COVID-19 Vaccination Among Patients Receiving Maintenance Renal Replacement Therapy: Immune Response, Real-World Effectiveness, and Implications for the Future

• Type of Material: Article
• Authors: Nadine Rouphael, Emory University; Mary Bausch-Jurken, Moderna Inc
• Language: English
• Date: 2023-08-04
• Publisher: OXFORD UNIV PRESS INC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/infdis/jiad162
• Title of Journal or Parent Work: JOURNAL OF INFECTIOUS DISEASES
• Volume: 228
• Issue: Suppl 1
• Start Page: S46
• End Page: S54
• Keywords: mRNA vaccine; HEMODIALYSIS; renal replacement therapy; Life Sciences & Biomedicine; COVID-19; Infectious Diseases; Immunology; dialysis; immunocompromised; BNT162B2; MESSENGER-RNA-1273; Science & Technology; Microbiology; SARS-CoV-2; SARS-COV-2 VACCINES
• Research Categories: Health Sciences, Immunology; Biology, Virology; Biology, Microbiology

Abstract

Chronic kidney disease affects more than 800 million people worldwide and often progresses to end-stage renal disease, which requires maintenance dialysis. Patients receiving dialysis are at higher risk for severe respiratory infections, including SARS-CoV-2 (the causative agent of COVID-19). In addition, many patients who receive dialysis also receive immunosuppressive treatments for conditions such as systemic vasculitis, systemic lupus erythematosus, or malignancies. Many studies have shown that while mRNA COVID-19 vaccines induce some level of immune response in patients receiving dialysis, the magnitude of response is often lower than that of healthy individuals, and responses rapidly wane. Importantly, the risk of COVID-19-related hospitalization and mortality for patients receiving dialysis is 4- to 8-fold higher compared with the general population. In this article, we summarize recent immunogenicity and real-world outcomes of COVID-19 mRNA vaccination among patients receiving dialysis, with a focus on the 3-dose extended primary series and additional (fourth) doses.