangi AL, Morrone LFP, and Tampoia M
- Subjects
- Humans, Antibodies, Viral, BNT162 Vaccine, Immunoglobulin G, Prospective Studies, Transplant Recipients, Vaccines, Kidney Transplantation adverse effects, Renal Dialysis, COVID-19 prevention & control, COVID-19 Vaccines adverse effects
- Abstract
Background: Vulnerable populations, such as hemodialysis (HD) patients and kidney transplant (RTx) recipients, have priority for anti-COVID-19 vaccination, because of their impaired immune status. Here, we investigated the immune response after vaccination with BNT162b2 (two doses plus booster) in HD and RTx patients., Methods: A prospective, observational study was started in two homogeneous groups of 55 HD and 51 RTx patients previously matched from a cohort of 336 patients. Anti-RBD IgG levels, assayed after the second dose with BNT162b2 mRNA, were used to stratify subjects into quintiles. After the second dose and after booster, anti-RBD and IGRA test were evaluated in RTx and HD, belonging to the first and fifth quintiles., Results: After the second dose of vaccine, the median circulating levels of anti-RBD IgG were significantly higher in HD (1456 AU/mL) compared to RTx (27.30 AU/mL). IGRA test showed significantly higher values in the HD (382 mIU/mL) compared with the RTx (73 mIU/mL). After the booster, humoral response increased significantly in both HD (p = 0.0002) and RTx groups (p = 0.009), whereas the T-cellular immunity remained essentially stable in most patients. In RTx patients with a low humoral response after the second dose, the third dose did not significantly strengthen either humoral or cellular immunity., Conclusions: For HD and RTx, there is great variability in the humoral response to anti-COVID-19 vaccination, with a stronger response in the HD group. The booster dose was ineffective at reinforcing the humoral and cellular immune response in most RTx patients hyporesponsive to the second dose., (© 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology.)
- Published
- 2023
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