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Sanders JF, Bemelman FJ, Messchendorp AL, et al. The RECOVAC Immune-response Study: The Immunogenicity, Tolerability, and Safety of COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant. Transplantation. 2021;doi: 10.1097/TP.0000000000003983.
Sanders, J. F., Bemelman, F. J., Messchendorp, A. L., Baan, C. C., van Baarle, D., van Binnendijk, R., Diavatopoulos, D. A., Frölke, S. C., Geers, D., GeurtsvanKessel, C. H., den Hartog, G., van der Heiden, M., Imhof, C., Kho, M. M. L., Koopmans, M. P. G., Malahe, S. R. K., Mattheussens, W. B., van der Molen, R., van Mourik, D., Remmerswaal, E. B. M., Rots, N., Vart, P., de Vries, R. D., Gansevoort, R. T., Hilbrands, L. B., Reinders, M. E. J. (2021). The RECOVAC Immune-response Study: The Immunogenicity, Tolerability, and Safety of COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant. Transplantation, . https://doi.org/10.1097/TP.0000000000003983
Sanders, Jan-Stephan F, et al. "The RECOVAC Immune-response Study: The Immunogenicity, Tolerability, and Safety of COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant." Transplantation vol. (2021). doi: https://doi.org/10.1097/TP.0000000000003983
Sanders JF, Bemelman FJ, Messchendorp AL, Baan CC, van Baarle D, van Binnendijk R, Diavatopoulos DA, Frölke SC, Geers D, GeurtsvanKessel CH, den Hartog G, van der Heiden M, Imhof C, Kho MML, Koopmans MPG, Malahe SRK, Mattheussens WB, van der Molen R, van Mourik D, Remmerswaal EBM, Rots N, Vart P, de Vries RD, Gansevoort RT, Hilbrands LB, Reinders MEJ. The RECOVAC Immune-response Study: The Immunogenicity, Tolerability, and Safety of COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant. Transplantation. 2021 Nov 09; doi: 10.1097/TP.0000000000003983. Epub 2021 Nov 09. PMID: 34753894.
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Transplantation. 2021 Nov 09; doi: 10.1097/TP.0000000000003983. Epub 2021 Nov 09.

The RECOVAC Immune-response Study: The Immunogenicity, Tolerability, and Safety of COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant.

Transplantation

Jan-Stephan F Sanders, Frederike J Bemelman, A Lianne Messchendorp, Carla C Baan, Debbie van Baarle, Rob van Binnendijk, Dimitri A Diavatopoulos, Sophie C Frölke, Daryl Geers, Corine H GeurtsvanKessel, Gerco den Hartog, Marieke van der Heiden, Celine Imhof, Marcia M L Kho, Marion P G Koopmans, S Reshwan K Malahe, Wouter B Mattheussens, Renate van der Molen, Djenolan van Mourik, Ester B M Remmerswaal, Nynke Rots, Priya Vart, Rory D de Vries, Ron T Gansevoort, Luuk B Hilbrands, Marlies E J Reinders,

Affiliations

  1. Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  2. Renal Transplant Unit, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  3. Department of Internal Medicine, Nephrology, and Transplantation, Erasmus MC Transplant Institute, Erasmus Medical Center, Rotterdam, the Netherlands.
  4. Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, the Netherlands.
  5. Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
  6. Radboud Center for Infectious Diseases, Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands.
  7. Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands.
  8. Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.
  9. Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
  10. Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

PMID: 34753894 DOI: 10.1097/TP.0000000000003983

Abstract

BACKGROUND: In kidney patients COVID-19 is associated with severely increased morbidity and mortality. A comprehensive comparison of the immunogenicity, tolerability, and safety of COVID-19 vaccination in different cohorts of kidney patients and a control cohort is lacking.

METHODS: This investigator driven, prospective, controlled multicenter study included 162 participants with chronic kidney disease (CKD) stages G4/5 (eGFR < 30 mL/min/1.73m2), 159 participants on dialysis, 288 kidney transplant recipients, and 191 controls. Participants received 2 doses of the mRNA-1273 COVID-19 vaccine (Moderna). The primary endpoint was seroconversion.

RESULTS: Transplant recipients had a significantly lower seroconversion rate when compared with controls (56.9% versus 100%, P < 0.001), with especially mycophenolic acid, but also, higher age, lower lymphocyte concentration, lower eGFR, and shorter time after transplantation being associated with nonresponder state. Transplant recipients also showed significantly lower titers of neutralizing antibodies and T-cell responses when compared with controls. Although a high seroconversion rate was observed for participants with CKD G4/5 (100%) and on dialysis (99.4%), mean antibody concentrations in the CKD G4/5 cohort and dialysis cohort were lower than in controls (2405 [interquartile interval 1287-4524] and 1650 [698-3024] versus 3186 [1896-4911] BAU/mL, P = 0.06 and P < 0.001, respectively). Dialysis patients and especially kidney transplant recipients experienced less systemic vaccination related adverse events. No specific safety issues were noted.

CONCLUSIONS: The immune response following vaccination in patients with CKD G4/5 and on dialysis is almost comparable to controls. In contrast, kidney transplant recipients have a poor response. In this latter, patient group development of alternative vaccination strategies are warranted.Supplemental visual abstract; http://links.lww.com/TP/C307.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

The authors declare no conflicts of interest

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