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Review of Early Immune Response to SARS-CoV-2 Vaccination Among Patients With CKD

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posted on 2021-12-01, 10:53 authored by EJ Carr, A Kronbichler, M Graham-Brown, G Abra, C Argyropoulos, L Harper, EV Lerma, RS Suri, J Topf, M Willicombe, S Hiremath
Background: The effects of the coronavirus disease-2019 (COVID-19) pandemic, particularly among those with chronic kidney disease (CKD), who commonly have defects in humoral and cellular immunity, and the efficacy of vaccinations against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are uncertain. Methods: To inform public health and clinical practice, we synthesized published studies and preprints evaluating surrogate measures of immunity after SARS-CoV-2 vaccination in patients with CKD, including those receiving dialysis or with a kidney transplant. Results: We found 35 studies (28 published, 7 preprints), with sample sizes ranging from 23 to 1140 participants and follow-up ranging from 1 week to 1 month after vaccination. Seventeen of these studies enrolled a control group. In the 22 studies of patients receiving dialysis, the development of antibodies was observed in 18% to 53% after 1 dose and in 70% to 96% after 2 doses of mRNA vaccine. In the 14 studies of transplant recipients, 3% to 59% mounted detectable humoral or cellular responses after 2 doses of mRNA vaccine. After vaccination, there were a few reported cases of relapse or de novo glomerulonephritis, and acute transplant rejection, suggesting a need for ongoing surveillance. Conclusion: Studies are needed to better evaluate the effectiveness of SARS-CoV-2 vaccination in these populations. Rigorous surveillance is necessary for detection of long-term adverse effects in patients with autoimmune disease and transplant recipients. For transplant recipients and those with suboptimal immune responses, alternate vaccination platforms and strategies should be considered. As additional data arise, the NephJC COVID-19 page will continue to be updated (http://www.nephjc.com/news/covid-vaccine).

Funding

EJC was supported by the Francis Crick Institute which receives its core funding from Cancer Research UK (FC001827), the UK Medical Research Council (FC001827), and the Wellcome Trust (FC001827). This research was funded in whole, or in part, by the Wellcome Trust (FC001827).

History

Citation

Kidney International Reports Volume 6, Issue 9, September 2021, Pages 2292-2304

Author affiliation

Department of Cardiovascular Sciences, University of Leicester

Version

  • VoR (Version of Record)

Published in

Kidney International Reports

Volume

6

Issue

9

Pagination

2292 - 2304

Publisher

Elsevier BV

issn

2468-0249

Acceptance date

2021-06-21

Copyright date

2021

Available date

2021-12-01

Notes

For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

Language

en

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