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Abstract: PO0142

Breakthrough COVID-19 Infection in Hemodialysis Patients Following mRNA-1273 (Moderna) Vaccine Administration

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Fuca, Nicholas, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Chan, Lili, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Campbell, Kirk N., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Shaikh, Aisha, Memorial Sloan Kettering Cancer Center, New York, New York, United States
Background

Patients on maintenance hemodialysis are highly susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We recently reported that 95% (58/61) hemodialysis patients developed anti-receptor binding domain (RBD) IgG antibody following the 2-dose Moderna vaccine administration. The incidence of breakthrough COVID-19 infection in hemodialysis patients following vaccination is not known.

Methods

All hemodialysis patients (n=61) received the 2-dose Moderna vaccine series. Anti-RBD IgG titer was measured at 1-, 2-, 4- weeks after the 1st vaccine dose. The 2nd vaccine dose was administered 29±3.9 days after the 1st dose. Anti-RBD IgG titer was measured at 1-week following the 2nd vaccine dose. Nasal swabs were performed every 2-weeks to detect SARS-CoV-2 RNA as part of routine surveillance. Additionally, nasal swab tests were performed if patients exhibited signs or symptoms suggestive of COVID-19. Patients were followed for 2-months following the 2nd vaccine dose administration.

Results

Three patients tested positive for SARS-CoV-2 RNA following vaccination. Of these 3 patients, 2 patients tested positive at day-7- and at day-12 following the 1st vaccine dose respectively. Both these patients presented with symptoms of fever and dyspnea, and both had undetectable anti-RBD IgG titer at the time of COVID-19 diagnosis.
A third patient tested positive for SARS-CoV-2 RNA on routine nasal swab surveillance test at day-40 following the 2nd vaccine dose administration. At the time of the test, the patient had a positive anti-RBG IgG titer. The patient remained asymptomatic and had an uneventful course. Viral genome analysis revealed that the infection was due to the B.1.526 SARS-CoV-2 variant, also known as the New York variant.

Conclusion

Breakthrough COVID-19 infections were rare in fully vaccinated hemodialysis patients up to 2-months following the Moderna vaccine administration. One case of SARS-CoV-2 breakthrough infection was due to the B.1.526 variant.