Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study
Borja Quiroga 1 , María José Soler 2 3 , Alberto Ortiz 3 4 , Carlos Jesús Jaravaca Mantecón 5 , Nathasha Nava Pérez 5 , Marta Serra Martín 6 , Yurika Sato 6 , Antonio José Marin Franco 7 , Diana Flor Pazmiño Zambrano 7 , Rafael Lucena Valverde 8 , Mayra Ortega Diaz 8 , Carmen Calderón González 9 , Juan Manuel Cazorla López 10 , Mónica Pereira 4 , Emilio González Parra 4 , Ana Sánchez Horrillo 1 , Carmen Sánchez González 1 , Néstor Toapanta 2 , Secundino Cigarrán Guldris 11 , Rosa Sánchez Hernández 12 , Soledad Pizarro Sánchez 13 , María Muñiz Rincón 14 , Nuria Garcia-Fernández 15 , Natalia Blanco Castro 16 , Rocío Collantes Mateo 17 , Manuel Augusto Quiroz Morales 18 , Beatriz Escamilla-Cabrera 19 , Isabel Berdud Godoy 20 , Beatriz Gil-Casares Casanova 21 , Alba Leyva 22 , José Rojas 22 , Ron T Gansevoort 23 , Patricia de Sequera 3 8 , SENCOVAC collaborative network
Background: Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose.
Methods: This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed.
Results: A total of 711 patients [67% male, median age (range) 67 (20-89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P = .001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P = .693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P = .001), lower time from booster (P = .043) and past breakthrough SARS-CoV-2 infection (P < .001).
Conclusions: In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infection.