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Abstract: TH-PO932

mRNA Vaccines Increase SARS-CoV-2 Antibody Levels Among Dialysis Patients Initially Vaccinated With Adenovirus Vector-Based SARS-CoV-2 Vaccine (Ad26.COV2.S)

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)


  • Willetts, Joanna, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Ficociello, Linda, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Johnson, Curtis D., Spectra Laboratories, Milpitas, California, United States
  • Alexander, Sandra E., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Mullon, Claudy, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Hymes, Jeffrey L., Fresenius Medical Care, Waltham, Massachusetts, United States

Antibody (AB) response to Ad26.COV2.S vaccine (AdV) was observed to be lower than with mRNA vaccines in dialysis patients and additional vaccine doses were recommended. We conducted a quality improvement project in Fresenius Kidney Care clinics to track AB response in dialysis patients initially administered AdV who later received or did not receive additional vaccine doses.


AB response was measured in remnant blood with semiquantitative chemiluminescent assay detecting IgG AB directed against receptor binding domain of S1 subunit of SARS-CoV-2 spike antigen (Siemens); AB index >1 was considered reactive, >7 as adequate, and > 750 was maximum detected. All patients who received an AdV, had 2 AB measures after vaccination, and were not Covid-19 positive/suspected cases were included in the analysis. Patients were classified into 4 groups based on vaccine doses received: AdV single dose (n=103); AdV+AdV (n=8); AdV+mRNA (n=329); AdV+mRNA+mRNA (n=14). First AB measurement occurred after initial AdV dose and Last AB measurements occurred after additional vaccine doses.


AB was measured, on average, 97 (sd 12) days and 325 (sd 14) days after first AdV dose for First AB and Last AB measurements, respectively. Distribution of AB responses are shown in Figure. At Last AB measurement, AB index ≤ 7 was common for AdV and AdV + AdV groups (43% and 51%, respectively). However, it was rare in AdV+mRNA and AdV+mRNA+mRNA groups (7% and 0%, respectively).


Patients who were initially vaccinated with AdV, had improved AB response after one or two mRNA vaccine doses. This response was more pronounced than when patients were administered an additional AdV dose.


  • Commercial Support – Fresenius Medical Care