Patients receiving dialysis for severe kidney disease have less of an immune system response to COVID-19 vaccines than patients who aren’t receiving this treatment, a new study finds.
Researchers at a Taiwanese hospital analyzed 32 studies and nearly 5,000 patients with late-stage renal disease.
Around 41% of dialysis patients experienced an immune response to the coronavirus following their first dose, while 89 percent experienced an immune response after receiving their second dose.
Researchers found that dialysis patients had significantly lower immune responses than non-dialysis patients, but that the difference was smaller after two doses.
These findings suggest that dialysis patients should prioritize third-, and possibly fourth-generation vaccine doses.

A new meta-analysis has shown that patients who receive dialysis treatment have lower immune responses against Covid vaccines. Pictured: A senior receives dialysis treatment (file image)

In several studies, patients on dialysis had lower immune responses to Covid vaccines than those who did not receive this treatment.
Chronic kidney disease patients are more at risk for severe Covid symptoms, hospitalizations and even death.
Dialysis patients with kidney disease, who have to manually filter out waste from their bodies, are particularly vulnerable. They have a weak immune system.
Patients who have had kidney transplants must also take drugs that suppress their immune system, increasing their Covid risk.
In addition, weakened immune systems can also reduce a patient’s response to Covid vaccines.
As a result, many studies in the past year have examined what happens in these patients’ immune systems after they get vaccinated.
A new paper published in JAMA Network Open Tuesday compiles the results from several of these studies. It focuses on dialysis patients.
Researchers at Chang Gung Memorial Hospital in Linkou (Taiwan) performed a systemic and meta-analysis, which combined data from multiple clinical trials.
These clinical studies were found by the researchers after they searched medical databases for articles published between 2020 and 2021 that looked at the Covid vaccine response in patients with late-stage kidney disease.
The meta-analysis consisted of 32 studies, six were preprints, which means that these studies hadn’t been peer-reviewed.
The studies involved nearly 5,000 patients from the U.S.A., U.K. Canada, Australia, and other countries.
Overall, dialysis patients had an 86% immune response rate to Covid vaccines. However, this rate varied widely between studies.
About 41 percent of patients had an immune response after their first vaccination.
This rate was approximately 40 percent lower than that of patients not receiving dialysis treatment.

The researchers found that Dialysis patients with diabetes were more likely than those without it to have a lower immune reaction to the Covid vaccinations.
However, after a second dose of vaccine, the immune response rate for dialysis patients rose to 89 percent.
This was only 12 percent lower than the rate in non-dialysis patients, suggesting that secondary exposures to the coronavirus are key for dialysis patients’ immune systems.
A few dialysis patients who participated in the meta-analysis received the third dose of Covid vaccine.
These patients had an immune response rate of 94 percent.
The immune response rate for dialysis patients who were infected by Covid prior to vaccination was also 96 percent.
The researchers additionally looked at patients’ age, sex, and other medical characteristics.
The analysis showed that patients with diabetes or immunosuppressive medications had lower antibody levels.

Dialysis patients’ immune systems have a reduced ability to make anti-spike protein antibodies and neutralizing antibodies, the researchers said – but second and third doses can help increase immune system activity.
Researchers also noted that the meta-analysis was focused on antibody response to Covid vaccinations.
Other types of Covid immunity exist – stored in immune cells that’remember the virus over long times of time’ – but these have not been as extensively studied.
The study suggests that dialysis patients should be given priority for the Covid vaccine booster shots.
On Monday, the Centers for Disease Control and Prevention recommended that some immunocompromised Americans should even consider receiving a fourth vaccine dose six months after their third dose.
This additional dose would be available to approximately three percent of Americans.