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Abstract: PO0133

Predictors of Response to SARS-CoV-2 Vaccines Among Maintenance Dialysis Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Hsu, Caroline M., Tufts Medical Center, Boston, Massachusetts, United States
  • Weiner, Daniel E., Tufts Medical Center, Boston, Massachusetts, United States
  • Aweh, Gideon N., Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Manley, Harold J., Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Ladik, Vladimir, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Frament, Jill M., Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
  • Johnson, Doug, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Lacson, Eduardo K., Tufts Medical Center, Boston, Massachusetts, United States
Background

Vaccines against SARS-CoV-2 are highly effective in the general population; however, their efficacy may be diminished in maintenance dialysis patients, a population particularly vulnerable to COVID-19. We assessed vaccine response in a national sample of maintenance dialysis patients.

Methods

Using retrospective clinical data, we assessed seroresponse to vaccine among maintenance dialysis patients cared for at 130 Dialysis Clinic, Inc (DCI) facilities. Via a clinical protocol available to early vaccinating facilities, antibodies against SARS-CoV-2 spike antigen were semi-quantitatively assessed beginning with the monthly blood draw at least two weeks after completion of a SARS-CoV-2 vaccine series. Vaccine response was defined as a titer ≥2 U/L, and logistic regression analysis was used to identify characteristics associated with response. Patients with history of COVID-19 prior to antibody assessment were excluded.

Results

Among 1,352 patients, 996 (74%) had a serologic response. Serologic response differed significantly by vaccine type: 314/386 (81%) among BNT162b2/Pfizer recipients, 615/655 (94%) among mRNA-1273/Moderna recipients, and 67/311 (22%) among Ad26.COV2.S/Janssen recipients. Age greater than 75, lack of hepatitis B immunity, immune-modulating medication, lower serum albumin, and COPD were associated with vaccine non-response (Figure).

Conclusion

Serologic response to mRNA vaccines is robust among chronic dialysis patients, and the use of mRNA vaccines should be promoted aggressively in this vulnerable population. High rates of non-response to the Janssen vaccine warrant further study. Future research should evaluate the potential role for boosters and whether seroresponse corresponds with protection from COVID-19.

Funding

  • NIDDK Support