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Abstract: PO0145

Extremely Low Humoral Immune Responses to BNT162b2 Vaccine in Nursing Home Residents Undergoing Hemodialysis

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)


  • Kitamura, Mineaki, Nagasaki Renal Center, Nagasaki, Japan
  • Takazono, Takahiro, Nagasaki Daigaku Igakubu Daigakuin Ishiyakugaku Sogo Kenkyuka, Nagasaki, Nagasaki, Japan
  • Nishino, Tomoya, Nagasaki Daigaku Igakubu Daigakuin Ishiyakugaku Sogo Kenkyuka, Nagasaki, Nagasaki, Japan
  • Funakoshi, Satoshi, Nagasaki Renal Center, Nagasaki, Japan

As coronavirus disease 2019 (COVID-19) can cause lethal outcomes in hemodialysis (HD) patients, they should be protected effectively by vaccination. HD patients are known to have a weak immune response to vaccines, and the seropositive rate three week after first vaccination (BNT162b2 Pfizer) is around 35%. However, its efficacy among elderly HD patients remains unknown. We aimed to evaluate spike antibody levels of nursing home residents on long-term maintenance HD after the BNT162b2 vaccine, comparing those of health care workers.


Between April and May 2021, HD patients from a nursing home (nursing home group) and health care workers (the control group) who received BNT162b2 were included. Those with a prior history of COVID-19 were excluded. IgG anti-spike against COVID-19 were measured by Elecsys Roche (cut off index <1.0) 3 weeks after the first injection.


The study included 27 nursing home residents on HD and 191 care workers, and 2 care workers were excluded due to a prior history of COVID-19. The nursing home group were 84±9 years old and 41% male, and the median of HD vintage was 51 months (IQR 28-119), and the control group were 45±14 years old and 29% male. Only 6 patients in the nursing group were confirmed as seropositive (22%), whereas the rate of responder in the control group was 99% (p<0.001). Notably, the IgG levels of 20 patients in the nursing home group were under the detectable level (<0.4). In contrast, the median of the IgG levels in the control group was 42 (IQR 18-87). Moreover, the prevalence of adverse reactions, such as developing fever, in the nursing home group was low compared to the control group (p<0.001)


The seropositive rate after BNT162b2 in elderly HD patients was quite low owing to poor immune responses. To prevent a COVID-19 outbreak in nursing homes, IgG levels against COVID-19 in elderly residents on HD should be paid attention to.