Pfizer-BioNTech COVID-19 Vaccine Promising for Patients on Hemodialysis

The Pfizer-BioNTech COVID-19 vaccine elicited promising clinical and biological responses in patients undergoing hemodialysis, according to a research letter published in Nephrology Dialysis Transplantation.¹

In this ongoing study being conducted at a hemodialysis center in Marseille, France, researchers evaluated response to the mRNA vaccine in patients 4 weeks after the second dose using the Elecsys® Anti-SARS-CoV-2 S antibody test (Roche), which specifically detects antibodies against the SARS-CoV-2 spike protein.

Researchers started to administer the vaccine beginning on January 18, 2021. As of early March, nearly 70% of the patients (326/470) at the dialysis center had received both doses of the vaccine. Data were elicited from 244 patients (mean age, 76 years; 70% men).  Most patients had hypertension (87%); additional comorbid conditions included diabetes (37%) and heart disease (35%). Three 3 patients were undergoing chemotherapy, and 1 patient was on immunosuppressive therapy.

Of the 244 patients, 91% (n=221) had a positive antibody response (antibody level >15 U/mL) with 58% of patients having an antibody level greater than 250 U/mL; only 23 patients (9%) had a negative antibody response (antibody level <15 U/mL).

Age was a significant factor in those who had a positive antibody response vs those who had a negative antibody response (mean age, 70 vs 77 years, respectively; P =.005). Patients undergoing chemotherapy or immunosuppression all had antibody levels below 15 U/mL and showed no response to the vaccination.

The researchers noted that although patients undergoing dialysis represent a vulnerable population who may have “lower vaccine efficacy and shorter period of immunoprotection” as illustrated in a recent study by Grupper et al,² the findings from this study are promising because COVID-19 cases at this dialysis center dramatically decreased beginning in mid-February, just 3 weeks after administering the first dose of the vaccine.¹

They added that more data from real-world settings are needed to further confirm vaccine efficacy in this population.

References

1. Frantzen L, Cavaille G, Thibeaut S, El-Haik Y. Efficacy of the BNT162b2 mRNA Covid-19 vaccine in a hemodialysis cohort. Nephrol Dial Transplant. Published online April 24, 2021. doi:10.1093/ndt/gfab165

2. Grupper A, Sharon N, Finn T, et al. Humoral response to the Pfizer BNT162b2 vaccine in patients undergoing maintenance hemodialysis. Clin J Am Soc Nephrol. Published online April 6, 2021. doi:10.2215/CJN.03500321