{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T19:55:10Z","timestamp":1768679710310,"version":"3.49.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Due to the waning humoral response after a two-dose SARS-CoV-2 mRNA vaccination, a third booster was recommended in hemodialyis patients. Data on a\u00a0heterologous mRNA-vector regimen, which might improve immunogenicity, are very\u00a0limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this observational study 36 chronic hemodialysis patients (mean (SD) age 66.9 (15.9) years, 33.3% females) were followed up for 13 months. All patients were vaccinated twice using the mRNA-BNT162b2 vaccine, followed by a 3<jats:sup>rd<\/jats:sup> dose of the vector vaccine Ad26COVS1 eight months later. We assessed the humoral response by quantifying the anti-SARS-CoV-2 spike IgG antibody and neutralizing antibody concentrations. The cellular immune response was evaluated <jats:italic>via<\/jats:italic> SARS-CoV-2 spike protein-specific interferon-\u03b3 release assay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The seroconversion rate was 47.2%, 100%, 69.4% and 100% one month after the 1<jats:sup>st<\/jats:sup> dose, one and six months after the 2<jats:sup>nd<\/jats:sup> dose and four months after the heterologous 3<jats:sup>rd<\/jats:sup> dose. The median (Q1, Q3) anti-SARS-CoV-2 spike IgG concentrations at the same time were 28.7 (13.2, 69.4) BAU\/ml, 1130.0 (594.5, 1735.0) BAU\/ml, 89.7 (26.4, 203.8) BAU\/ml, and 2080.0 (1062.5, 2080.0) BAU\/ml. The percentage of patients with neutralizing antibodies was 58.3% after the 2<jats:sup>nd<\/jats:sup> dose and improved to 100% after the 3<jats:sup>rd<\/jats:sup> dose (<jats:italic>P &amp;lt;<\/jats:italic>0.001). A positive T-cell response was found in 50% of patients after the 3<jats:sup>rd<\/jats:sup> dose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A third heterologous booster dose helped to sustain humoral immunity in almost all hemodialysis patients and induced a significant T-cellular response in half of them. Stimulating the immune response against SARS-CoV-2 by two different vaccine platforms seems to be a promising approach.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.907615","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T12:10:59Z","timestamp":1655986259000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Humoral and Cellular Immune Response After a 3-Dose Heterologous SARS-CoV-2 Vaccination Using the mRNA-BNT162b2 and Viral Vector Ad26COVS1 Vaccine in Hemodialysis Patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Tamara","family":"Davidovic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Schimpf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Abbassi-Nik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Stockinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannelore","family":"Sprenger-M\u00e4hr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Lhotta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuel","family":"Zitt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.10.006","article-title":"Waning 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