The incidence of severe COVID-19 infections was lower than expected among dialysis patients from the beginning of vaccine rollout, and antibody titers against the SARSCoV-2 spike protein decreased substantially within 6 months of vaccination in patients receiving maintenance dialysis, according to two studies published in the Clinical Journal of the American Society of Nephrology. In the first study, researchers estimated the association between vaccine exposure and severe COVID-19 infection in dialysis patients versus the general population. From the beginning of vaccine rollout, the incidence in dialysis patients was lower than predicted, with incidence rate ratios of 0.37 and 0.50 for vaccine exposure in dialysis patients and per 10% increase in vaccine coverage in the same-aged general population, respectively. In the second study, Eduardo Lacson, MD, MPH, and colleagues analyzed 1,870 patients on maintenance dialysis who received a complete COVID-19 vaccine series, in cluding 1,569 without prior COVID-19, and found declines in antibody titers over time for patients without prior COVID-19. There was an association seen for maximum titer in the first 2 months after vaccination with durability of the antispike immunoglobulin G sero response.