Among patients receiving dialysis, the antibody response to SARS-CoV-2 wanes through 5-6 months and is related to risk for breakthrough infection, according to a study published in Annals of Internal Medicine. Shuchi Anand, MD, and colleagues determined longitudinal antibody-based response after SARS-CoV-2 vaccination among 4,791 patients, including 2,563 vaccinated participants. Antibodies to the receptor-binding domain (RBD) of SARS-CoV-2 were measured from plasma, and every breakthrough case was matched to five control patients to evaluate whether peak or pre-breakthrough RBD values were associated with breakthrough infection. The estimated proportion with an undetectable RBD response increased from 6.6% to 20.2% at 14-30 days after vaccination and at 5-6 months after vaccination, respectively. There was a decrease in the estimated median index values from 91.9 at 14-30 days after vaccination to 8.4 at 5-6 months after vaccination. Breakthrough infections occurred in 56 patients, with samples collected a median of 21 days before infection.

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