RT Journal Article
SR Electronic
T1 Differences in mRNA-1273 (Moderna) and BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine immunogenicity among patients undergoing dialysis
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E297
OP E305
DO 10.1503/cmaj.211881
VO 194
IS 8
A1 Yau, Kevin
A1 Chan, Christopher T.
A1 Abe, Kento T.
A1 Jiang, Yidi
A1 Atiquzzaman, Mohammad
A1 Mullin, Sarah I.
A1 Shadowitz, Ellen
A1 Liu, Lisa
A1 Kostadinovic, Ema
A1 Sukovic, Tatjana
A1 Gonzalez, Anny
A1 McGrath-Chong, Margaret E.
A1 Oliver, Matthew J.
A1 Perl, Jeffrey
A1 Leis, Jerome A.
A1 Bolotin, Shelly
A1 Tran, Vanessa
A1 Levin, Adeera
A1 Blake, Peter G.
A1 Colwill, Karen
A1 Gingras, Anne-Claude
A1 Hladunewich, Michelle A.
YR 2022
UL http://www.cmaj.ca/content/194/8/E297.abstract
AB Background: Differences in immunogenicity between mRNA SARS-CoV-2 vaccines have not been well characterized in patients undergoing dialysis. We compared the serologic response in patients undergoing maintenance hemodialysis after vaccination against SARS-CoV-2 with BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna).Methods: We conducted a prospective observational cohort study at 2 academic centres in Toronto, Canada, from Feb. 2, 2021, to July 20, 2021, which included 129 and 95 patients who received the BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines, respectively. We measured SARS-CoV-2 immunoglobulin G antibodies to the spike protein (anti-spike), receptor binding domain (anti-RBD) and nucleocapsid protein (anti-NP) at 6–7 and 12 weeks after the second dose of vaccine and compared those levels with the median convalescent serum antibody levels from 211 controls who were previously infected with SARS-CoV-2.Results: At 6–7 weeks after 2-dose vaccination, we found that 51 of 70 patients (73%) who received BNT162b2 and 83 of 87 (95%) who received mRNA-1273 attained convalescent levels of anti-spike antibody (p < 0.001). In those who received BNT162b2, 35 of 70 (50%) reached the convalescent level for anti-RBD compared with 69 of 87 (79%) who received mRNA-1273 (p < 0.001). At 12 weeks after the second dose, anti-spike and anti-RBD levels were significantly lower in patients who received BNT162b2 than in those who received mRNA-1273. For anti-spike, 70 of 122 patients (57.4%) who received BNT162b2 maintained the convalescent level versus 68 of 71 (96%) of those who received mRNA-1273 (p < 0.001). For anti-RBD, 47 of 122 patients (38.5%) who received BNT162b2 maintained the anti-RBD convalescent level versus 45 of 71 (63%) of those who received mRNA-1273 (p = 0.002).Interpretation: In patients undergoing hemodialysis, mRNA-1273 elicited a stronger humoral response than BNT162b2. Given the rapid decline in immunogenicity at 12 weeks in patients who received BNT162b2, a third dose is recommended in patients undergoing dialysis as a primary series, similar to recommendations for other vulnerable populations.