Some vaccinated dialysis patients with no prior COVID-19 infection show low antibody index
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In a letter to the editor of Kidney Medicine Journal, researchers wrote that patients on dialysis without prior COVID-19 infection showed a low antibody response after the COVID-19 vaccine from Johnson & Johnson.
“This finding differs from other reports of mRNA vaccines showing high response among dialysis patients,” the researchers wrote.
They sought to determine whether patients on various dialysis modalities, vaccinated in 20 dialysis clinics, differed in antibody response to the Johnson & Johnson vaccine between July and August 2021.
Researchers measured antibody response in remnant blood samples taken from routine laboratory tests approximately 95 days after vaccine administration. Using a semi-quantitative chemiluminescent assay for immunoglobulin-G targeting the receptor binding domain of the S1 subunit of SARS-CoV-2 spike antigen, researchers evaluated patients’ responses to the vaccine.
The 839 patients were then categorized as patients on in-center hemodialysis who were vaccinated in dialysis clinics, patients on in-center hemodialysis who were vaccinated in communities, patients on peritoneal dialysis and patients on home hemodialysis. The groups showed similar antibody responses.
While a multivariable ANOVA revealed no difference in antibody index by modality or vaccine administration location, there was a difference by prior COVID-19 history.
“In summary, most dialysis patients vaccinated with the Johnson & Johnson vaccine without a previous history of COVID-19 had an undetectable (52%) or inadequate (33%) antibody index. This finding differs from other reports of mRNA vaccines showing high response among dialysis patients,” Jeffrey L. Hymes, MD, chief medical officer of Fresenius Medical Care in Massachusetts, and colleagues wrote. “We observe no difference across modalities or vaccination setting in antibody response. These results support the continuation of vaccination programs at dialysis clinics.”
Researchers added, “The CDC recommends booster shots of any authorized COVID-19 vaccine [more than] 2 months after the Johnson & Johnson vaccine, although boosters of Johnson & Johnson are not recommended for those who developed thrombosis with thrombocytopenia syndrome after Johnson & Johnson vaccination. Fresenius Kidney Care dialysis clinics are currently administering mRNA boosters vaccines to its patients, although patients may receive the Johnson & Johnson vaccine within the community.”
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