Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, South Korea.
Department of Laboratory Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea.
Front Immunol. 2022 Jun 6;13:894700. doi: 10.3389/fimmu.2022.894700. eCollection 2022.
The Korean government decided to schedule heterologous vaccinations on dialysis patients for early achievement of immunization against Coronavirus disease 2019(COVID-19). However, the effects of heterologous immunizations in hemodialysis (HD) patients are unclear. One hundred (HD) patients from Gangdong Kyung Hee University Hospital and Kyung Hee Medical Center and 100 hospital workers from Gangdong Kyung Hee University Hospital were enrolled in this study. The HD patients received the mixing schedule of ChAdOx1/BNT162b2 vaccinations at 10-week intervals, while hospital workers received two doses of ChAdOx1 vaccines at 12-week intervals. Serum IgG to a receptor-binding domain (RBD) of the S1 subunit of the spike protein of SARS-CoV-2 was measured 1 month after the first dose, 2 months and 4 months after the second dose. The median [interquartile range] anti-RBD IgG was 82.1[34.5, 176.6] AU/ml in HD patients and 197.1[124.0, 346.0] AU/ml in hospital workers (P < 0.001) after the first dose. The percentage of positive responses (IgG > 50 AU/ml) was 65.0% and 96.0% among the both group, respectively (P < 0.001). The anti-RBD IgG levels increased significantly by 2528.8 [1327.6, 5795.1] AU/ml with a 100.0% positive response rate in HD patients 2 months after the second dose, which was higher than those in hospital workers 981.4[581.5, 1891.4] AU/ml (P < 0.001). Moreover, anti-RBD IgG remains constantly high, and positive response remains 100% in HD patients 4 months after the second dose. This study suggests that heterologous vaccinations with ChAdOx1/BNT162b2 can be an alternative solution on HD patients for early and strong induction of humoral response.
韩国政府决定为透析患者安排异源疫苗接种，以早日实现对 2019 年冠状病毒病（COVID-19）的免疫。然而，异源免疫在血液透析（HD）患者中的效果尚不清楚。本研究纳入了来自 Gangdong Kyung Hee 大学医院和 Kyung Hee 医疗中心的 100 名 HD 患者和来自 Gangdong Kyung Hee 大学医院的 100 名医院工作人员。HD 患者接受 ChAdOx1/BNT162b2 疫苗的混合接种方案，间隔 10 周，而医院工作人员则间隔 12 周接受两剂 ChAdOx1 疫苗。在第一剂后 1 个月、第二剂后 2 个月和 4 个月测量血清中针对 SARS-CoV-2 刺突蛋白 S1 亚单位受体结合域（RBD）的 IgG。HD 患者的中位[四分位间距]抗-RBD IgG 为 82.1[34.5, 176.6] AU/ml，医院工作人员为 197.1[124.0, 346.0] AU/ml（P < 0.001）。两组的阳性反应（IgG > 50 AU/ml）百分比分别为 65.0%和 96.0%（P < 0.001）。HD 患者在第二剂后 2 个月时，抗-RBD IgG 水平显著增加了 2528.8 [1327.6, 5795.1] AU/ml，阳性反应率为 100.0%，高于医院工作人员的 981.4[581.5, 1891.4] AU/ml（P < 0.001）。此外，HD 患者在第二剂后 4 个月时，抗-RBD IgG 持续升高，阳性反应率保持 100%。这项研究表明，ChAdOx1/BNT162b2 的异源疫苗接种可能是 HD 患者早期和强烈诱导体液反应的替代方案。
