Journal
VACCINES
Volume 10, Issue 8, Pages -Publisher
MDPI
DOI: 10.3390/vaccines10081328
Keywords
hemodialysis; SARS-CoV-2; COVID-19 vaccination; in-vitro viral neutralization
Categories
Funding
- BMBF initiative NaFoUniMedCovid19 [01KX2021]
- Bavarian research network FOR-COVID
- Bavarian research network Bay-VOC
- German Center for Infection Research (DZIF)
- project Virological and immunological determinants of COVID-19 pathogenesis-lessons to get prepared for future pandemics [KA1-Co-02]
- Helmholtz Association's Initiative and Networking Fund
- subproject B-FAST
- subproject COVIM
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Hemodialysis patients benefit from receiving a fourth COVID-19 vaccination, as it significantly increases their neutralization capacity against the Delta and Omicron variants.
Hemodialysis patients are exposed to a markedly increased risk when infected with SARS-CoV-2. To date, it is unclear if hemodialysis patients benefit from four vaccinations. A total of 142 hemodialysis patients received four COVID-19 vaccinations until March 2022. RDB binding antibody titers were determined in a competitive surrogate neutralization assay. Vero-E6 cells were infected with SARS-CoV-2 variants of concern (VoC), Delta (B.1.617.2), or Omicron (B.1.1.529, sub-lineage BA.1) to determine serum infection neutralization capacity. Four weeks after the fourth vaccination, serum infection neutralization capacity significantly increased from a 50% inhibitory concentration (IC50, serum dilution factor 1:x) of 247.0 (46.3-1560.8) to 2560.0 (1174.0-2560.0) for the Delta VoC, and from 37.5 (20.0-198.8) to 668.5 (182.2-2560.0) for the Omicron VoC (each p < 0.001) compared to four months after the third vaccination. A significant increase in the neutralization capacity was even observed for patients with high antibody titers after three vaccinations (p < 0.001). Ten patients with SARS-CoV-2 breakthrough infection after the first blood sampling had by trend lower prior neutralization capacity for Omicron (p = 0.051). Our findings suggest that hemodialysis patients benefit from a fourth vaccination in particular in the light of the highly infectious SARS-CoV-2 Omicron-variants. A routinely applied four-time vaccination seems to broaden immunity against variants and would be recommended in hemodialysis patients.
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