COVID-19 vaccination in patients with chronic kidney disease : exploring humoral immunity, perceptions, and health information-seeking behavior

Background: People living with chronic kidney disease (CKD) face an increased risk of severe illness from COVID-19, making vaccination a key strategy to reduce hospitalization and death in this population. There is limited information regarding the humoral immune response over time to COVID-19 vaccination in non-dialysis-dependent CKD (NDD-CKD) patients, particularly after the third dose, and whether this response varies by kidney function, assessed by estimated glomerular filtration rate (eGFR). Information on factors that shape COVID-19 vaccine uptake, including health information-seeking behavior (HISB) and perceptions, within the CKD population are also undefined. Methods: This thesis consists of two studies (Chapter 2 and 3), conducted within British Columbia and Ontario, Canada, between Aug 2021 – April 2023. Chapter 2: A prospective observational study that investigated the serologic response after a third mRNA COVID-19 vaccine dose in NDD-CKD patients over a 9-month follow-up period. Chapter 3: A mixed methods cross-sectional web-based survey that investigated perceptions, HISB, comprehension, and trust in information on COVID-19 in CKD patients (including dialysis and transplant). Results: Anti-spike and Anti-RBD antibody levels peaked 2 months after the third dose (1131 and 1672 BAU/mL, respectively), and high seropositivity rates (above 93% and 85%, respectively) were seen over the 9-month follow up period. There was no association found between eGFR and mounting a robust antibody response or on the magnitude of antibody levels over time. Chapter 3: A majority (65%) of CKD patients sought out information on COVID-19 and those with a higher number of COVID-19 vaccine doses were associated with having sought out (P =.017), comprehended (P < .001), and trusted (P =.005) COVID-19 related information. Most CKD patients strongly agreed to statements regarding the benefits of COVID-19 vaccination. Questions posed by survey respondents about COVID-19 centered on four major categories: vaccination strategy, vaccine effectiveness, vaccine safety, and the impact of COVID-19 on kidney health. Conclusion: NDD-CKD patients had a strong humoral immune response following a third mRNA COVID-19 vaccine dose and there were no observed differences in this response by eGFR. CKD patients exhibited high HISB, trust, and comprehension on COVID-19 information, and perceptions towards the COVID-19 vaccines were mostly favorable.Medicine, Faculty ofMedicine, Department ofGraduat

sj-docx-3-cjk-10.1177_20543581241242550 – Supplemental material for Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey

Supplemental material, sj-docx-3-cjk-10.1177_20543581241242550 for Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey by Omosomi Enilama, Cynthia MacDonald, Pearl Thompson, Umair Khan, Selina Allu, Mary Beaucage, Kevin Yau, Matthew J. Oliver, Michelle A. Hladunewich and Adeera Levin in Canadian Journal of Kidney Health and Disease</p

sj-docx-1-cjk-10.1177_20543581241242550 – Supplemental material for Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey

Supplemental material, sj-docx-1-cjk-10.1177_20543581241242550 for Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey by Omosomi Enilama, Cynthia MacDonald, Pearl Thompson, Umair Khan, Selina Allu, Mary Beaucage, Kevin Yau, Matthew J. Oliver, Michelle A. Hladunewich and Adeera Levin in Canadian Journal of Kidney Health and Disease</p

sj-docx-2-cjk-10.1177_20543581241242550 – Supplemental material for Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey

Supplemental material, sj-docx-2-cjk-10.1177_20543581241242550 for Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey by Omosomi Enilama, Cynthia MacDonald, Pearl Thompson, Umair Khan, Selina Allu, Mary Beaucage, Kevin Yau, Matthew J. Oliver, Michelle A. Hladunewich and Adeera Levin in Canadian Journal of Kidney Health and Disease</p

sj-docx-4-cjk-10.1177_20543581241242550 – Supplemental material for Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey

Supplemental material, sj-docx-4-cjk-10.1177_20543581241242550 for Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey by Omosomi Enilama, Cynthia MacDonald, Pearl Thompson, Umair Khan, Selina Allu, Mary Beaucage, Kevin Yau, Matthew J. Oliver, Michelle A. Hladunewich and Adeera Levin in Canadian Journal of Kidney Health and Disease</p

Omicron variant neutralizing antibodies following BNT162b2 BA.4/5 versus mRNA-1273 BA.1 bivalent vaccination in patients with end-stage kidney disease

Abstract Neutralization of Omicron subvariants by different bivalent vaccines has not been well evaluated. This study characterizes neutralization against Omicron subvariants in 98 individuals on dialysis or with a kidney transplant receiving the BNT162b2 (BA.4/BA.5) or mRNA-1273 (BA.1) bivalent COVID-19 vaccine. Neutralization against Omicron BA.1, BA.5, BQ.1.1, and XBB.1.5 increased by 8-fold one month following bivalent vaccination. In comparison to wild-type (D614G), neutralizing antibodies against Omicron-specific variants were 7.3-fold lower against BA.1, 8.3-fold lower against BA.5, 45.8-fold lower against BQ.1.1, and 48.2-fold lower against XBB.1.5. Viral neutralization was not significantly different by bivalent vaccine type for wild-type (D614G) (P = 0.48), BA.1 (P = 0.21), BA.5 (P = 0.07), BQ.1.1 (P = 0.10), nor XBB.1.5 (P = 0.10). Hybrid immunity conferred higher neutralizing antibodies against all Omicron subvariants. This study provides evidence that BNT162b2 (BA.4/BA.5) and mRNA-1273 (BA.1) induce similar neutralization against Omicron subvariants, even when antigenically divergent from the circulating variant

sj-docx-1-cjk-10.1177_20543581231160511 – Supplemental material for Determining the Longitudinal Serologic Response to COVID-19 Vaccination in the Chronic Kidney Disease Population: A Clinical Research Protocol

Supplemental material, sj-docx-1-cjk-10.1177_20543581231160511 for Determining the Longitudinal Serologic Response to COVID-19 Vaccination in the Chronic Kidney Disease Population: A Clinical Research Protocol by Kevin Yau, Omosomi Enilama, Adeera Levin, Marc G. Romney, Joel Singer, Peter Blake, Jeffrey Perl, Jerome A. Leis, Robert Kozak, Hubert Tsui, Shelly Bolotin, Vanessa Tran, Christopher T. Chan, Paul Tam, Miten Dhruve, Christopher Kandel, Jose Estrada-Codecido, Tyler Brown, Aswani Siwakoti, Kento T. Abe, Queenie Hu, Karen Colwill, Anne-Claude Gingras, Matthew J. Oliver and Michelle A. Hladunewich in Canadian Journal of Kidney Health and Disease</p