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Kidney Week

Abstract: SA-PO593

Immune Response of Heterologous vs. Homologous Prime-Boost Regimens with Adenoviral Vectored and mRNA COVID-19 Vaccines in Immunocompromised Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Chu, Chang, Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
  • Krämer, Bernhard K., Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
  • Hocher, Berthold, Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
Background

Due to rare but major adverse reactions to the AstraZeneca adenoviral ChAdOx1-S-nCoV-19 vaccine (ChAd), German health authorities recommended adults under 60 who received one dose of ChAd, to receive a second dose of the BioNTech mRNA BNT162b2 vaccine (BNT) as a booster. Studies in the general population suggest an enhanced efficacy of the heterologous (ChAd-BNT) compared to the homologous (BNT-BNT) vaccination regimen. However, an analysis of the efficacy in patient populations with a high risk of severe COVID-19 due to acquired immunodeficiency is still missing.

Methods

We therefore compared both vaccination regimens in healthy controls, patients on dialysis and patients with rheumatic diseases concerning the humoral and cellular immune response.

Results

The humoral and cellular immune response differed substantially in healthy controls compared to patients with acquired immunodeficiency. Overall, the most significant differences between the two immunization regimens were found in neutralizing antibodies. These were higher after a heterologous immunization. Healthy controls responded well to both vaccination regimens. However, the formation of neutralizing antibodies was more pronounced after a heterologous immunization. Dialysis patients, on the other hand, only developed an adequate humoral and particularly cellular immune response after a heterologous immunization. Rheumatic patients also - to a weaker extent compared to dialysis patients - benefited from a heterologous immunization.

Conclusion

In conclusion, the heterologous COVID-19 vaccination regimens (ChAd-BNT) seem to have an advantage over the homologous vaccination regimens, especially in immunocompromised patients such as patients with end-stage kidney disease treated with hemodialysis.