Kidney patients have a higher chance of a severe course of COVID-19 and more often die from the disease than healthy people
A large clinical study in four university hospitals shows that booster vaccinations against the coronavirus are useful in people with a new kidney. Even if they did not develop an immune response after the first two or three injections, the immune system still activates in 60% after a follow-up injection. These results are published in The Lancet Infectious Diseases.
Kidney patients have a higher chance of a severe course of COVID-19 and more often die from the disease than healthy people. Previous studies have looked at whether kidney patients respond well to vaccinations. This showed that people have a lower immune response after a kidney transplant, only half develop antibodies after two vaccines. One explanation is that they take drugs that suppress the immune system to prevent rejection of the transplanted kidney.
A group of researchers at Radboudumc, led by internist-nephrologist Luuk Hilbrands, investigated whether a different vaccination strategy could improve the immune response in these patients. The study, funded by ZonMW and the Kidney Foundation, was conducted in four Dutch university hospitals: Radboudumc Nijmegen, Amsterdam UMC, UMC Groningen and Erasmus MC Rotterdam.
No differences between groups
More than 300 kidney transplant patients took part in the study, who still had no antibodies against the corona virus after two or three vaccines, based on blood measurements. Hilbrands, coordinating author of the article: ‘The control group received one dose of Moderna. In addition, we examined three alternatives. One group received a double dose, so a shot of Moderna in both arms. One group received a different type of vaccine, namely Janssen. And a group received one dose of Moderna, during which we temporarily stopped some of the medication that suppresses the immune system.’
The study showed that around sixty percent of the participants developed an immune response after these booster vaccinations. The research team looked at antibodies and also at immune cells. They saw no differences in the immune response between the groups studied. So the type of vaccine, the dose and the discontinuation of medication made no difference.
keep boosting
The main message of the study is: keep vaccinating. ‘If we do not measure an immune response in people with a new kidney after two or three vaccinations, they are inclined to stop vaccinating. Now it appears that the next booster does have an effect, in our study even sixty percent still get a reaction,’ explains Hilbrands. ‘After every booster, we achieve an immune response in more people. The concentrations of antibodies also rise sharply after repeated injections.’
The value of repeated vaccinations has only been demonstrated in this study for people with a new kidney. But Hilbrands also recommends booster shots for other kidney patients: ‘Some patients also take medicines that suppress the immune system, resulting in a reduced response to vaccines. Other kidney patients respond better to vaccines, but repeat vaccines remain important for them too, because the effect of vaccination diminishes over time.’
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