To the editor:Patients with end-stage renal disease undergoing dialysis are at very high risk of death in case of COVID-191Jager K.J. Kramer A. Chesnaye N.C. et al.Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe.. Growing evidence suggests that a relatively high proportion of dialysis patients develops anti-SARS-Cov2-antibodies after vaccination, albeit to a lesser extent than healthy controls2

Simon B, Rubey H, Treipl A, et al. Haemodialysis patients show a highly diminished antibody response after COVID-19 mRNA vaccination compared to healthy controls. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2021.

. Here, we investigated whether there are differences in anti-SARS-CoV2 antibody levels (directed against the receptor binding domain (RBD) of the S1 subunit of the Spike (S) protein, measured with the SARS-CoV-2 IgG II Quant assay, Abbott) in hemodialysis patients without a history of SARS-CoV2-infection after full vaccination (2 doses) with one of the two currently available mRNA-vaccines (BNT162b2, Biontech/Pfizer or mRNA-1273, Moderna) against SARS-CoV2, 3 weeks after administration of the second vaccine dose. A patient flow chart, study methods, patient demographics and additional analyses are shown in the supplement. In the entire cohort (N=116), 3 patients (2.6%; 2 vaccinated with BNT162b2, 1 vaccinated with mRNA-1273) remained anti-S-antibody negative.Patients vaccinated with mRNA-1273 showed significantly higher anti-S-antibody titers (median 1507, IQR 612-3112 BAU/ml) compared to patients vaccinated with BNT162b2 (median 676, IQR 197-1363 BAU/ml; pfigure 1). After correction for age, sex, diabetes status, serum albumin, dialysis dose, previous kidney transplantation, ongoing immunosuppressive medication and active malignancy, mRNA-1273 vaccinated patients showed 2.98-fold higher anti-S antibody titers compared to patients vaccinated with BNT162b2 in a linear regression analysis (p

Figure 1Anti-S-antibody titers (log-scale) in hemodialysis patients according to vaccine type.

Show full caption

Open circles indicate anti-S-antibody titers of individual patients. Horizontal red lines indicate median antibody titers. BAU…binding antibody units.

In conclusion, hemodialysis patients vaccinated with mRNA-1273 showed higher anti-S-antibody titers than patients vaccinated with BNT162b2.

Supplementary MaterialReferencesJager K.J. Kramer A. Chesnaye N.C. et al.

Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe.

Kidney Int. 98: 1540-1548

Simon B, Rubey H, Treipl A, et al. Haemodialysis patients show a highly diminished antibody response after COVID-19 mRNA vaccination compared to healthy controls. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2021.

Article InfoPublication History

Accepted: July 2, 2021

Received in revised form: June 28, 2021

Received: May 22, 2021

Publication stageIn Press Journal Pre-ProofIdentification

DOI: https://doi.org/10.1016/j.kint.2021.07.004

Copyright

© 2021 Published by Elsevier, Inc., on behalf of the International Society of Nephrology.

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