LETTER TO EDITOR Year : 2023  |  Volume : 50  |  Issue : 1  |  Page : 133

Three-dose COVID-19 Vaccine for hemodialysis patient: Expected usefulness

Beuy Joob1, Viroj Wiwanitkit2
1 Sanitation 1 Medical Academic Center, Bangkok, Thailand
2 Department of Community Medicine, Dr. D. Y. Patil Vidhayapeeth, Pune, Maharashtra, India

Date of Submission25-Nov-2021Date of Decision29-Oct-2022Date of Acceptance18-Nov-2022Date of Web Publication24-Mar-2023

Correspondence Address:
Beuy Joob
Sanitation 1 Medical Academic Center, Bangkok
Thailand

Source of Support: None, Conflict of Interest: None

Check

DOI: 10.4103/jss.jss_161_21

How to cite this article:
Joob B, Wiwanitkit V. Three-dose COVID-19 Vaccine for hemodialysis patient: Expected usefulness. J Sci Soc 2023;50:133

Sir,

The COVID-19 vaccine is the new preventive tool against the COVID-19 outbreak. An important clinical concern of the new COVID-19 is on vaccine efficacy. The most available COVID-19 is a two-dose vaccine. The second dose is intended for promoting effective immunity is required. In a normal healthy person, up to 100%, the protective antibody could be observed after the second dose of the vaccine.[1],[2] However, there is still a postvaccination COVID-19 which might imply a problem on immunogenicity. An idea for the third dose of vaccine for increasing immunity against pathogens is proposed.[3]

A three-dose vaccination might be useful for some groups of vaccines who have an impaired immune system. A hemodialysis patient usually has impaired immunity and the recent report showed that there is a poorer immune response to the COVID-19 vaccine than to normal healthy subjects.[2] Here, the authors estimate the usefulness of a three-dose COVID-19 vaccine for hemodialysis patients. The authors used a clinical mathematical model analysis for estimating the expected usefulness of the third-dose COVID-19 vaccine for hemodialysis patients. Primary data from a previous report[2] are used for analysis. Regarding the primary study, it is a prospective single-center research; nonexposed patients on dialysis were studied. Focusing on the protocols, the mRNA vaccine BNT162b2 with a two-dose standard regimen was researched. Omicron variations are the most prevalent COVID-19 variants in the environment, followed by Delta variants. According to the referenced study, for the hemodialysis group, SARS-CoV-2-neutralizing antibodies exceeded the threshold for neutralization seen in 18% and 82% after getting the first and the second dose, respectively.

The increasing rate is due to bolstering is equal to 64%. Applying this rate for simulating the effect of the third dose on hemodialysis cases, SARS-CoV-2-neutralizing antibodies that exceeded the threshold for neutralization will be expected in 100%. From this modeling, it can show that the third dose of the COVID-19 vaccine should be considered for hemodialysis patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 

  References 
1.Monin L, Laing AG, Muñoz-Ruiz M, McKenzie DR, Del Molino Del Barrio I, Alaguthurai T, et al. Safety and immunogenicity of one versus two doses of the COVID-19 vaccine BNT162b2 for patients with cancer: Interim analysis of a prospective observational study. Lancet Oncol 2021;22:765-78.  
    2.Speer C, Göth D, Benning L, Buylaert M, Schaier M, Grenz J, et al. Early humoral responses of hemodialysis patients after COVID-19 vaccination with BNT162b2. Clin J Am Soc Nephrol 2021;16:1073-82.  
    3.Iversen PL, Bavari S. Is there space for a three-dose vaccine to fight the spread of SARS-CoV-2? Lancet Infect Dis 2021;21:1054-5.