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@article{Martin:2022:10.1016/j.lanepe.2022.100478,
author = {Martin, P and Gleeson, S and Clarke, C and Thomson, T and Edwards, H and Spensley, K and Mortimer, P and Mcintyre, S and cox, A and Pickard, G and Lightstone, E and Thomas, D and McAdoo, S and kelleher, P and Prendecki, M and Willicombe, M},
doi = {10.1016/j.lanepe.2022.100478},
journal = {The Lancet Regional Health Europe},
title = {Comparison of immunogenicity and clinical effectiveness between BNT162b2 and ChAdOx1 SARS-CoV-2 vaccines in people with end-stage kidney disease receiving haemodialysis: a prospective, observational cohort study},
url = {http://dx.doi.org/10.1016/j.lanepe.2022.100478},
volume = {21},
year = {2022}
}

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TY  - JOUR
AB  - Background:People with end-stage kidney disease, including people on haemodialysis, are susceptible to greater COVID-19 related morbidity and mortality. This study compares the immunogenicity and clinical effectiveness of BNT162B2 versus ChAdOx1 in haemodialysis patients.Methods:In this observational cohort study, 1021 patients were followed-up from time of vaccination until December 2021. All patients underwent weekly RT-PCR screening. Patients were assessed for nucleocapsid(anti-NP) and spike(anti-S) antibodies at timepoints after second(V2) and third(V3) vaccinations. 191 patients were investigated for T-cell responses. Vaccine effectiveness (VE) for prevention of infection, hospitalisation and mortality was evaluated using the formula VE=(1-adjustedHR)x100.Findings:45.7% (467/1021) had evidence of prior infection. There was no difference in the proportion of infection-naïve patients who seroconverted by vaccine type, but median anti-S antibody titres were higher post-BNT162b2 compared with ChAdOx1; 462(152-1171) and 78(20-213) BAU/ml respectively, p<0.001.  Concomitant immunosuppressant use was a risk factor for non-response, OR 0.12[95% CI 0.05–0.25] p<0.001.  Post-V3 (all BNT162b2), median anti-S antibody titres remained higher in those receiving BNT162b2 versus ChAdOx1 as primary doses; 2756(187–1246) and 1250(439–2635) BAU/ml respectively, p=0.003.Anti-S antibodies waned over time. Hierarchical levels of anti-S post-V2 predicted risk of infection; patients with no/low anti-S being at highest risk. VE for preventing infection, hospitalisation and death was 53% (95% CI 6–75), 77% (95% CI 30–92) and 93% (95% CI 59–99) respectively, with no difference seen by vaccine type.Interpretation:Serum anti-S concentrations predict risk of breakthrough infection. Anti-S responses vary dependent upon clinical features, infection history and vaccine type. Monitoring of serological responses may enable individualised approaches
AU  - Martin,P
AU  - Gleeson,S
AU  - Clarke,C
AU  - Thomson,T
AU  - Edwards,H
AU  - Spensley,K
AU  - Mortimer,P
AU  - Mcintyre,S
AU  - cox,A
AU  - Pickard,G
AU  - Lightstone,E
AU  - Thomas,D
AU  - McAdoo,S
AU  - kelleher,P
AU  - Prendecki,M
AU  - Willicombe,M
DO  - 10.1016/j.lanepe.2022.100478
PY  - 2022///
SN  - 2666-7762
TI  - Comparison of immunogenicity and clinical effectiveness between BNT162b2 and ChAdOx1 SARS-CoV-2 vaccines in people with end-stage kidney disease receiving haemodialysis: a prospective, observational cohort study
T2  - The Lancet Regional Health Europe
UR  - http://dx.doi.org/10.1016/j.lanepe.2022.100478
UR  - http://hdl.handle.net/10044/1/98559
VL  - 21
ER  -

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