SEHA Kidney Care, SEHA-Abu Dhabi Health Services Company, Abu Dhabi, UAE.
Department of Medicine, Khalifa University, Abu Dhabi, UAE.
Nephrology (Carlton). 2022 Mar;27(3):260-268. doi: 10.1111/nep.13980. Epub 2021 Oct 5.
To establish the responses to the Sinopharm HB02 COVID-19 vaccination in the dialysis population, which are not well established. We examined the humoral responses to the Sinopharm COVID vaccine in haemodialysis patients.
Standard vaccinations (two doses at interval of ~21 days) were given to all consenting haemodialysis patients on dialysis (n = 1296). We measured the antibody responses at 14-21 days after the second vaccine to define the development of anti-spike antibodies >15 AU/ml after vaccination and observed the clinical effects of vaccination.
Vaccination was very well tolerated with few side-effects. In those who consented to antibody measurements, (n = 446) baseline sampling showed 77 had positive antibodies, yet received full vaccination without any apparent adverse events. Positive anti-spike antibodies developed in 50% of the 270 baseline negative patients who had full sampling, compared with 78.1% in the general population. COVID infection continues to occur in both vaccinated and unvaccinated individuals, but in the whole group vaccination appears to have been associated with a reduction in the case fatality rate.
The humoral immune responses to standard HB02 vaccination schedules are attenuated in a haemodialysis cohort, but likely the vaccine saves lives. We suggest that an enhanced HB02 vaccination course or antibody checking may be prudent to protect this vulnerable group of patients. We suggest a booster dose of this vaccine at 3 months should be given to all dialysis patients, on the grounds that it is well tolerated even in those with good antibody levels and there may be a survival advantage.
确定尚未明确的接受国药控股 HB02 新冠肺炎疫苗接种的透析人群的反应。我们研究了血液透析患者对国药控股 COVID 疫苗的体液反应。
所有同意接受透析（n=1296）的血液透析患者均给予标准疫苗接种（两剂，间隔约 21 天）。我们在第二次疫苗接种后 14-21 天测量抗体反应，以确定接种后抗刺突抗体>15 AU/ml 的发展情况，并观察疫苗接种的临床效果。
疫苗接种耐受性良好，副作用较少。在同意进行抗体测量的患者中（n=446），基线采样显示 77 例有阳性抗体，但在没有明显不良反应的情况下接受了全程疫苗接种。在有完整采样的 270 例基线阴性患者中，有 50%的患者产生了阳性抗刺突抗体，而普通人群的这一比例为 78.1%。接种疫苗和未接种疫苗的个体仍会继续发生 COVID 感染，但在整个群体中，疫苗接种似乎与降低病死率有关。
标准 HB02 疫苗接种方案在血液透析队列中引起的体液免疫反应减弱，但疫苗可能挽救生命。我们建议，对于这一脆弱患者群体，强化 HB02 疫苗接种方案或抗体检查可能是谨慎的做法。我们建议所有透析患者在 3 个月时接种这种疫苗的加强剂量，因为即使在抗体水平良好的患者中，这种疫苗也具有良好的耐受性，而且可能具有生存优势。
