Evidence map›Paper›PMID 34671782›Full record

ArticlemedRxiv : the preprint server for health sciences2021

SARS-CoV-2 vaccine antibody response and breakthrough infection in dialysis.

Shuchi Anand, Maria E Montez-Rath, Jialin Han, Pablo Garcia, LinaCel Cadden, Patti Hunsader, Curt Morgan, Russell Kerschmann, Paul Beyer, Mary Dittrich and 3 more

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Shuchi AnandDepartment of Medicine (Nephrology), Stanford University.
Maria E Montez-RathDepartment of Medicine (Nephrology), Stanford University.
Jialin HanDepartment of Medicine (Nephrology), Stanford University.
Pablo GarciaDepartment of Medicine (Nephrology), Stanford University.
LinaCel CaddenAscend Clinical Laboratory.
Patti HunsaderAscend Clinical Laboratory.
Curt MorganAscend Clinical Laboratory.
Russell KerschmannAscend Clinical Laboratory.
Paul BeyerAscend Clinical Laboratory.
Mary DittrichUS Renal Care.
Geoffrey A BlockUS Renal Care.
Glenn M ChertowDepartments of Medicine (Nephrology), and Epidemiology and Population Health, Stanford University.
Julie ParsonnetDepartments of Medicine (Infectious Diseases and Geographic Medicine), and Epidemiology and Population Health, Stanford University.

Funding

Chronic kidney disease of unknown etiology: applying a multidisciplinary approach to investigate the world's most common tubulointerstitial kidney diseaseR01DK127138 · NIDDK · STANFORD UNIVERSITY · PI MONTEZ RATH, MARIA · 2021 to 2025
$2.7M
Mentoring Patient-Oriented Clinical Investigators in NephrologyK24DK085446 · NIDDK · STANFORD UNIVERSITY · PI CHERTOW, GLENN MATTHEW · 2010 to 2022
$1.4M
NIDDK NIH HHS K24 DK085446NIDDK NIH HHS R01 DK127138
6 · The paper itself

Abstract

backgroundPatients receiving dialysis are a sentinel population for groups at high risk for death and disability from COVID-19. Understanding correlates of protection post-vaccination can inform immunization and mitigation strategies.

methodsMonthly since January 2021, we tested plasma from 4791 patients receiving dialysis for antibodies to the receptor-binding domain (RBD) of SARS-CoV-2 using a high-throughput assay. We qualitatively assessed the proportion without a detectable RBD response and among those with a response, semiquantitative median IgG index values. Using a nested case-control design, we matched each breakthrough case to five controls by age, sex, and vaccination-month to determine whether peak and pre-breakthrough RBD IgG index values were associated with risk for infection post-vaccination.

resultsAmong 2563 vaccinated patients, the proportion without a detectable RBD response increased from 6.6% [95% CI 5.5-8.1] in 14-30 days post-vaccination to 20.2% [95% CI 17.1-23.8], and median index values declined from 92.7 (95% CI 77.8-107.5) to 3.7 (95% CI 3.1-4.3) after 5 months. Persons with SARS-CoV-2 infection prior-to-vaccination had higher peak index values than persons without prior infection, but values equalized by 5 months (p=0.230). Breakthrough infections occurred in 56 patients, with samples collected a median of 21 days pre-breakthrough. Peak and pre-breakthrough RBD values <23 (equivalent to <506 WHO BAU/mL) were associated with higher odds for breakthrough infection (OR: 3.7 [95% CI 2.0-6.8] and 9.8 [95% CI 2.9-32.8], respectively).

conclusionsThe antibody response to SARS-CoV-2 vaccination wanes rapidly, and in persons receiving dialysis, the persisting antibody response is associated with risk for breakthrough infection.

Identifiers

PMID34671782
PMCPMC8528091

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.