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Vaccines
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Effectiveness of SARS-CoV-2 Vaccines in Hemodialysis Patients
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Effectiveness of SARS-CoV-2 Vaccines in Hemodialysis Patients

A special issue of Vaccines (ISSN 2076-393X).

Deadline for manuscript submissions: closed (29 September 2023) | Viewed by 6049

Special Issue Editors

Dr. Kan Kikuchi

E-Mail Website
Guest Editor
Division of Nephrology, Tokyo, Japan
Interests: dialysis
Dr. Koki Yamashita

E-Mail Website
Guest Editor
1. Maxwell International, Inc., Chiba, Japan
2. College of Liberal Arts and Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Interests: clinical trials; epidemiology; public health; research and development; effectiveness study; efficacy and safety; evidence-based medicine; publication practice

Special Issue Information

Dear Colleagues,

The severity and fatality rates of dialysis patients infected with SARS-CoV-2 have been reported to be higher than in the general population. In a primary series of vaccinations, hemodialysis patients have been reported to have lower levels of neutralizing antibodies compared to the general population. However, responses after a booster dose have been reported to be higher in dialysis patients than in the general population. Although the cause of this altered immune response is unknown, determining the relationship between elevated neutralizing antibody titers and the severity of illness or fatality is important. Recently, attention has been paid not only to liquid immunity but also to cellular immunity, and various studies have been conducted on immune responses in dialysis patients. The purpose of this Special Issue is to feature the immune response of SARS-CoV-2 vaccines in hemodialysis patients through basic research, the antibody titer response and cellular immune response through clinical research, and the effect on severity and lethality in clinical practice.

Dr. Kan Kikuchi
Dr. Koki Yamashita
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • SARS-CoV-2 infection
  • SARS-CoV-2 immunology
  • SARS-CoV-2 prevention
  • SARS-CoV-2 vaccine
  • SARS-CoV-2 antibody therapy
  • hemodialysis

Published Papers (4 papers)

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14 pages, 1252 KiB  
Article
COVID-19 Vaccine Antibody Response in a Single-Center Urban Hemodialysis Unit
by Mingyue He, Rui Song, Zakir Shaik, Crystal A. Gadegbeku, Louise Enderle, Christina Petyo, Sally B. Quinn, Zoe Pfeffer, Kathleen Murphy, Steven Kelsen, Aaron D. Mishkin, Jean Lee and Avrum Gillespie
Vaccines 2023, 11(7), 1252; https://doi.org/10.3390/vaccines11071252 - 18 Jul 2023
Cited by 1 | Viewed by 1170
Abstract
Background: The longitudinal response to the COVID-19 vaccines among patients on hemodialysis with and without prior SARS-CoV-2 infection has not been well characterized. Methods: To guide vaccination strategies in patients on hemodialysis, it is critical to characterize the longevity and efficacy of the [...] Read more.
Background: The longitudinal response to the COVID-19 vaccines among patients on hemodialysis with and without prior SARS-CoV-2 infection has not been well characterized. Methods: To guide vaccination strategies in patients on hemodialysis, it is critical to characterize the longevity and efficacy of the vaccine; therefore, we conducted a prospective single-center monthly antibody surveillance study between March 2021 and March 2022 to investigate the dynamic humoral response to a series of COVID-19 mRNA vaccines in patients on hemodialysis with and without prior SARS-CoV-2 infection. Monthly quantitative antibody testing was performed using the Beckman Coulter Access SARS-CoV-2 IgG Antibody Test©, which detects IgG antibodies targeting the receptor binding domain (RBD) of the SARS-CoV-2 spike protein. Results: This cohort of 30 participants (mean age: 61 ± 3 years) predominantly self-identified as African American (97%) and male (53%). Eight participants (27%) had recovered from COVID-19 (recovered) before the vaccine initiation. All participants received two vaccine doses, and 86.6% received a 6-month booster dose. Among patients naïve to COVID-19, the antibody positivity rate (APR) was 55% post-first-dose, 91% post-second-dose, 50% pre-booster at 6 months, 100% post-booster, and 89% at 6 months post-booster. Recovered patients sustained a consistent 100% APR throughout the year. The naïve patients demonstrated lower peak antibody levels post-second-dose than the recovered patients (17.9 ± 3.2 vs. 44.7 ± 5.6, p < 0.001). The peak antibody levels post-booster showed no significant difference between both groups (27.1 ± 3.9 vs. 37.9 ± 8.2, p = 0.20). Two naïve patients contracted COVID-19 during the follow-up period. Conclusions: The patients naïve to COVID-19 exhibited an attenuated and foreshortened antibody response following two doses of the mRNA vaccines compared with the recovered patients, who maintained 100% APR before the booster dose. The 6-month booster dose counteracted declining immunity and stimulated antibody responses in the naïve patients, even in previously non-responsive patients. This observation implies that different booster vaccination strategies might be required for COVID-19-naïve and -recovered patients. Post-vaccination antibody testing may serve as a valuable tool for guiding vaccination strategies. Full article
(This article belongs to the Special Issue Effectiveness of SARS-CoV-2 Vaccines in Hemodialysis Patients)
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9 pages, 1181 KiB  
Article
Cellular and Humoral Immune Responses after Breakthrough Infection in Patients Undergoing Hemodialysis
by Masataro Toda, Ayumi Yoshifuji, Tetsuo Nakayama, Setsuko Mise-Omata, Emi Oyama, Yoshifumi Uwamino, Ho Namkoong, Motoaki Komatsu, Akihiko Yoshimura, Naoki Hasegawa, Kan Kikuchi and Munekazu Ryuzaki
Vaccines 2023, 11(7), 1214; https://doi.org/10.3390/vaccines11071214 - 6 Jul 2023
Viewed by 1136
Abstract
Coronavirus disease 2019 (COVID-19) following primary immunization (breakthrough infection) has been reported in hemodialysis patients; however, their post-infection immune status remains unclear. We evaluated the humoral and cellular immunity of hemodialysis patients after breakthrough infection. Hemodialysis patients who had received primary immunization against [...] Read more.
Coronavirus disease 2019 (COVID-19) following primary immunization (breakthrough infection) has been reported in hemodialysis patients; however, their post-infection immune status remains unclear. We evaluated the humoral and cellular immunity of hemodialysis patients after breakthrough infection. Hemodialysis patients who had received primary immunization against COVID-19 at least six months prior to the study but developed mild/moderate COVID-19 before a booster dose (breakthrough infection group) and hemodialysis patients who were not infected with COVID-19 but received a booster dose (booster immunization group) were recruited. In both groups, SARS-CoV-2 antigen-specific cytokines and IgG levels were measured three weeks after infection or three weeks after receiving a booster dose. Memory T and B cells were also counted in the breakthrough infection group using flow cytometry three weeks after infection. Significantly higher SARS-CoV-2 antigen-specific IgG, IFN-γ, IL-5, TNF-α, and IL-6 levels occurred in the breakthrough infection group compared to the booster immunization group (p = 0.013, 0.039, 0.024, 0.017, and 0.039, respectively). The SARS-CoV-2 antigen-specific IgG and cytokine levels were not significantly different between the two groups. The breakthrough infection group had significantly higher percentages of central and effector memory T cells and regulatory T cells than the comparison group (p = 0.008, 0.031, and 0.026, respectively). Breakthrough infections may induce stronger cellular and humoral immune responses than booster immunizations in hemodialysis patients. Full article
(This article belongs to the Special Issue Effectiveness of SARS-CoV-2 Vaccines in Hemodialysis Patients)
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13 pages, 932 KiB  
Article
The Humoral Response to SARS-CoV-2 Vaccine in Hemodialysis Patients Is Correlated with Nutritional Status
by Merav Jacobson-Naftali, Odile Azoulay, Sigal Frishman, Lihi Godny, Boris Zingerman, Benaya Rozen-Zvi and Timna Agur
Vaccines 2023, 11(7), 1141; https://doi.org/10.3390/vaccines11071141 - 24 Jun 2023
Cited by 1 | Viewed by 1309
Abstract
Hemodialysis patients are highly susceptible to poor nutritional status. Our objective was to investigate whether poor nutritional status during mRNA-SARS-CoV-2 vaccination is correlated with impaired vaccine responses. This retrospective study was conducted in two hospital-based dialysis units. The nutritional status of hemodialysis patients [...] Read more.
Hemodialysis patients are highly susceptible to poor nutritional status. Our objective was to investigate whether poor nutritional status during mRNA-SARS-CoV-2 vaccination is correlated with impaired vaccine responses. This retrospective study was conducted in two hospital-based dialysis units. The nutritional status of hemodialysis patients was assessed, using a malnutrition inflammation score (MIS) at the time of their first BNT162b2 vaccine dose. One month after the second vaccine dose, we performed a quantitative assessment of antibodies against the spike protein (anti-S1 IgG). A total of 115 hemodialysis patients, with an average age of 72 were enrolled in the study. Among them, 39 (33.9%) were female, and 67 (58.2%) had diabetes mellitus. In 43/115 (37.4%) patients, moderate to severe malnutrition (MIS > 5) was detected. Comparatively, malnourished patients showed a lower log-transformed mean level of anti-S1 IgG compared to those with normal nutrition (2.91 ± 0.83 vs. 3.25 ± 0.72, respectively, p = 0.024). In a multivariable analysis that adjusted for age, sex, and KT/V, the nutritional status assessed by an MIS remained inversely associated with an anti-S1 IgG response [B; −0.066 (−0.117 to −0.015)]. In conclusion, moderate to severe malnutrition in hemodialysis patients is associated with reduced humoral responses to BNT162b2 vaccination. Full article
(This article belongs to the Special Issue Effectiveness of SARS-CoV-2 Vaccines in Hemodialysis Patients)
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12 pages, 1179 KiB  
Systematic Review
Humoral Response in Hemodialysis Patients Post-SARS-CoV-2 mRNA Vaccination: A Systematic Review of Literature
by Kin Israel Notarte, Jesus Alfonso Catahay, Princess Juneire Peligro, Jacqueline Veronica Velasco, Abbygail Therese Ver, Jonathan Jaime Guerrero, Jin Liu, Giuseppe Lippi, Stefanie W. Benoit, Brandon Michael Henry and César Fernández-de-las-Peñas
Vaccines 2023, 11(4), 724; https://doi.org/10.3390/vaccines11040724 - 24 Mar 2023
Cited by 19 | Viewed by 2016
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has infected over 600 million individuals and caused nearly 7 million deaths worldwide (10 January 2023). Patients with renal disease undergoing hemodialysis are among those most adversely affected, [...] Read more.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has infected over 600 million individuals and caused nearly 7 million deaths worldwide (10 January 2023). Patients with renal disease undergoing hemodialysis are among those most adversely affected, with an increased predisposition to SARS-CoV-2 infection and death. This systematic review aimed to pool evidence assessing the humoral response of hemodialysis patients (HDP) post-mRNA SARS-CoV-2 vaccination. A systematic search of the literature was performed through MEDLINE, CINAHL, PubMed, EMBASE, and Web of Science databases, as well as medRxiv and bioRxiv preprint servers up to 10 January 2023. Cohort and case-control studies were included if they reported an immune response in one group of patients undergoing hemodialysis who received mRNA SARS-CoV-2 vaccination compared with another group of patients receiving the same vaccine but not on hemodialysis. The methodological quality was assessed using the Newcastle-Ottawa Scale. Meta-analysis was not deemed appropriate due to the high heterogeneity between studies. From the 120 studies identified, nine (n = 1969 participants) met the inclusion criteria. Most studies (n = 8/9, 88%) were of high or medium methodological quality (≥6/9 stars). The results revealed that HDP developed lower antibody levels across all timepoints post-vaccination when compared with controls. Patients with chronic kidney disease elicited the highest antibody immune response, followed by HDP and, lastly, kidney transplant recipients. Overall, post-vaccination antibody titers were comparatively lower than in the healthy population. Current results imply that robust vaccination strategies are needed to address waning immune responses in vulnerable populations. Full article
(This article belongs to the Special Issue Effectiveness of SARS-CoV-2 Vaccines in Hemodialysis Patients)
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