Each author contributed important intellectual content during manuscript drafting or revision. Footnotes Supplementary File (PDF) Supplementary questionnaire on vaccine reactions and global tolerance after the fourth vaccine dose. Table?S1. a history of immunosuppression (Supplementary Table?S1). At 15 [14; 22] days after the fourth booster dose, antispike Ab titer significantly increased from 923 [369; 2019] to 21,883 [10,234; SX 011 42,870] AU/ml (Figure?1 ; Supplementary Figure?S3), which corresponds to a 19-fold increase (median) in antispike Ab titer. Ab titer after the fourth dose was 3.4-fold higher (median) than the Ab peak reached after the third dose. Dose 4 appeared well-tolerated (Supplementary Figure?S4), and no serious adverse event was observed. After the fourth dose, only 2 patients developed a breakthrough infection (vs. 7 cases of coronavirus disease 2019 after the third dose; Supplementary Table?S2). Open in a separate window Figure?1 Kinetics of antispike antibodies. The figure shows the antispike antibody (Ab) levels before, and 1 (M1), 3 (M3), and 6 (M6) months SX 011 after the third dose of the mRNA BNT162b2 vaccine, and after the fourth vaccine dose (BNT162b2 PfizerCBioNech or mRNA-1273 Moderna) in dialysis patients. Each point represents individual data. Antibody titers lower than 1 cannot be plotted in the graph because of the logarithm scale. The red points and vertical lines indicate the median with interquartile range. Conversion factor: 1 AU/ml?= 1.0288 BAU/ml. To conclude, our finding shows that a 3-dose regimen of an mRNA-based vaccine with a fourth booster dose appears to produce an important antibody response in dialysis patients, with a significant increase in antispike Ab titer. Long-term follow-up studies are needed to assess if this vaccination strategy elicits a durable and robust protective immune response against SARS-CoV-2 in dialysis patients. Data Statement The data that support the findings of this study are available from the corresponding author upon reasonable request. Disclosure All the authors declared no competing interests. Acknowledgments The authors thank patients for their participation in the study. Author Contributions SX 011 PH and A-LF researched the idea, created the study design, acquired the data, and analyzed and interpreted the data. A-LF provided statistical analyses. SK performed the antispike serology testing. Each author contributed important intellectual content during manuscript drafting or revision. Footnotes Supplementary File (PDF) Supplementary questionnaire on vaccine reactions and global tolerance after the fourth vaccine dose. Table?S1. Characteristics of the study population. Table?S2. Characteristics of the patients with breakthrough coronavirus disease 2019 (COVID-19) after the third or the fourth vaccine dose during the Rabbit polyclonal to MAP2 fifth wave pandemic. Figure?S1. Vaccination strategy in dialysis patients. Figure?S2. Flowchart. Figure?S3. Kinetics of the antispike antibodies. Figure?S4. Self-reported tolerance. Supplementary Material Supplementary File (PDF)Click here to view.(469K, pdf).