Title : Neutralizing antibodies response to SARS-COV-2 XBB1.5 mRNA vaccine in nephrology patients on dialysis against different viral variants
Abstract:
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of deaths and substantial morbidity worldwide, particularly in fragile subjects including dialysis patients. The continuous evolution of SARS-CoV-2 alters its pathogenicity and infectivity in human hosts, thus vaccines need to be continuously updated. XBB.1.5 mRNA vaccines are updated vaccine approved in September 2023 to help protect against the evolving threat of COVID-19.
Methods: In the present study we have performed the analyses of the IgG neutralization titers against 10 different viral variants in dialysis patients and healthy controls vaccinated with XBB 1.5 containing mRNA vaccine. 84 patients receiving maintenance dialysis and 10 healthy controls were enrolled. The nephrology patients had been vaccinated with 4 doses the original mRNA-based vaccines and in November 2023-January 2024 they received the 5th dose with the XBB1.5 updated vaccine. Healthy controls received 3 doses of the original vaccine, and at the end of 2023 received an additional dose of XBB 1.5 updated vaccine. Serum samples were taken before the vaccination and 1 to 1.5 months later. The surrogate IgG SARS-CoV-2 neutralization test, developed by Lausanne University Hospital researchers was used to evaluate the response to the vaccination and its potentials to neutralize 10 SARS-CoV-2 viral variants.
Results: Dialysis patients mount significant response to the vaccination in terms of the production of neutralizing antibodies. Those who were vaccinated and received up to 4th doses responded strongly with the production of neutralizing IgG, especially against wild type (WT) and Delta Sars-CoV-2 variants but not for other variants. 5th dose of new, XBB 1.5 vaccine, gave significant boost and augmented the neutralizing IgG titers not only against WT and Delta variant, but significant increased protection against XBB, XBB.1.5, BQ.1, BA.1, BA.2.86, BA.4, GK.1, and EG5.1 variants. The levels of the IgG neutralizing titers of patients were not significantly different from those of healthy controls.
Conclusions: Dialysis patients respond to SARS-COV-2 XBB1.5 updated vaccine similarly to healthy controls. This vaccine generated high IgG titers that can neutralize new SARS-CoV-2 variants. These data support the vaccination of fragile nephrological subjects with the updated vaccine to protect them from severe diseases and extend protection against new variants.
Audience Take Away:
- Both primary care physician and nephrologist will acquire valuable information on SARS-COV-2 vaccine efficacy in dialysis patients
- The information from this work can address the question on the opportunity to vaccinate dialysis subjects and on the most recent XBB1.5 mRNA vaccine efficacy to protect against viral variants in these patients
- This research will give updates on SARS-COV-vaccine safety and efficacy to be employed in nephrology and vaccinology teachings