The pandemic caused by the SARS-CoV-2 coronavirus has been especially detrimental to patients with end-stage renal disease. History with other vaccines suggests that patients with renal disease may not respond adequately to the SARS-CoV-2 vaccine. The aim of this study is to evaluate the immunity to SARS-CoV-2 mRNA vaccines in renal patients. Post SARS-CoV-2 vaccination first, and after the booster dose, antibodies and cellular immunity were studied in patients on hemodialysis (N = 20), peritoneal dialysis (N = 10) and renal transplantation (N = 10). After the two doses of vaccine, there was an effective immunity in dialysis patients, with 100% seroconversion and 87% detection of cellular immunity (85% in hemodialysis and 90% in peritoneal dialysis). In contrast, in renal transplant recipients there was only 50% seroconversion and cellular immunity was detected in 30% of patients. After the booster dose, all dialysis patients achieved a cellular and antibody immunity, whereas in transplant patients, despite improvement, 20% did not produce antibodies and in 37.5% cellular immunity could not be detected.

The mRNA vaccine plus booster performs excellently in dialysis patients, whereas in kidney transplant recipients, despite the booster, complete immunization is not achieved. After two doses of mRNA vaccines against SARS-CoV-2, there was an effective cellular and humoral immunity in patients on dialysis. In renal transplant recipients, the SARS-CoV-2 vaccine was not effective, as more than 50% of patients had no cellular and/or humoral immunity. The booster dose ensured that all patients on dialysis generated a complete immunity.In renal transplant recipients, booster dose improved immunity but did not achieve complete patient immunity. The cellular immunity is less dependent on the time since the last dose than humoral.

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Mishita
Jornal co-ordinator
Journal of Clinical & Experimental Nephrology