SARS-CoV-2 vaccine antibody response and breakthrough infection in dialysis
| Autor: | LinaCel Cadden, Shuchi Anand, Jialin Han, Curt Morgan, Russell Kerschmann, Julie Parsonnet, Mary Dittrich, Maria E. Montez-Rath, Geoffrey A. Block, Glenn M. Chertow, Patti Hunsader, Pablo Garcia, Paul Beyer |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
education.field_of_study biology Coronavirus disease 2019 (COVID-19) business.industry medicine.medical_treatment Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Population Breakthrough infection Vaccination Antibody response Internal medicine biology.protein medicine Antibody education business Dialysis |
| Popis: | BackgroundPatients receiving dialysis are a sentinel population for groups at high risk for death and disability from COVID-19. Understanding correlates of protection post-vaccination can inform immunization and mitigation strategies.MethodsMonthly since January 2021, we tested plasma from 4791 patients receiving dialysis for antibodies to the receptor-binding domain (RBD) of SARS-CoV-2 using a high-throughput assay. We qualitatively assessed the proportion without a detectable RBD response and among those with a response, semiquantitative median IgG index values. Using a nested case-control design, we matched each breakthrough case to five controls by age, sex, and vaccination-month to determine whether peak and pre-breakthrough RBD IgG index values were associated with risk for infection post-vaccination.ResultsAmong 2563 vaccinated patients, the proportion without a detectable RBD response increased from 6.6% [95% CI 5.5-8.1] in 14-30 days post-vaccination to 20.2% [95% CI 17.1-23.8], and median index values declined from 92.7 (95% CI 77.8-107.5) to 3.7 (95% CI 3.1-4.3) after 5 months. Persons with SARS-CoV-2 infection prior-to-vaccination had higher peak index values than persons without prior infection, but values equalized by 5 months (p=0.230). Breakthrough infections occurred in 56 patients, with samples collected a median of 21 days pre-breakthrough. Peak and pre-breakthrough RBD values ConclusionsThe antibody response to SARS-CoV-2 vaccination wanes rapidly, and in persons receiving dialysis, the persisting antibody response is associated with risk for breakthrough infection. |
| Databáze: | OpenAIRE |
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