ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

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.