A Third Dose or Booster Dose of SARS-CoV-2 mRNA-1273 Vaccine Increases Antibody Levels Among Dialysis Patients

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Background: To help protect dialysis patients from COVID-19, efforts have been made to ensure widespread vaccination, however, reports have shown waning antibody (AB) levels that may decline faster than the general population. The current analysis examines AB response to a 3rd or booster dose of mRNA-1273 vaccine among dialysis patients across 7 dialysis clinics in Massachusetts. Methods: All patients received 2 mRNA-173 doses and had AB measured 250+ days after 2nd dose (when additional/booster doses were available). Covid-19 positive/suspected cases were not included in the analysis. As part of a quality improvement project, patients were classified into 3 groups based on further doses received: mRNA booster (Booster 50 mcg), mRNA additional dose (Additional; 100 mcg), and no second dose or booster (Primary). AB response was measured in remnant blood with semiquantitative chemiluminescent assay detecting IgG AB directed against receptor binding domain of S1 subunit of SARS-CoV-2 spike antigen (Siemens); AB index >1 was considered reactive, >7 as adequate, and > 750 was maximum detected. For time periods with multiple AB measurements, the latest AB value was utilized. Results: Distribution of AB levels before and after booster/additional dose are presented in figure. Before booster/additional dose few patients had AB levels > 750 (2%). After booster or additional dose, 58% and 50% had AB levels > 750, respectively. AB response ≤ 7 was common (46%) before and rare after booster and additional dose (2% and 0%). Conclusions: After the administration of booster/additional doses of mRNA COVID-19 vaccines, nearly all patients had at least adequate AB response and the majority had maximum response. This is contrasted with the patients not receiving booster/additional dose, where 72% had adequate AB response and 27% had maximum response. Funding: Commercial Support - Fresenius Medical Care

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