Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study
Authors: Quiroga Borja , Soler María José , Ortiz Alberto , Jaravaca Mantecón Carlos Jesús , Nava Pérez Nathasha , Serra Martín Marta , Sato Yurika , Marin Franco Antonio José , Pazmiño Zambrano Diana Flor , Lucena Valverde Rafael , Ortega Diaz Mayra , Calderón González Carmen , Cazorla López Juan Manuel , Pereira Mónica , González Parra Emilio , Sánchez Horrillo Ana , Sánchez González Carmen , Toapanta Néstor , Cigarrán Guldris Secundino , Sánchez Hernández Rosa , Pizarro Sánchez Soledad , Muñiz Rincón María , Garcia-Fernández Nuria , Blanco Castro Natalia , Collantes Mateo Rocío , Quiroz Morales Manuel Augusto , Escamilla-Cabrera Beatriz , Berdud Godoy Isabel , Gil-Casares Casanova Beatriz , Leyva Alba , Rojas José , Gansevoort Ron T , de Sequera Patricia ,   SENCOVAC collaborative network, Carretero Marta Puerta , Tocora Daniel Gaitán , Rodríguez Mª Teresa Jaldo , Zanón Tamar Talaván , Suárez Esther Rodriguez , Santolaya Alfredo José Sáenz , Calero Raquel Cerrajero , Cobo Patricia Arribas , Ramos Patricia Muñoz , Gracia-Iguacel Carolina , Martin-Cleary Catalina , Sánchez-Rodríguez Jinny , Ramos-Verde Ana , Giraldo Yohana Gil , Suárez Pablo Ruano , Perpén Antonio Fernández , Ramos Andrés Fernández , Villanueva Laura Salanova , Cortiñas Alejandra , Díez Arias Pablo A , Cárdenas Alicia Cabrera , de Santos Antonio , Núñez Almudena , Cuadrado Guillermina Barril , Repollet Raquel , Moreso Francesc , Azancot María Antonieta , Ramos Natalia , Bestard Oriol , Cidraque Ignacio , Bermejo Sheila , Agraz Irene , Prat Oreto , Medina Carlota , Pardo Emma , Saiz Alejandro , Granados Nicolás Menéndez , Cabo María Jesús Corton , Alarcón Walter López , Alexandru Simona , Suarez Laura García Puente , Saico Saul Pampa , Tapia Marisol Poma , Osorio Laura Rodríguez , Zamora Rocío , Moreno Paloma Leticia Martin , González Noelia Ania , Ortiz Ana Sabalza , Iñarrea María Nieves Bastida , García Teresa , Narváez Carlos , Orellana Cristhian , León José Luis Pizarro , García Manuel Antonio Martínez , Jiménez Benaldina García , Moya Juan de Dios Ramiro , Espinosa Diana López , Herrador Alejandro Jiménez , Zurita Manuel Navarro , Álvarez Leonardo Díaz , Martínez Álvaro González , Arroyo Sandra Báez , Fernández Raquel Reina , Vargas Marlyn Janella Suárez , Casero Rocío Calurano , Useche Gustavo , de Miguel Carmen Santamaría , Palacios Ángel , Henningsmeyer Brenda , Calve Esther Orero , Moya José Lacueva , Gash Sandra Castellano , Martínez Lara Ruíz , De La Manzanara Perez Virginia Lopez , Arevalo Marta Calvo , Calvo Jose Antonio Herrero , Salgueira Mercedes , Aresté Nuria , de los Ángeles Rodríguez María , Collantes Rocío , Martínez Ana Isabel , Moyano María Jesús , Víbora Elena Jiménez , Hernández Aurelio Pastor Rodríguez , Rebollo María Sagrario García , Hernández Juana Margarita Rufino , Aguilera Esther Torres , Alea Rolando Tello , Del Rosario Saldaña Margie Soledad , de la Pisa Ana María Urraca , Monzon Lidia Sendino , Anachuri Karina Ampuero , Garcia Esther Hernández , Gomez Victoria Oviedo , Cavalotti Ignacio Manzur , Zorita Itziar Navarro , López Sol Otero , González Sara Outon , Montañez Carlos Soto , de Arellano Serna Manuel Ramírez , Perich Luis Guirado , de la Rosa Eva Cotilla 
Published: July 2022

ABSTRACT

Background
Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose.

Methods
This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed.

Results
A total of 711 patients [67% male, median age (range) 67 (20–89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P = .001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P = .693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P = .001), lower time from booster (P = .043) and past breakthrough SARS-CoV-2 infection (P &lt; .001).

Conclusions
In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infection.