Among US adults with renal failure undergoing hemodialysis, the risk of SARS-CoV-2 infection during the Omicron-dominant period was higher among patients without vaccination and with 1–2 doses compared with 3 doses of mRNA vaccines. Regardless of vaccine doses, the risk of infection was higher among patients with low circulating levels of antibodies to SARS-CoV-2.
Washington, DC (August 15, 2022) — In a recent study published in JASN, a third dose of a COVID-19 mRNA vaccine in adults with kidney failure undergoing hemodialysis enhanced the patients’ protection against SARS-CoV-2 infection during duration of Omicron- dominant period. A patient’s response to vaccination or prior infection—as measured by circulating levels of anti-SARS-CoV-2 antibodies—was also a significant predictor of subsequent risk of infection. In the study of randomly selected patients undergoing hemodialysis in the United States, a team led by Shuchi Anand, MD, MS, Pablo Garcia, MD, MS, and Maria Montez Rath, PhD (Stanford University School of Medicine) monitored patients monthly . SARS-CoV-2 antibody levels and confirmed COVID-19 infection during the Omicron-dominant period from December 25, 2021 to January 31, 2022 using electronic health records. Among 3,576 dialysis patients, 901 (25%) received a third dose of mRNA vaccine from December 1, 2022, and early antibody responses to the third doses were strong. During the Omicron-dominant period, SARS-CoV-2 infection was documented in 340 (7%) patients. The risk of infection was doubled among unvaccinated patients and nearly 1.5 times higher with 1–2 doses compared with 3 doses. Regardless of vaccine doses, the risk of infection was at least 2-fold higher among patients with low circulating levels of antibodies to SARS-CoV-2. “The COVID-19 pandemic continues to evolve, and it is clear that COVID-19 will become an endemic infection—that is, an infection that circulates at regular intervals in our community. In such a situation, it is critical to devise strategies that protect the most vulnerable medical individuals with appropriate doses of vaccines or additional preventive measures (such as monoclonal antibodies) and timely treatments,” said Dr. Anand. “Measuring an individual’s circulating antibody response to SARS-CoV-2 can help us identify higher-risk individuals who are eligible for enhanced protection among dialysis patients and other immunocompromised or vulnerable populations.” Additional co-authors include Jialin Han, LinaCel Cadden, Patti Hunsader, Curt Morgan, Russell Kerschmann, Paul Beyer, Mary Dittrich, Julie Parsonnet, Glenn Chertow, and Geoffrey Block. Disclosures: LC, PH, CM, RK, and PB are used by Ascend Clinical Laboratories. MD and GB are used by US Renal Care. GC is a member of the Board of Satellite Healthcare, a not-for-profit hemodialysis organization. The article, titled “SARS-CoV-2 infection during the Omicron outbreak among hemodialysis patients: the role of circulating antibodies and receptor-binding doses of vaccine,” will appear online August 15, 2022. doi : 10.1681/asn.2022040504. The content of this article does not reflect the views or opinions of the American Society of Nephrology (ASN). Responsibility for the information and opinions expressed herein rests solely with the authors. ASN does not offer medical advice. All content in ASN publications is for informational purposes only and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or to diagnose or treat any medical condition. Consult your doctor or other qualified health care provider if you have any questions about a medical condition or before taking any medication, changing your diet, or starting or stopping any course of treatment. Do not ignore or delay getting professional medical advice because of information you access through ASN. Call 911 or your doctor for all medical emergencies. About ASN Since 1966, ASN has been leading the fight to prevent, treat and cure kidney disease worldwide, educating healthcare professionals and scientists, promoting research and innovation, communicating new knowledge and supporting the highest quality care for patients. ASN has more than 20,000 members representing 132 countries. For more information, visit www.asn-online.org and follow us on Facebook, Twitter, LinkedIn and Instagram.
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