Publication date: Jul 19, 2024
(1) Background: Compared to medical personnel, SARS-CoV-2mRNA vaccination-related positive immunity rates, levels, and preservation over time in dialysis and kidney transplant patients are reduced. We hypothesized that COVID-19 pre-exposure influences both vaccination-dependent immunity development and preservation in a group-dependent manner. (2) Methods: We evaluated 2- and 9-month follow-up data in our observational Dia-Vacc study, exploring specific cellular (interferon-γ release assay = IGRA) and/or humoral immune responses (IgA/IgG/RBD antibodies) after two SARS-CoV-2mRNA vaccinations in 2630 participants, including medical personnel (301-MP), dialysis patients (1841-DP), and kidney transplant recipients (488-KTR). Study participants were also separated into COVID-19 pre-exposure (hybrid immunity) positive (n = 407) versus negative (n = 2223) groups. (3) Results: COVID-19 pre-exposure improved most vaccination-related positive immunity rates in KTR and DP at 2 months but not in MP, where rates reached almost 100% independent of hybrid immunity. In the COVID-19-negative study, patients’ immunity faded between two and nine months, evaluated via the percentage of patients with an RBD antibody decrease >50%, and was markedly group- (MP-17. 8%, DP-52. 2%, and KTR-38. 6%) and vaccine type-dependent. In contrast, in all patient groups with COVID-19, pre-exposure RBD antibody decreases of >50% were similarly rare (MP-4. 3%, DP-7. 2%, and KTR-0%) but still vaccine type-dependent, with numerically reduced numbers in mRNA-1273- versus BNT162b2mRNA-treated patients. Multivariable regression analysis of RBD antibody changes between two and nine months by interval scale categorization confirmed COVID-19 pre-exposure as a factor in inhibiting strong RBD Ab fading. COVID-19 pre-exposure in MP and DP also numerically reduced T-cell immunity fading. In DP, symptomatic (versus asymptomatic) COVID-19 pre-exposure was identified as a factor in reducing strong RBD Ab fading after vaccination. (4) Conclusions: After mRNA vaccination, immunity positivity rates in DP and KTR but not MP, as well as immunity preservation in MP/DP/KTR, are markedly improved via prior COVID-19 infection. In DP, prior symptomatic compared to asymptomatic COVID-19 disease was particularly effective in blocking immunity fading after mRNA vaccination.
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| Concepts | Keywords |
|---|---|
| Bnt162b2mrna | COVID-19 vaccination |
| Kidney | DiaVacc Study |
| Month | hybrid immunity |
| Vaccination | immunity fading |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | VO | vaccination |
| disease | VO | time |
| disease | MESH | COVID-19 |
| pathway | REACTOME | Release |
| disease | IDO | assay |
| disease | VO | vaccine |
| disease | IDO | cell |
| disease | MESH | infection |
| disease | VO | effective |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | Tumor |
| disease | IDO | blood |
| drug | DRUGBANK | Indoleacetic acid |
| disease | MESH | seroconversion |
| disease | VO | population |
| disease | MESH | asymptomatic disease |
| drug | DRUGBANK | Spinosad |
| disease | IDO | history |
| drug | DRUGBANK | Cysteamine |
| drug | DRUGBANK | Trestolone |
| drug | DRUGBANK | Aspartame |
| disease | VO | titer |
| disease | MESH | diabetes mellitus |
| disease | MESH | hepatitis |
| disease | MESH | Hypertension |
| disease | MESH | Glomerulonephritis |
| disease | MESH | Interstitial nephritis |
| disease | MESH | Vasculitis |
| disease | MESH | Polycystic kidney |
| disease | MESH | Liver cirrhosis |
| drug | DRUGBANK | Monomethyl fumarate |
| drug | DRUGBANK | Medroxyprogesterone acetate |
| drug | DRUGBANK | Belatacept |
| disease | VO | vaccinated |