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DOI: 10.1055/a-1375-4471
SARS-CoV-2-Impfungen – Was muss der Nephrologe wissen?
SARS-CoV-2 vaccines – what the nephrologist should know
Was ist neu?
Impfstoffe Innerhalb von nur 15 Monaten nach Beginn der COVID-19-Pandemie stehen bereits mehrere SARS-CoV-2-Impfstoffe zum klinischen Einsatz bereit. Während das Zielmolekül aller prädominierenden Vakzine das Spike-Protein von SARS-CoV-2 ist, lassen sie sich anhand ihres Wirkprinzip in mRNA-basierte, Vektor-basierte und Protein-basierte Impfstoffe unterscheiden.
Bedeutung für chronisch nierenkranke Menschen Das Aussprechen von Empfehlungen für chronisch nierenkranke Menschen ist aufgrund deren geringer Repräsentation in den Zulassungsstudien erschwert – wie bei anderen Patienten mit schwerer Komorbidität. Aufgrund von urämischem Immundefekt und/oder medikamentöser Immunsuppression könnte die Effektivität der Impfung im Einzelfall relativ vermindert sein. Dennoch profitieren vermutlich gerade diese Patienten von einer Impfung, da sie ein erhöhtes Risiko für einen schweren oder gar tödlichen COVID-19-Verlauf aufweisen.
Abstract
Only fifteen months after the beginning of the COVID-19 pandemic, several vaccines are already available for clinical use. While the spike protein of SARS-CoV-2 constitutes the main target of all predominant SARS-CoV-2 vaccines, they work by different mechanisms (mRNA-based vaccines vs. vector-based vaccines vs. protein-based vaccines).
Though there are slight differences regarding the level of protection against mild COVID-19, all five vaccines that have been through phase 3 trials were nearly 100 % effective in preventing severe or fatal cases of COVID-19. The side effects were of short duration.
Patients with chronic kidney disease (or other significant comorbidities) were largely excluded from Phase 3 trials, which makes definite recommendations concerning their vaccination difficult. The vaccine’s effectiveness may be reduced in that population due to a uremic immune defect and/or immunosuppressive medication. However, these patients have an increased risk for severe or fatal COVID-19, so that they may particularly benefit from the vaccine.
Publication History
Article published online:
29 March 2021
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