{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T08:03:35Z","timestamp":1768550615184,"version":"3.49.0"},"posted":{"date-parts":[[2021,7,22]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":29,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2021,10,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hemodialyzed patients are at higher risk for COVID-19 and were prioritized in the Portuguese vaccination campaign<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a prospective, longitudinal, cohort analysis of 143 patients on hemodialysis and 143 age-matched controls along BTN162b2 vaccination. ELISA quantified anti-full-length Spike IgG, IgM and IgA levels prior to the first vaccine dose (t0); 3 weeks later (second dose, t1); and 3 weeks later (t2); 127 patients were re-evaluated140 (t3) and 180 days (t4) after the first dose.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seroconversion at t1 was remarkably low in patients, with positivity for anti-spike IgG, IgM and IgA antibodies of 29.4%, 12% and 41%, respectively, increasing to 90.9% (IgG) and 83.9% (IgA) in t2, (IgM remained unchanged). Below 70 years of age anti-spike IgG levels at t1 were significantly lower compared to age-matched controls and showed a profile similar to older individuals. Immunosuppression was associated with lower antibody responses (p=0.005 at t1; p=0.008 at t2). Previous unresponsiveness to hepatitis B vaccination (75\/129, 58% of patients negative for anti-HBs antibodies) did not correlate with humoral unresponsiveness to BTN162b2. Anti-spike IgG, IgM and IgA positivity and antibody levels significantly decay at t3, with IgG levels showing further waning at t4.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The large majority of hemodialyzed patients showed IgG seroconversion upon BNT162b2 mRNA vaccination, albeit a sizable proportion of patients presented poor responses. Follow-up of antibody responses 180 days post vaccination unveiled significant decay of anti-spike antibodies and warrant close monitoring of COVID-19 infection and further studies on reinforced vaccination schedules in patients undergoing maintenance hemodialysis.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2021.07.20.21260849","type":"posted-content","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T17:00:19Z","timestamp":1626973219000},"source":"Crossref","is-referenced-by-count":5,"title":["Longitudinal analysis of antibody responses to the Pfizer BNT162b2 vaccine in Patients Undergoing Maintenance Hemodialysis"],"prefix":"10.64898","author":[{"given":"Andr\u00e9","family":"Weigert","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0691-4308","authenticated-orcid":false,"given":"Marie-Louise","family":"Bergman","sequence":"additional","affiliation":[]},{"given":"L\u00edgia","family":"Gon\u00e7alves","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3254-9404","authenticated-orcid":false,"given":"Iolanda","family":"Godinho","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4477-4492","authenticated-orcid":false,"given":"N\u00e1dia","family":"Duarte","sequence":"additional","affiliation":[]},{"given":"Rita","family":"Abrantes","sequence":"additional","affiliation":[]},{"given":"Patr\u00edcia","family":"Borges","sequence":"additional","affiliation":[]},{"given":"Ana","family":"Brennand","sequence":"additional","affiliation":[]},{"given":"Vanessa","family":"Malheiro","sequence":"additional","affiliation":[]},{"given":"Paula","family":"Matoso","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5213-4903","authenticated-orcid":false,"given":"Onome","family":"Akpogheneta","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7266-0006","authenticated-orcid":false,"given":"Lindsay","family":"Kosack","sequence":"additional","affiliation":[]},{"given":"Pedro","family":"Cruz","sequence":"additional","affiliation":[]},{"given":"Estela","family":"Nogueira","sequence":"additional","affiliation":[]},{"given":"Magda","family":"Pereira","sequence":"additional","affiliation":[]},{"given":"Ana","family":"Ferreira","sequence":"additional","affiliation":[]},{"given":"Marco","family":"Marques","sequence":"additional","affiliation":[]},{"given":"Telmo","family":"Nunes","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o","family":"Viana","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4761-614X","authenticated-orcid":false,"given":"Jocelyne","family":"Demengeot","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7225-1907","authenticated-orcid":false,"given":"Carlos","family":"Penha-Gon\u00e7alves","sequence":"additional","affiliation":[]}],"member":"54368","reference":[{"key":"2021100607250414000_2021.07.20.21260849v2.1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaa314"},{"key":"2021100607250414000_2021.07.20.21260849v2.2","doi-asserted-by":"crossref","unstructured":"Haas EJ , Angulo FJ , Mclaughlin JM , Anis E , Singer SR , Khan F , Brooks N , Smaja M , Mircus G , Pan K , Southern J , Swerdlow DL , Jodar L , Levy Y , Alroy-Preis S : Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data. http:\/\/www.thelancet.com [Internet] 397: 2021 Available from: https:\/\/doi.org\/10.1016\/ [cited 2021 Jun 21]","DOI":"10.1016\/S0140-6736(21)00947-8"},{"key":"2021100607250414000_2021.07.20.21260849v2.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034577"},{"key":"2021100607250414000_2021.07.20.21260849v2.4","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1001\/jama.2021.7152","article-title":"Association Between Vaccination With BNT162b2 and Incidence of Symptomatic and Asymptomatic SARS-CoV-2 Infections Among Health Care Workers","volume":"325","year":"2021","journal-title":"JAMA [Internet]"},{"key":"2021100607250414000_2021.07.20.21260849v2.5","doi-asserted-by":"crossref","unstructured":"Grupper A , Sharon N , Finn T , Cohen R , Israel M , Agbaria A , Rechavi Y , Schwartz IF , Schwartz D , Lellouch Y , Shashar M : Humoral Response to the Pfizer BNT162b2 Vaccine in Patients Undergoing Maintenance Hemodialysis. 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