Immune Responses After COVID-19 Vaccination in Kidney Transplant Recipients and Patients on Dialysis

A new study reveals the extent to which kidney transplant recipients and individuals with kidney failure who are on dialysis mount immune responses—which include the production of antibodies and the activation of T cells—to COVID-19 vaccination. The findings are published in JASN.

Data are scare on whether kidney transplant recipients and individuals on dialysis receive sufficient protection from COVID-19 vaccines. To investigate, Dominique Bertrand, MD (Rouen University Hospital, in France) and his colleagues examined immune responses after vaccination with the Pfizer-BioNTech COVID-19 mRNA vaccine in 45 kidney transplants recipients and 10 patients undergoing chronic hemodialysis. 

After the second vaccine dose, 88.9% of patient on dialysis and only 17.8% of kidney transplant recipients developed antibodies against the virus that causes COVID-19. A specific T-cell response against the virus was evident in 100% of patients on dialysis and 57.8% of kidney transplant recipients. The immune response seemed to be influenced by the immunosuppressive drugs that kidney transplant recipients took, with some drugs having a greater effect than others.

"The vaccine seems efficient in individuals undergoing dialysis, indicating that vaccination should be highly recommended in these patients," said Dr. Bertrand. "By contrast, the low antibody response observed in kidney transplant recipients is worrying; however, antibodies are not the full spectrum of protection induced by the vaccine. T cell immunity is probably also very important." 

The findings may be useful for developing an effective strategy of vaccination for kidney transplant recipients.

Study co-authors include Mouad Hamzaoui, MD, PhD, Veronique Lemée, MD, Julie Lamulle, Mélanie Hanoy, MD, Charlotte Laurent, MD, Lebourg Ludivine, MD, Isabelle Etienne, MD, Mathilde Lemoin, MD, Dorian Nezam, MD, Jean-Christophe Plantier, MD, PhD, Olivier Boyer, MD, PhD, Dominique Guerrot, MD, PhD, and Sophie Candon, MD, PhD.

Disclosures: The authors reported no financial disclosures.

The article, titled "Antibody and T Cell response to SARS-CoV-2 Messenger RNA BNT162b2 Vaccine in Kidney Transplant Recipients and Hemodialysis Patients," will appear online at http://jasn.asnjournals.org/ on June 9, 2021, doi: 10.1681/ASN.2021040480. 

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). 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 for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 21,000 members representing 131 countries.