Simon Benedikt, Rubey Harald, Gromann Martin, Knopf-Völkerer Astrid, Hemedi Boris, Zehetmayer Sonja, Kirsch Bernhard
Institute for Medical-Chemical Laboratory Diagnostics, Mistelbach-Gänserndorf State Clinic, 2130 Mistelbach, Austria.
Department for Internal Medicine III-Nephrology and Diabetology, Mistelbach-Gänserndorf State Clinic, 2130 Mistelbach, Austria.
Vaccines (Basel). 2022 Apr 28;10(5):694. doi: 10.3390/vaccines10050694.
Hemodialysis (HD) patients have an increased risk of severe SARS-CoV-2 infection. In this study, we assess the impact of a third vaccine dose (3D) on antibody levels and T cell response in HD patients and a healthy control group in a prospective cohort study consisting of 60 HD patients and 65 healthy controls. Each participant received two doses of the BNT-162b2 mRNA vaccine and an mRNA vaccine 3D. The SARS-CoV-2 antibody response was measured 6 months after the second vaccine dose and 6 to 8 weeks after the 3D. We assessed INF-γ secretion 6-8 weeks post 3D in 24 healthy controls, 17 HD patients with a normal response, and 20 low responder HD patients. The groups were compared using univariate quantile regressions and multiple analyses. After the 3D, the SARS-CoV-2-specific antibody and INF-γ titers of most HD patients were comparable to those of healthy controls. A subgroup of HD patients who had shown a diminished antibody response after the first two vaccine doses developed a significantly lower antibody and INF-γ response compared to responder HD patients and controls even after the 3D. A new strategy is needed to protect low/non-responder HD patients from severe SARS-CoV-2 infection.
血液透析（HD）患者感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险增加。在本研究中，我们在一项前瞻性队列研究中评估了第三剂疫苗（3D）对HD患者和健康对照组抗体水平及T细胞反应的影响，该研究包括60名HD患者和65名健康对照。每位参与者接受两剂BNT-162b2 mRNA疫苗和一剂mRNA疫苗3D。在第二剂疫苗接种后6个月以及3D接种后6至8周测量SARS-CoV-2抗体反应。我们在24名健康对照、17名反应正常的HD患者和20名低反应HD患者中评估了3D接种后6 - 8周的γ干扰素分泌情况。使用单变量分位数回归和多重分析对各组进行比较。3D接种后，大多数HD患者的SARS-CoV-2特异性抗体和γ干扰素滴度与健康对照相当。在前两剂疫苗接种后抗体反应减弱的HD患者亚组，即使在3D接种后，其抗体和γ干扰素反应仍显著低于反应型HD患者和对照组。需要一种新策略来保护低反应/无反应的HD患者免受严重SARS-CoV-2感染。
