Vaccination in kidney disease: what did we learn from COVID-19 pandemic.

IF 2.2 3区医学 Q3 PERIPHERAL VASCULAR DISEASE Current Opinion in Nephrology and Hypertension Pub Date : 2023-09-01 DOI:10.1097/MNH.0000000000000901

Sana F Khan

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引用次数: 1

Abstract

Purpose of review: Patients with kidney disease were prioritized during COVID-19 vaccination efforts. Initial data on vaccine seroconversion and efficacy were confounded by heterogeneous vaccination regimens as well as response assessments. Recent data have addressed responses to evolving vaccine regimens, and addressed concerns in this high-risk population.

Recent findings: mRNA vaccines BNT162b2 (Pfizer/BioNTech), mRNA1273 (Moderna) were the predominant vaccines used in two and three-dose regimens. Although population-based studies show reduced rates of seroconversion in kidney disease cohorts, there continues to be evolving efficacy largely due to emerging variants, and utilization of ongoing vaccine development. Recommendations on vaccination regimens now exclude use of monovalent mRNA vaccines, with bivalent vaccines are now the preferred effective vaccination. Individualization and adjustment of immunosuppressive drugs is recommended for maximal serological response in transplant recipients and patient with autoimmune kidney diseases.

Summary: Waning responses to initial vaccination regimen, as well as emerging variants of concern have resulted in multiple dose regimens being investigated in patient with kidney disease. Use of bivalent mRNA vaccine is now recommended for initial as well as subsequent vaccine doses.

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肾脏疾病的疫苗接种:我们从COVID-19大流行中学到了什么?

回顾目的:在COVID-19疫苗接种工作中，肾脏疾病患者被优先考虑。关于疫苗血清转换和效力的初步数据因不同的疫苗接种方案和反应评估而混淆。最近的数据涉及对不断发展的疫苗方案的反应，并解决了这一高危人群的关切。最近发现:mRNA疫苗BNT162b2(辉瑞/BioNTech)和mRNA1273 (Moderna)是两剂和三剂方案中使用的主要疫苗。尽管基于人群的研究显示肾脏疾病队列中的血清转换率降低，但主要由于新出现的变体和正在开发的疫苗的利用，疗效仍在不断变化。关于疫苗接种方案的建议现在排除了单价mRNA疫苗的使用，二价疫苗现在是首选的有效疫苗接种。建议个体化和调整免疫抑制药物，以使移植受者和自身免疫性肾脏疾病患者获得最大的血清学反应。摘要:对初始疫苗接种方案的反应减弱，以及新出现的担忧变体，导致对肾病患者进行多剂量方案的研究。现在建议在初始和后续疫苗剂量中使用二价mRNA疫苗。

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来源期刊

Current Opinion in Nephrology and Hypertension 医学-泌尿学与肾脏学

CiteScore

5.70

自引率

6.20%

发文量

132

审稿时长

6-12 weeks

期刊介绍： A reader-friendly resource, Current Opinion in Nephrology and Hypertension provides an up-to-date account of the most important advances in the field of nephrology and hypertension. Each issue contains either two or three sections delivering a diverse and comprehensive coverage of all the key issues, including pathophysiology of hypertension, circulation and hemodynamics, and clinical nephrology. Current Opinion in Nephrology and Hypertension is an indispensable journal for the busy clinician, researcher or student.