Patients on hemodialysis are at an increased risk of COVID-19, however they were excluded from effectiveness trials of SARS-CoV-2 vaccinations. In a large, representative group of adult hemodialysis patients in the United States, researchers conducted a retrospective, observational research to determine the real-world efficacy and immunogenicity of two mRNA SARS-CoV-2 vaccines. In separate, parallel investigations, patients who started a vaccination series with BNT162b2 or mRNA-1273 in January and February 2021 were matched with unvaccinated patients, and the risk of outcomes was examined for days 1-21, 22-42, and 43 following the first dose. Blood samples were taken roughly 28 days following the second dosage from a selection of consenting patients, and anti–SARS-CoV-2 immunoglobulin G levels were assessed.

The BNT162b2 vaccination was administered to 12,169 patients (who were matched with 44,377 unvaccinated controls); the mRNA-1273 vaccine was administered to 23,037 patients (matched with 63,243 unvaccinated controls). Compared to controls, vaccinated patients had a decreased likelihood of being diagnosed with COVID-19 after vaccination (hazard ratio and 95% CI for BNT162b2 was 0.21 [0.13, 0.35] and for mRNA-1273 was 0.27 [0.17, 0.42] for days> 43). Vaccinated patients were much less likely than unvaccinated patients to be hospitalized after a COVID-19 diagnosis (for BNT162b2, 28.0% vs 43.4%; for mRNA-1273, 37.2% versus 45.6%) and significantly less likely to die (for BNT162b2, 4.0% versus 12.1% ; for mRNA-1273, 5.6% versus 14.5% ). Antibodies were found in 98.1% (309/315) of BNT162b2 patients and 96.0% (308/321) of mRNA-1273 patients, respectively.

Vaccination with BNT162b2 or mRNA-1273 was related with a decreased incidence of COVID-19 diagnosis and a lower risk of hospitalization or mortality among those diagnosed with COVID-19 in hemodialysis patients. SARS-CoV-2 antibodies were found in virtually all patients following immunization. The data suggested that the vaccinations should be used in this group.

Reference: jasn.asnjournals.org/content/33/1/49