Patients on hemodialysis have an elevated risk for COVID-19 but were not included in efficacy trials of SARS-CoV-2 vaccines.

We conducted a retrospective, observational study to estimate the real-world effectiveness and immunogenicity of two mRNA SARS-CoV-2 vaccines in a large, representative population of adult hemodialysis patients in the United States. In separate, parallel analyses, patients who began a vaccination series with BNT162b2 or mRNA-1273 in January and February 2021 were matched with unvaccinated patients and risk for outcomes were compared for days 1-21, 22-42, and ≥43 after first dose. In a subset of consented patients, blood samples were collected approximately 28 days after the second dose and anti–SARS-CoV-2 immunoglobulin G was measured.

A total of 12,169 patients received the BNT162b2 vaccine (matched with 44,377 unvaccinated controls); 23,037 patients received the mRNA-1273 vaccine (matched with 63,243 unvaccinated controls). Compared with controls, vaccinated patients’ risk of being diagnosed with COVID-19 postvaccination became progressively lower during the study period (hazard ratio and 95% confidence interval for BNT162b2 was 0.21 [0.13, 0.35] and for mRNA-1273 was 0.27 [0.17, 0.42] for days ≥43). After a COVID-19 diagnosis, vaccinated patients were significantly less likely than unvaccinated patients to be hospitalized (for BNT162b2, 28.0% versus 43.4%; for mRNA-1273, 37.2% versus 45.6%) and significantly less likely to die (for BNT162b2, 4.0% versus 12.1%; for mRNA-1273, 5.6% versus 14.5%). Antibodies were detected in 98.1% (309/315) and 96.0% (308/321) of BNT162b2 and mRNA-1273 patients, respectively.

In patients on hemodialysis, vaccination with BNT162b2 or mRNA-1273 was associated with a lower risk of COVID-19 diagnosis and lower risk of hospitalization or death among those diagnosed with COVID-19. SARS-CoV-2 antibodies were detected in nearly all patients after vaccination. These findings support the use of these vaccines in this population.

接受血液透析的患者感染 COVID-19 的风险较高，但未被纳入 SARS-CoV-2 疫苗的功效试验。

我们进行了一项回顾性观察性研究，以评估两种 mRNA SARS-CoV-2 疫苗在美国大量有代表性的成年血液透析患者中​​的真实有效性和免疫原性。在单独的平行分析中，将在 2021 年 1 月和 2021 年 2 月开始 BNT162b2 或 mRNA-1273 疫苗接种系列的患者与未接种疫苗的患者进行匹配，并比较首次接种后第 1-21 天、第 22-42 天和≥43 天的结果风险. 在同意的患者子集中，在第二次给药后约 28 天收集血样，并测量抗 SARS-CoV-2 免疫球蛋白 G。

共有 12,169 名患者接种了 BNT162b2 疫苗（与 44,377 名未接种疫苗的对照相匹配）；23,037 名患者接种了 mRNA-1273 疫苗（与 63,243 名未接种疫苗的对照相匹配）。与对照组相比，接种疫苗的患者在接种疫苗后被诊断为 COVID-19 的风险在研究期间逐渐降低（BNT162b2 的风险比和 95% 置信区间为 0.21 [0.13, 0.35]，而 mRNA-1273 的风险比和 95% 置信区间为 0.27 [0.17, 0.42] ≥ 43 天）。在确诊 COVID-19 后，接种疫苗的患者住院的可能性明显低于未接种疫苗的患者（对于 BNT162b2，分别为 28.0% 和 43.4%；对于 mRNA-1273，分别为 37.2% 和 45.6%），并且死亡的可能性也明显更低（对于 BNT162b2， 4.0% 对 12.1%；对于 mRNA-1273，5.6% 对 14.5%）。在 98.1% (309/315) 和 96 中检测到抗体。

在接受血液透析的患者中，接种 BNT162b2 或 mRNA-1273 疫苗与较低的 COVID-19 诊断风险和较低的 COVID-19 住院或死亡风险相关。接种疫苗后，几乎所有患者都检测到了 SARS-CoV-2 抗体。这些发现支持在该人群中使用这些疫苗。