Kidney Week

Abstract: FR-PO1100

The Comparison of Humoral Response Between Third and Fourth Doses of COVID-19 Vaccines in ESRD on Hemodialysis (HD)

Session Information

• COVID-19 - II
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Kim, Dae Kyu, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)

Dae Kyu Kim,

• Joo, Yoosun, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)

Yoosun Joo,

• Jung, Su Woong, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)

Su Woong Jung,

• Kim, Jin sug, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)

Jin sug Kim,

• Moon, Ju young, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)

Ju young Moon,

• Jeong, Kyunghwan, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)

Kyunghwan Jeong,

• Hwang, Hyeon Seok, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)

Hyeon Seok Hwang,

• Kim, Yang Gyun, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)

Yang Gyun Kim,

Background

The humoral response of coronavirus disease 2019 (COVID-19) vaccine in hemodialysis (HD) patients decrease substantillay overtime compare to the general population. Currently, experts recommend to recieve additional boosting vaccines against these high risk patients. However, the effects between additional third and fourth boosting vaccine in HD patients are not yet clear.

Methods

Total 86 HD patients from two hospitals (Gangdong Kyung Hee University Hospital and Kyung Hee Medical Center) were enrolled in this study. Patients were classifed into 4 groups according to the total dose of vaccines and whether they were infected with COVID-19. Serum IgG to receptor-binding domain (RBD) of the S1 subunit of the spike protein of SARS-CoV-2 was measured at 1 month after the first dose (T1), 2 months (T2) and 4 months after the second dose (T3), 4 months after third dose and (T4), 4-7 month after fourth dose of vaccine or 11 month after third dose (T5) for all groups. Neutralizing antibody also measured at T3 and T4 by plaque reduction neutralization test.

Results

Anti-RBD IgG after the second dose (T3) of vaccine was rapidly decreased (median [interquartile range] 1255.7[642.0, 2337.1] AU/ml), but it was significantly elevated after third dose (T4) in COVID19 naïve HD patients 3979.1[1966.1, 17098.1] AU/ml. The level of anti-RBD IgG was markedly higher in the COVID19 naïve patients with 4^th doses than in them with 3^rd doses (14075.3[4527.1, 30460.0], 2492.5[851.2, 17086.3] AU/ml, P < 0.001). However, the difference of anti-RBD IgG levels between 3^rd and 4^th vaccine was not observed in the COVID19 infected HD patients. Anti-RBD antibody titers were well correlated with neutralizing antibodies against omicron and delta at T3 and T4 (P < 0.001). Of the total 34 COVID-19 infected patients, 6 patients had high severity(4 hospital admission, 2 death), and their anti-RBD IgG showed a lower trend than those with COVID-19 naïve 1255.7[642.0, 2337.1] AU/ml and low severity COVID-19 infected patients 1486.4[677.6, 3044.1]. In particular, two death HD patientsed showed significantly lower anti-RBD IgG(342, 317 AU/ml).

Conclusion

Humoral response was better after 4^th dose compared with 3^rd doses in COVID-19 naïve HD patients.