Immunogenicity and Safety of the Three-Dose COVID-19 Vaccine Regimen in Patients Receiving Renal Replacement Therapy: A Systematic Review and Meta-Analysis

Overview

Journal Kidney Dis (Basel)

Specialty Nephrology

Date 2024 May 16

PMID 38751793

Authors

Becky Mingyao Ma

Anthony Raymond Tam

Kam Wa Chan

Ivan Fan Ngai Hung

Sydney Chi Wai Tang

Tak Mao Chan

Desmond Yat-Hin Yap

Affiliations

Soon will be listed here.

Abstract

Background: A three-dose regimen is the current standard for COVID-19 vaccination, but systematic data on immunogenicity and safety in chronic kidney disease patients remains limited.

Objectives: We conducted a meta-analysis on the immunogenicity and safety of three-dose COVID-19 vaccination in patients on renal replacement therapy (RRT).

Methods: Systematic literature search in four electronic databases yielded twenty eligible studies (2,117 patients, 94% of whom received mRNA vaccines) for meta-analysis.

Results: The overall seropositivity rate of anti-SARS-CoV-2 was 74.2% (95% CI: 65.0-83.4%) after three-dose COVID-19 vaccination. The seropositivity rate of anti-SARS-CoV-2 in kidney transplant recipients (KTRs) was 64.6% (95% CI: 58.7-70.5%), and 43.5% (95% CI: 38.5-48.6%) of non-responders after second dose became seropositive after third dose. The seropositivity rate of anti-SARS-CoV-2 was 92.9% (95% CI: 89.5-96.2%) in dialysis patients, and 64.6% (95% CI: 46.8-82.3%) of non-responders after second dose became seropositive after third dose. In KTRs, each year increase in transplant vintage was associated with 35.6% increase in anti-SARS-CoV-2 seropositivity (95% CI: 15.9-55.4%, = 0.01). There were no serious adverse events attributed to vaccination in KTRs, and the commonest local and systemic adverse events were injection site pain and fatigue, respectively.

Conclusion: Three-dose COVID-19 vaccination regimen in patients on RRT is associated with reduced immunogenicity, especially in KTRs. There are no adverse events associated with third-dose COVID-19 vaccine in KTRs.

Citing Articles

Feasibility and Effectiveness of Vaccines for COVID-19: An Umbrella Review.

SeyedAlinaghi S, Pashapouryeganeh A, Dehghani S, Mirzapour P, Abbaspour F, Afroughi F Arch Acad Emerg Med. 2024; 13(1):e6.

PMID: 39318867 PMC: 11417638. DOI: 10.22037/aaem.v12i1.2357.

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