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Abstract: PO0135

Anti-Spike Antibody Responses in Hemodialyzed Patients Vaccinated with Anti-COVID-19 BNT162b2 mRNA Vaccine

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Godinho, Iolanda, Davita Óbidos, Óbidos, Portugal
  • Abrantes, Ana rita, Davita Óbidos, Óbidos, Portugal
  • Bergman, Marie-Louise Lisa, Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Gonçalves, Lígia Antunes, Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Duarte, Nádia, Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Borges, Patricia C., Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Brennand, Ana, Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Malheiro, Vanessa Costa, Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Matoso, Paula G., Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Akpogheneta, Onome, Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Demengeot, Jocelyne, Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Penha-Gonçalves, Carlos, Instituto Gulbenkian de Ciencia, Oeiras, Portugal
  • Marques, Marco Alexandre, Affidea Portugal, Lisboa, Lisboa, Portugal
  • Nogueira, Estela, Davita Óbidos, Óbidos, Portugal
  • Cruz, Pedro Azevedo, Davita Óbidos, Óbidos, Portugal
  • Weigert, Andre L., Davita Óbidos, Óbidos, Portugal
Background

Patients under hemodialysis are at higher risk of developing severe complications upon SARS-CoV-2 infection and were prioritized in the Portuguese vaccination campaign.

Methods

We performed a longitudinal analysis of antibody responses upon vaccination with BNT162b2 mRNA (Pfizer/BioNTech, Comirnaty) in a cohort of 156 hemodialyzed patients. Direct ELISA was used to quantify IgG, IgM and IgA anti-full-length Spike antibody levels against calibrated sera from naturally infected patients at three points: day of the first vaccine dose (t0); 3 weeks later (day of the second dose, t1), and 3 weeks after the second inoculation (t2) for 143/156 patients. Anti-n was also measured in t0 and patients anti-n positive were excluded.

Results

We observed that 90.9% of the patients developed anti-spike IgG antibodies after the second vaccine dose (t2). Seroconversion was remarkably low at t1 after the first vaccine dose with only 29.4% of patients developing anti-spike IgG antibodies. In addition to positivity, the second vaccine dose markedly increased IgG antibody levels. IgA levels were also higher at t2 with 83.9% of the patients achieving positivity while IgM positivity only reached 29.4%. Age showed a significant negative effect on the humoral response at t2 for anti-Spike IgG and for IgM, particularly over 60 years.
Further analysis revealed that nine patients under immunosuppression therapies showed significantly lower humoral response along the vaccine schedule (p=0.005 at t1; p=0.008 at t2). Interestingly, the inability to develop anti-HBs antibodies upon hepatitis B vaccination frequently found in hemodialyzed patients was not correlated with lack of responsiveness to SARS-CoV-2 vaccination.

Conclusion

The large majority hemodialyzed patients showed a significant humoral response to BNT162b2 mRNA vaccination, but a sizable proportion of patients showed low antibody levels when compared to responses in the general population (medRxiv 2021.03.19.21253680).

Age Group (years)27-4950-5960-6970-7980-8990-93
IgG (median)2.272.092.071.842.000.54
IgG (IQR)(2.1-2.4)(1.9-2.3)(1.8-2.2)(1.6-2.2)(1.6-2.2)(0.38-1.9)