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ORIGINAL ARTICLE

Exploring the Immune Response to COVID-19 Vaccines in Dialysis and Transplant Patients

Hui Wen You

Hui Wen You

Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia

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Soo Kun Lim

Soo Kun Lim

Head of Renal Division University Malaya Medical Center, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia

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Boon Hong Kong

Boon Hong Kong

Department of Molecular Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia

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Shian Feng Cheng

Shian Feng Cheng

Department of Nephrology, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia

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Reena Rajasuriar

Reena Rajasuriar

Department of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia

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Hui Wei You

Corresponding Author

Hui Wei You

School of Economics and Management, Xiamen University Malaysia, Sepang, Selangor, Malaysia

Faculty of Business, UNITAR International University, Petaling Jaya, Selangor, Malaysia

Correspondence:

Hui Wei You ([email protected])

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First published: 14 July 2025

Funding: The authors received no specific funding for this work.

ABSTRACT

Introduction

This study explores immune responses to SARS-CoV-2 vaccination among dialysis patients and kidney transplant recipients (KTRs). Dialysis patients and KTRs often exhibit lower seroconversion rates, particularly the latter, due to immunosuppressive therapies.

Methods

The prospective study was conducted at the University Malaya Medical Centre (UMMC), involving 62 dialysis patients and 49 KTRs.

Results

Dialysis patients exhibited high seroconversion (97.8%) and T-cell response (77.4%). In contrast, KTRs had poor seroconversion (59.2%) and a weak T-cell response (44.9%) after a third dose. Furthermore, 32.7% of KTRs were non-reactive in both antibody and T-cell responses. A moderate correlation was found between antibody levels and T-cell responses in KTRs (p = 0.033, r = 0.305). Among dialysis patients, lower BMI was significantly associated with reduced seroconversion, while longer dialysis duration and the presence of hypertension were positively associated with antibody response. Other clinical factors, including age, gender, diabetes, and prior COVID-19 infection, showed no significant association.

Conclusion

The findings suggest dialysis patients respond better to vaccination, while KTRs experience impaired immune responses. Within dialysis patients, BMI, dialysis duration, and hypertension influenced antibody response. Monitoring post-vaccination immune responses in KTRs may help identify non-responders, who could benefit from alternative vaccination strategies or adjustments in immunosuppressive therapy. This study was approved by the University Malaya Medical Centre Medical Research Ethics Committee (UMMC-MREC), Approval No: 202131-9888.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

Data will be made available upon request.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.