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Abstract: TH-PO962

Neutralising Antibodies Against SARS-CoV-2 and Variants of Concern in In-Centre Haemodialysis Patients in the United Kingdom

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Carr, Edward, The Francis Crick Institute, London, London, United Kingdom
  • Beale, Rupert, The Francis Crick Institute, London, London, United Kingdom

Group or Team Name

  • NAOMI Consortium, Crick COVID Immunity Consortium, Legacy Study Consortium
Background

Haemodialysis patients have significant morbidity and mortality from SARS-CoV-2 infection. In-centre haemodialysis (IC-HD) patients are at particular risk at times of high community transmission as they must attend healthcare settings for life-preserving treatment sessions. In the UK, adenoviral or mRNA vaccines were used for doses 1 and 2 in IC-HD. mRNA vaccines were used for subsequent doses. IC-HD patients are not reported by the phase 3 vaccine trials. Given the coalescence of uraemia, immunosuppressive primary renal diseases and treatments, together with prior experience using other vaccines (for example influenza), we anticipated that IC-HD patients would have an attenuated response to SARS-CoV-2 vaccination.

Methods

As a UK-wide consortium, we have used a high-throughput live virus microneutralisation assay to determine the ability of IC-HD patient sera to neutralise ancestral SARS-CoV-2 and variants of concern (VOCs). Ancestral binding Spike antibodies were also assessed by an ancestral S1 ELISA and by a flow cytometry method with full-length trimeric Spike.

Results

We will report IC-HD neutralisation titres after fourth doses and to the newest VOCs, BA.4 and BA.5. Neutralising responses to the first three doses in IC-HD patients are already published by the consortium (Carr et al. The Lancet 2021 and 2022). We will show heterogeneity in the cross-neutralising ability of IC-HD patient sera, and explore how population-level ancestral binding antibody correlations neutralisation titres might not generalise to the individual patient.

Conclusion

Three doses were required for most IC-HD patients to generate neutralising titres against Delta and Omicron BA.1. Further doses are likely required to maintain high serological protection in this vulnerable group of renal patients.

Funding

  • Private Foundation Support