Van Praet J, Reynders M, De Bacquer D, et al. - In this prospective multicenter study of 543 hemodialysis patients and 75 healthy volunteers, a greater immunogenicity of mRNA-1273 vaccine, than BNT162b2, was evident which could be associated with its higher mRNA dose. This implies that hemodialysis patients’ impaired immune response to SARS-CoV-2 vaccination might be improved with a high-dose vaccine.

• As per preliminary evidence, SARS-CoV-2 vaccination in hemodialysis patients induces a blunted early serological response.

• Participants were assessed at 4 or 5 weeks and 8 or 9 weeks post-receipt of the BNT162b2 or mRNA-1273 vaccine, respectively.

• An incomplete, delayed humoral immune response and a blunted cellular immune response was seen in hemodialysis patients vs healthy volunteers.

• Patients vaccinated with mRNA-1273 vs BNT162b2 had significantly greater geometric mean antibody titers at both time points.

• A larger proportion of patients vaccinated with mRNA-1273 vs BNT162b2 achieved the threshold of 4,160 AU/ml, corresponding with high neutralizing antibody titers in vitro (53.6% vs 31.8% at 8 or 9 weeks).

• Independent predictors of the humoral and cellular responses were: COVID-19 experience, vaccine type, immunosuppressive drug use, serum albumin, lymphocyte count, hepatitis B vaccine nonresponder status, and dialysis vintage.