Immunogenicity of the Two mRNA SARS-CoV-2 Vaccines in a Large Cohort of Dialysis Patients

Round 1

Reviewer 1 Report

I appreciate the opportunity to review the manuscript entitled "Immunogenicity and safety of the two mRNA SARS-CoV-2 vaccines in a large cohort of dialysis patients.” In present study authors have evaluated the humoral and cellular response after vaccination with the ‘’two doses of either of the two authorized mRNA vaccines in a cohort of 310 patients on maintenance dialysis.

However, the author may take note of the major and minor remarks listed below to improve the manuscript:

Major comments:

1.      Though the authors have mentioned some points as limitations of the present study, I would highly recommend the use of a healthy control group in the present manuscript.

2.      Several studies have reported the effect of an earlier SARS-CoV-2 infection on cellular and humoral immune responses. However, in the present study, there is no information available for the same. Though it is not part of the exclusion criteria, it has an impact on both the parameters. I would suggest grouping the patients accordingly.

3.      It is understandable that the patient’s follow-up is difficult after the sample collection. However, plotting of breakthrough infections that occurred before sample collection will have an impact on the study observation.

4.      Earlier studies discussed in line numbers 47–50 and 206-210 suggest the uremic condition has a significant impact on humoral immune response generation, which needs to be discussed and correlated with the present study observations.

5.      Based on the study observation, I would suggest changing the title to "Immunogenicity of the two mRNA SARS-CoV-2 vaccines in a large cohort of dialysis patients." As earlier, several detailed studies have reported the safety of the mentioned vaccines.

 

Minor comments:

1.      Line no: 84-89 mentions the sample collection 15 after a positive PCR. It is quite confusing Hence, I would recommend the patient’s stratification based on the SARS-CoV-2 infection prior to vaccination.

2.      Line no 93: mention the name of the antigen used for the stimulation.

3.      Line no: 153 Where is table 7?

Author Response

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Author Response File: Author Response.docx

Reviewer 2 Report

Thank you very much for giving me the opportunity to review the manuscript entitled 'Immunogenicity and safety of the two mRNA SARS-CoV-2 2 vaccines in a large cohort of dialysis patients'.

This is valuable data for considering vaccine strategies for dialysis patients.

However, I have some comments to this manuscript.

1.  The authors concluded only vaccine type was independently associated with immunogenicity. However, the number of those who received mRNA1273 was only 13. It is too small to reach the solid conclusion. 

2. About the analysis for factors associated with positive IgG among patients, I think there are too few antibody-negative cases for multivariate analysis. Analysis that focuses on the distribution of antibody titers instead of antibody positive/negative might be an alternative option.

3. The number of antibody-negative cases is only 17. I think it would be good to show each individual information as an appendix in a list.

4. The frequency of vaccine side effects appears to be lower than in the general population, so this should also be discussed.

Author Response

Please see the attachment

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Dear Authors,

Thank you for incorporating changes.