Cellular and humoral immunogenicity of a SARS-CoV-2 mRNA vaccine in patients on haemodialysis.

Abstract

BACKGROUND:

Patients with chronic renal insufficiency on maintenance haemodialysis face an increased risk of COVID-19 induced mortality and impaired vaccine responses. To date, only a few studies have addressed SARS-CoV-2 vaccine elicited immunity in this immunocompromised population.

METHODS:

We assessed immunogenicity of the mRNA vaccine BNT162b2 in at-risk dialysis patients and characterised systemic cellular and humoral immune responses in serum and saliva using interferon γ release assay and multiplex-based cytokine and immunoglobulin measurements. We further compared binding capacity and neutralization efficacy of vaccination-induced immunoglobulins against emerging SARS-CoV-2 variants Alpha, Beta, Epsilon and Cluster 5 by ACE2-RBD competition assay.

FINDINGS:

Patients on maintenance haemodialysis exhibit detectable but variable cellular and humoral immune responses against SARS-CoV-2 and variants of concern after a two-dose regimen of BNT162b2. Although vaccination-induced immunoglobulins were detectable in saliva and plasma, both anti-SARS-CoV-2 IgG and neutralization efficacy was reduced compared to a vaccinated non-dialysed control population. Similarly, T-cell mediated interferon γ release after stimulation with SARS-CoV-2 spike peptides was significantly diminished.

INTERPRETATION:

Quantifiable humoral and cellular immune responses after BNT162b2 vaccination in individuals on maintenance haemodialysis are encouraging, but urge for longitudinal follow-up to assess longevity of immunity. Diminished virus neutralization and interferon γ responses in the face of emerging variants of concern may favour this at-risk population for re-vaccination using modified vaccines at the earliest opportunity.

FUNDING:

Initiative and Networking Fund of the Helmholtz Association of German Research Centres, EU Horizon 2020 research and innovation program, State Ministry of Baden-Württemberg for Economic Affairs, Labour and Tourism.

• Authors: Monika Strengert, Matthias Becker, Gema Morillas Ramos, Alex Dulovic, Jens Gruber, Jennifer Juengling, Karsten Lürken, Andrea Beigel, Eike Wrenger, Gerhard Lonnemann, Anne Cossmann, Metodi V Stankov, Alexandra Dopfer-Jablonka, Philipp D Kaiser, Bjoern Traenkle, Ulrich Rothbauer, Gérard Krause, Nicole Schneiderhan-Marra, Georg M N Behrens
• Journal: EBioMedicine (EBioMedicine) Vol. 70 Pg. 103524 (Aug 2021) ISSN: 2352-3964 [Electronic] Netherlands
• PMID: 34391096 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.

Chemical References

• Antibodies, Neutralizing
• Antibodies, Viral
• COVID-19 Vaccines
• Immunoglobulin G
• Spike Glycoprotein, Coronavirus
• Vaccines, Synthetic
• BNT162 Vaccine

Topics

• Aged
• Antibodies, Neutralizing (immunology)
• Antibodies, Viral (immunology)
• BNT162 Vaccine
• COVID-19 (immunology)
• COVID-19 Vaccines (immunology)
• Female
• Humans
• Immunity, Cellular (immunology)
• Immunity, Humoral (immunology)
• Immunogenicity, Vaccine (immunology)
• Immunoglobulin G (immunology)
• Male
• Middle Aged
• Renal Dialysis (methods)
• SARS-CoV-2 (immunology)
• Spike Glycoprotein, Coronavirus (immunology)
• T-Lymphocytes (immunology)
• Vaccination (methods)
• Vaccines, Synthetic (immunology)
• mRNA Vaccines