Higher Risk Due to Health Conditions
COVID-19 Vaccination among People Living with HIV: Immunogenicity, Effectiveness, and Safety
Aslam Anis, University of British Columbia
COVID-19 may pose a greater risk to people living with HIV. This study is following 400 people living with HIV in Montreal, Ottawa, Toronto, and Vancouver to determine their COVID-19 immune responses. Researchers are also doing a population-based analysis of provincial public health to look at vaccine effectiveness in people living with HIV.
Research summary Results Study website View study on 
Safety immUnogenicity of Covid-19 vaCcines in systEmic immunE mediated inflammatory Diseases (SUCCEED)
Sasha Bernatsky, Research Institute of the McGill University Health Centre (RI-MUHC)
This study is following almost 2,000 patients with various autoimmune inflammatory diseases (IMIDs) to determine their immune response to COVID-19 vaccined. Researchers will provide patient groups, healthcare providers, and policy makers important information on immune response, safety and disease activity following vaccination in people living with IMIDs.
Research summary Results Study website View study on
A prospective multi-site observational study of SARS-CoV-2 vaccination immunogenicity in patients with hematologic malignancies
C. Arianne Buchan, Ottawa Hospital Research Institute
Individuals with blood cancers such as lymphoma, myeloma, and leukemia have weakened immune systems because of their disease and the treatments they receive. This Canada-wide study is looking at COVID-19 vaccine response and safety in people with blood cancers including those who have received stem cell transplants.
Research summary Results Study website View study on
Immune response after COVID-19 vaccination during maintenance therapy in immune-mediated inflammatory diseases: an observational cohort study (IMPACT)
Vinod Chandran, University Health Network
At the time the study began, the efficacy of COVID-19 vaccines in patients with immune-mediated inflammatory diseases (IMID) was not well known as they were excluded from the clinical trials. This study aims to determine whether IMID patients treated with immunosuppressive medications still generate a protective immune response to the original SARS-CoV-2 virus and new variants after COVID-19 vaccination.
Research summary Results Study website View study on
COVID-19 Vaccine Immunogenicity and Safety in Immunodeficient patients
Juthaporn Cowan, Ottawa Hospital Research Institute
People with low immune systems were not included in the clinical trials for COVID-19 vaccines so it’s not known how they respond to the vaccines. Researchers in six provinces are following participants who have inborn error of immunity or certain medication-induced immunodeficiency to evaluate their immune response to COVID vaccines and assess vaccine safety.
Research summary Results Study website View study on
Prospective Evaluation of COVID-19 Vaccine in Transplant Recipients (PREVenT-COVID): A National Strategy
Deepali Kumar, University Health Network
This study is following more than 600 transplant recipients from several high-volume transplant centres in Canada over a two-year period to test the safety and effectiveness of COVID-19 vaccines in this immunosuppressed population. To assess long-term safety, researchers are developing a national safety surveillance system of COVID-19 vaccination amongst transplant recipients through the CANVAS network.
Research summary Results Study website View study on
Determining the safety and effectiveness of COVID-19 vaccination in the chronic kidney disease population
Matthew Oliver and Michelle Hladunewich, Sunnybrook Research Institute
Chronic kidney disease (CKD) patients are highly susceptible to infections, and COVID-19 in this group has led to frequent hospitalizations and higher mortality rates. Among other things, this study is measuring the antibody response to COVID-19 vaccination in 2,500 CKD patients. Researchers will also review the vaccines’ safety in CKD patients.
Research summary Results Study website View study on
Vaccines in a Time of Dual Pandemic: COVID-19 Vaccine in People with HIV
Mario Ostrowski, University of Toronto
People with HIV infection (PWH) aged 55 and older who are on combined anti-retroviral therapy (cART) have greater immunity problems because of the effects of both HIV and aging on their immune systems. This study is investigating whether PWH 55 years and older receiving COVID-19 vaccines develop levels of immunity comparable to people without HIV infection.
Research summary Results Study website View study on
Prospective Cohort Study to Examine Immunogenicity of SARS-CoV-2 Vaccination in Cancer Patients with Solid Malignancies
Glenwood Goss, Ottawa Hospital Research Institute
This study is investigating whether cancer patients can develop an immune system response to COVID-19 vaccines and is looking to provide critical information on the effectiveness of vaccines for people with cancer.
Research summary Results Study website View study on
Glenwood Goss
Glenwood Goss
Professor, University of Ottawa
Medical Oncologist, The Ottawa Hospital
Contact info
ggoss@toh.ca
Key words
Lung cancer
Cancer
IND
Phase 1
Clinical research
Translational research
Biomarkers
Medical oncology
Research interests
Lung cancer
Phase 1
Early drug development
Clinical research
Prospective Cohort Study to Examine Immunogenicity of SARS-CoV-2 Vaccination in Cancer Patients with Solid Malignancies
The large clinical trials of COVID-19 vaccines did not include individuals with compromised immune systems such as people with cancer, so there is limited safety data on the use of the vaccines in this group. In addition, many cancer patients have weakened immune systems due to their disease or because of treatments such as radiation and chemotherapy, which may reduce their immune response to vaccines. For these reasons, it is essential to determine if cancer patients develop sufficient immune response after COVID-19 vaccination.
Our study, called Prospective Cohort Study to Examine Immunogenicity of SARS-CoV-2 Vaccination in Cancer Patients with Solid Malignancies, brings together researchers from the Ottawa Hospital Research Institute and BC Cancer. The primary objective of our study is to compare vaccine-induced immune responses in cancer patients vs. healthy participants. To that extent, we are following 200 participants and analyzing blood samples taken before vaccination and at various time points afterward. We are looking at participants’ antibody production, how well these antibodies neutralize the SARS-CoV-2 virus, and how well their immune systems recognize the virus and develop lasting immunity against it. Since the introduction of additional vaccine doses for cancer patients, we have updated our study protocol to follow patients after their third and possibly fourth dose, to match the reality of a shifting vaccination landscape. Where possible, we are combining this information with other outcomes of vaccine effectiveness, such as whether or not patients become infected with the SARS-CoV-2 virus even though they are vaccinated.
The results of our study will help determine if cancer patients are able to develop an immune system response to the vaccine, and provide critical information to patients, health care providers, public health authorities and regulatory agencies on the effectiveness of vaccines for people with cancer.
Aslam Anis
Aslam Anis
Professor and Director pro tem, School of Population and Public Health, University of British Columbia
Director, Centre for Health Evaluation and Outcome Sciences
National Director, CIHR Canadian HIV Trials Network
Contact info
aslam.anis@ubc.ca
Key words
Health economics, HIV/AIDS, pharmaceuticals drugs, public health
Research interests
Pharmaceutical pricing and pharmaceutical industry regulations
Economic evaluation and economic decision analysis of health care interventions
Treatment cost-effectiveness and access
COVID-19 Vaccination among People Living with HIV: Immunogenicity, Effectiveness, and Safety
The first part of this study, called COVID-19 Vaccination among People Living with HIV: Immunogenicity, Effectiveness, and Safety, is following 400 people living with HIV in Montreal, Ottawa, Toronto, and Vancouver to determine their COVID-19 immune responses post-vaccine doses including third or fourth doses. Researchers are evaluating how well participants’ antibodies fight off the SARS-CoV-2 virus which causes COVID-19 and the durability and effectiveness of antibody response post-third vaccine dose. They are also comparing the data for this group with the immune responses from a control group of 100 people who do not have HIV.
The second part of this study involves a population-based analysis of provincial public health records in Ontario and British Columbia to look at vaccine effectiveness including third and fourth doses in people living with HIV compared to people who do not have HIV. Researchers are following more than 35,000 people living with HIV to note COVID-19 vaccine uptake and rates of SARS-CoV-2 infection and hospitalization. This includes looking at age, sex, where people live, socioeconomic status, comorbidities, HIV immune status, and the number of vaccine doses to see if these play a role in the effectiveness of COVID-19 vaccines.
The study results will provide important evidence to inform vaccination guidelines and public health strategies for the approximately 67,000 Canadians living with HIV.
Results: COVID-19 Vaccination among People Living with HIV: Immunogenicity, Effectiveness, and Safety
Sasha Bernatsky
Sasha Bernatsky, MD, PhD
Professor of Medicine, McGill University
Senior Clinical Investigator, Research Institute of the McGill University Health Centre
Nominate Principal Investigator, CAnadian Network for Advanced Interdisciplinary Methods (CANAIM)
Contact info:
Jennifer Lee (RIMUHC)
jennifer.lee@rimuhc.ca
Key words
Drug/device safety and effectiveness, Epidemiology, Autoimmunity, Rheumatic disease
Research interests
– Drug/device safety and effectiveness research
– Patient-centred outcomes research and evaluation
– Rheumatic disease outcomes
– Pharmacoepidemiology
– Administrative data/deep data analytics
Publications
– Bérard A, Sheehy O, Zhao JP, Vinet E, Quach C, Kassai B, Bernatsky S. Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy. PLoS One. 2021 May 19;16(5):e0251746. doi: 10.1371/journal.pone.0251746. PMID: 34010282; PMCID: PMC8133446.
– Hazlewood GS, Pardo Pardo J, Barnabe C, Schieir O, Barber CEH, Bernatsky S, Colmegna I, Hitchon C, Loeb M, Mertz D, Proulx L, Richards DP, Scuccimarri R, Tugwell P, Schünemann HJ, Mirza RD, Zhou AL, Nikolic RPA, Thomas M, Chase H, Ejaredar M, Nieuwlaat R. Canadian Rheumatology Association Recommendation for the Use of COVID-19 Vaccination for Patients With Autoimmune Rheumatic Diseases. J Rheumatol. 2021 May 15:jrheum.210288. doi: 10.3899/jrheum.210288. Epub ahead of print. PMID: 33993119.
– Mendel A, Bernatsky S, Askanase A, Bae SC, Clarke AE, Costedoat-Chalumeau N, Gladman DD, Gordon C, Hanly J, Jacobsen S, Kalunian K, Mak A, Mosca M, Pons-Estel BA, Ruiz-Irastorza G, Urowitz M, Vinet É. Hydroxychloroquine shortages among patients with systemic lupus erythematosus during the COVID-19 pandemic: experience of the Systemic Lupus International Collaborating Clinics. Ann Rheum Dis. 2021 Feb;80(2):1-2. doi: 10.1136/annrheumdis-2020-218164. Epub 2020 Jun 25. PMID: 32586918.
– Mendel A, Bernatsky S, Thorne JC, Lacaille D, Johnson SR, Vinet É. Hydroxychloroquine shortages during the COVID-19 pandemic. Ann Rheum Dis. 2020 May 20:annrheumdis-2020-217835. doi: 10.1136/annrheumdis-2020-217835. Epub ahead of print. PMID: 32434820.
– Zhao N, Liu Y, Smargiassi A, Bernatsky S. Tracking the origin of early COVID-19 cases in Canada. Int J Infect Dis. 2020 Jul;96:506-508. doi: 10.1016/j.ijid.2020.05.046. Epub 2020 May 17. PMID: 32425633; PMCID: PMC7231484.
COVID-19 Vaccination among People Living with HIV: Immunogenicity, Effectiveness, and Safety
People with rheumatoid arthritis, spondyloarthritis, inflammatory bowel disease, and psoriasis—which are examples of autoimmune inflammatory diseases—often take immunosuppressive drugs to help control symptoms, but these drugs can cause reduced immune responses to vaccines. Additionally, COVID-19 vaccine clinical trials did not include people with these diseases, so the effectiveness and side effects of the vaccines in this population is unclear.
This study, named Safety immUnogenicity of Covid-19 vaCcines in systEmic immunE mediated inflammatory Diseases (SUCCEED), is following almost 2,000 patients with various autoimmune inflammatory diseases to determine their immune response to the COVID-19 vaccine. The aim is to monitor vaccine-induced immunity, along with vaccine safety and effectiveness, starting with the first dose and continuing up to 6 months after the last dose received, which may be the third or fourth dose.
Participants do finger-prick blood tests at home at several points before and after vaccination, and researchers analyze these samples for antibodies to the SARS-CoV-2 virus. If researchers see evidence of a reduced immune response in any patient group, they perform in-depth studies to clarify the reasons for their reduced immune responses.
Participants are asked to complete questionnaires before and at several time points after vaccination regarding symptoms of possible side effects from the vaccine or from COVID-19 infection. Researchers are also monitoring patients’ disease activity with questionnaires and phone calls. They are cross-referencing provincial medical records with the study data to identify doctor visits and hospital admissions related to possible side effects from the vaccine, disease activity, or COVID-19 infection.
The study will provide patient groups, healthcare providers, public health administrators, and policy makers with important information on immune response, safety and disease activity following vaccination in people living with autoimmune inflammatory diseases.
COVID-19 Vaccination among People Living with HIV: Immunogenicity, Effectiveness, and Safety
C. Arianne Buchan
C. Arianne Buchan, MD MSc FRCPC
Assistant Professor, University of Ottawa
Infectious Diseases Physician, The Ottawa Hospital
Director, Adult Infectious Diseases Program, University of Ottawa
Research interests
Immunizations in immunocompromised patients
Infectious diseases outcomes in transplant and immunocompromised patients
Prevention of infection in transplant and immunocompromised patients
A prospective multi-site observational study of SARS-CoV-2 vaccination immunogenicity in patients with hematologic malignancies
Individuals with blood cancers such as lymphoma, myeloma, and leukemia have weakened immune systems because of their disease and the treatments they receive. This group also has a significantly higher risk of death from COVID-19 compared to the general population, so vaccination is very important to help protect them from infection. The large COVID-19 vaccine trials did not include individuals with blood cancers, so it is not known if they develop a protective antibody response after vaccination, and whether this response lasts over time, although the vaccines are considered safe for people with blood cancers. In this study, researchers are interested in collecting vaccine safety data for this specific patient population.
This Canada-wide study is named A prospective multi-site observational study of SARS-CoV-2 vaccination immunogenicity in patients with hematologic malignancies. It includes investigators Dr. C. Ariane Buchan (University of Ottawa), Dr. Michael Sebag (McGill), Dr. Abi Vijenthira and Dr. Sita Bhella (University Health Network), and Dr. Peng Wang (University of Alberta), and is looking at COVID-19 vaccine response and safety in people with blood cancers including those who have received stem cell transplants. Researchers are collecting blood samples from participants at several different time points, including before they receive their vaccines, immediately after the vaccine, and then a few months later, to determine how their immune systems respond to the vaccination.
Study participants receive their individual results which allow them to learn more about their immune system’s response to the COVID-19 vaccine. We also ask them to discuss the results with their cancer doctor.
The data from the study will provide information to support doctors’ counselling practices and to inform public health decisions for vaccinating people with blood cancers and their family members. It will also inform public health measures for ongoing protections such as masking and distancing for this population.
Vinod Chandran
Vinod Chandran
Associate Professor, University of Toronto
Staff Rheumatologist, University Health Network and Sinai Health
Contact info
Vinod.chandran@uhn.ca
Key words
Arthritis, psoriasis, spondyloarthritis, biomarkers, metabolomics, mass spectrometry, immune response, outcome measures
Research interests
Biomarkers for psoriatic disease, immune response to vaccines in immunocompromised, metabolomics, remote monitoring of arthritis, synovial immunopathology
Immune response after COVID-19 vaccination during maintenance therapy in immune-mediated inflammatory diseases: an observational cohort study (IMPACT)
Immune-mediated inflammatory diseases (IMID) such as rheumatoid arthritis, spondyloarthritis, inflammatory bowel disease, or psoriasis affect up to five per cent of Canadians, many of whom are treated with immunosuppressive medications. At the time the study began, the efficacy of COVID-19 vaccines in patients with IMIDs was not well-known since they were excluded from the original vaccine studies. There was also very little information about whether vaccines offer protection to immunosuppressed patients against the new variants of SARS-CoV-2.
This study, called Immune response after COVID-19 vaccination during maintenance therapy in immune-mediated inflammatory diseases: an observational cohort study (IMPACT), aims to determine whether patients with IMIDs on immunosuppressive medications mount an adequate immune response to COVID-19 vaccines. Researchers are recruiting a total of 600 participants: 525 people with IMIDs, some of whom are being treated with immunosuppressive treatment and some who are not, and 75 healthy controls. They are collecting blood samples before COVID-19 vaccination, and at four to five time points after vaccination. They are then using our established laboratory methods to test these blood samples for antibody responses as well as cellular immune response to determine whether immune response to vaccination is compromised. We are also determining the immune response against new variants of the SARS-CoV-2 virus.
The results of this study will determine whether IMID patients treated with immunosuppressive medications still generate a protective immune response to the original SARS-CoV-2 and new variants after COVID-19 vaccination. Researchers will then ensure that all stakeholders including patient groups, public health administrators and policy makers are informed, and they will make recommendations for appropriate vaccination schedules for these potentially vulnerable patients.
Results: Immune response after COVID-19 vaccination during maintenance therapy in immune-mediated inflammatory diseases: an observational cohort study (IMPACT)
Juthaporn Cowan
Juthaporn Cowan
Assistant Professor, Department of Medicine, University of Ottawa & Department of Biochemistry, Microbiology and Immunology, University of Ottawa
Physician, Division of Infectious Diseases, The Ottawa Hospital, General Campus
Associated Scientist, The Ottawa Hospital Research Institute
Contact info
visidstudy@toh.ca
Key words
Primary immunodeficiency
B-cell depleting therapy
Vaccine response
Vaccine safety
VISID study
Research interests
Vaccination in immunodeficient patients
Infections in non-HIV immunodeficiency
Immunotherapy
Cellular and molecular immunology
Publications
Poenaru, Sonia., Abdallah, Sara., Corrales-Medina, Vicente., Cowan, Juthaporn.*. (2021). COVID-19 and post-infectious myalgic encephalomyelitis/chronic fatigue syndrome: A narrative review. Therapeutic Advances in Infectious Disease. DOI: 10.1177/20499361211009385.
Abdallah, S., Voduc, N., Corrales-Medina, V., McGuinty, M., Pratt, A., Chopra, A., Law, A., Garuba, H., Thavorn, K., Reid, R., Lavoie, K., Crawley, A., Chirinos, J., Cowan, J.*. (2021). Symptoms, pulmonary function and functional capacity four months after COVID-19. Annals of the American Thoracic Society. DOI: 10.1513/AnnalsATS.202012-1489RL.
COVID-19 Vaccine Immunogenicity and Safety in Immunodeficient patients.
People with low immune systems were not included in the clinical trials for COVID-19 vaccines so it’s not known how they respond to the vaccines. Canada’s immunization guidelines recommend that doctors evaluate the risks and benefits of vaccination for patients with low immune systems on a case-by-case basis, but the lack of clinical data means there is no risk-benefit information to draw on. To address this issue, our study, called COVID-19 Vaccine Immunogenicity and Safety in Immunodeficient Patients, is looking at how well people with low immune systems respond to COVID-19 vaccines and how safe the vaccines are for them.
These researchers are based in six provinces and are following study participants who have inborn error of immunity or have a certain medication-induced immunodeficiency in a range of conditions such as multiple sclerosis, lymphoma, and rheumatoid arthritis. To test participants’ response to the vaccine, they are measuring their antibodies to the SARS-CoV-2 virus and evaluating how well the antibodies inhibit the virus from infecting them. They are also evaluating another part of the immune system by determining the number of T-cells that produce a protein in response to SARS-CoV-2. We are comparing participants’ antibody levels and T-cell response before and after vaccination to those of healthy individuals. To evaluate vaccine safety, researchers are monitoring any adverse events (side effects) that participants experience following vaccination.
The study has strong support from the Special Immunization Clinic (SIC) network, provincial public health units and patient organizations. The results will provide important data to help protect people with immune deficiencies against COVID-19 and determine which component of the immune system is essential in the COVID-19 vaccine response so that tailored vaccines can be developed in future.
Deepali Kumar
Deepali Kumar MD, MSc, FRCPC, FAST
Professor of Medicine, University of Toronto
Transplant Infectious Diseases Consultant, University Health Network
Director of Transplant Infectious Diseases, University Health Network
Key words
Vaccine
Immunology
Cell-mediated immunity
Emerging diseases
Serology
Research interests
Immune response to vaccines in transplant recipients
Immune response to viruses in transplant recipients
Epidemiology of emerging infectious diseases in transplantation
Donor-derived infections
Publications
Humoral and Cellular immune response and Safety of 2-dose SARS-CoV-2 mRNA-1273 (Moderna) vaccine in Solid Organ Transplant Recipients. Victoria G. Hall, Victor H. Ferreira, Matthew Ierullo, Terrance Ku, Tina Marinelli, Beata Majchrzak-Kita, Anila Yousuf, Vathany Kulasingam, Atul Humar, Deepali Kumar. American Journal of Transplantation (in press).
Paucisymptomatic COVID-19 in lung transplant recipient following two doses of mRNA-1273 (Moderna) vaccine. Marinelli T, Chaparro C, Humar A, Kumar D.J Heart Lung Transplant. 2021 Jun 23:S1053-2498(21)02358-5. doi: 10.1016/j.healun.2021.06.007. Online ahead of print.PMID: 34274181 No abstract available.
Prospective Clinical, Virologic, and Immunologic Assessment of COVID-19 in Transplant Recipients. Marinelli T, Ferreira VH, Ierullo M, Ku T, Lilly L, Kim SJ, Schiff J, Sidhu A, McDonald M, Hosseini-Moghaddam SM, Husain S, Rotstein C, Majchrzak-Kita B, Kulasingam V, Humar A, Kumar D.Transplantation. 2021 Jun 18. doi: 10.1097/TP.0000000000003860. Online ahead of print.PMID: 34149003
A call to routinely test lower respiratory tract samples for SARS-CoV-2 in lung donors. Kumar D, Humar A, Keshavjee S, Cypel M.Am J Transplant. 2021 Jul;21(7):2623-2624. doi: 10.1111/ajt.16576. Epub 2021 Apr 1.PMID: 33756058 Free PMC article. No abstract available.
Prospective observational study and serosurvey of SARS-CoV-2 infection in asymptomatic healthcare workers at a Canadian tertiary care center. Ferreira VH, Chruscinski A, Kulasingam V, Pugh TJ, Dus T, Wouters B, Oza A, Ierullo M, Ku T, Majchrzak-Kita B, Humar ST, Bahinskaya I, Pinzon N, Zhang J, Heisler LE, Krzyzanowski PM, Lam B, Lungu IM, Manase D, Pace KM, Mashouri P, Brudno M, Garrels M, Mazzulli T, Cybulsky M, Humar A, Kumar D.PLoS One. 2021 Feb 16;16(2):e0247258. doi: 10.1371/journal.pone.0247258. eCollection 2021.PMID: 33592074
COVID-19: A global transplant perspective on successfully navigating a pandemic. Kumar D, Manuel O, Natori Y, Egawa H, Grossi P, Han SH, Fernández-Ruiz M, Humar A.Am J Transplant. 2020 Jul;20(7):1773-1779. doi: 10.1111/ajt.15876. Epub 2020 Apr 12.PMID: 32202064
Prospective Evaluation of COVID-19 Vaccine in Transplant Recipients (PREVenT-COVID): A National Strategy
People who have undergone a solid organ transplant or a stem cell transplant are at greater risk for severe COVID-19 disease due to their life-long immunosuppression, a factor which may also reduce their immune response to COVID-19 vaccines. In Canada, we are well positioned to investigate the safety and effectiveness of vaccines in people who have had transplants because of well-established transplantation and vaccination networks for research and knowledge-sharing, and high-quality research and laboratory capabilities. This research group has extensive clinical trials experience in evaluating other vaccines, such as those for influenza and HPV, in transplant recipients and our national partner network provides results to public health decision makers, patients and their families.
Our study, called PRospective Evaluation of COVID-19 Vaccine in Transplant Recipients (PREVenT-COVID): A National Strategy, is following more than 600 transplant recipients from several high-volume transplant centres over a two-year period to test the safety and effectiveness of COVID-19 vaccines. We are taking blood samples at multiple time points to assess both short-term and long-term vaccine-induced immune responses: before vaccination, at three to four weeks after the first, second, third and possibly fourth dose, then at six months and one year after the last dose. We are also looking at data from other transplant patients who have already been infected with COVID-19 to compare their antibody response.
The study results will be communicated to transplant patients and their advocacy and support groups, research organizations and public health agencies to provide important and ongoing information on vaccine safety in transplant recipients.
Results: Prospective Evaluation od COVID-19 Vaccine in Transplant Recipients (PREVenT-COVID): A National Strategy
Matthew Oliver
Matthew Oliver
Associate Professor – University of Toronto
Staff Nephrologist – Sunnybrook Health Sciences Centre
Division Head of Nephrology – Sunnybrook Health Sciences Centre
Regional Medical Lead – Toronto Central – Ontario Renal Network, Ontario Health
Contact info
matthew.oliver@sunnybrook.ca
Key words
Chronic kidney disease
Dialysis
SARS-CoV-2
Covid-19
Vaccine
Research interests
Epidemiology of outcomes for individuals on dialysis therapy
Methods and complications of maintaining dialysis access
Optimizing home dialysis
Renal information systems
Prevention of kidney failure
Publications
Yau K, Abe KT, Naimark D, Oliver MJ, Perl J, Leis J, Bolotin S, Tran V, Mullin S, Shadowitz E, Garnham-Takaoka J, De Launay K, Takaoka A, Straus SE, McGreer AJ, Chan CT, Colwill K, Gingra AC, Hladunewich MA. Evaluation of the SARS-CoV-2 Antibody Response to the BNT162b2 Vaccine in Patients Undergoing Dialysis. JAMA Network. 2021 Jun 30. In Press.
Taji L, Thomas D, Oliver MJ, Ip J, Tang Y, Yeung A, Cooper R, House AA, McFarlane P, Blake PG. COVID-19 in patients undergoing long-term dialysis in Ontario. CMAJ. 2021 Feb 22;193(8):E278-E284
Oliver MJ, Crabtree JH. Prioritizing Peritoneal Catheter Placement during the COVID-19 Pandemic: A Perspective of the American Society of Nephrology COVID-19 Home Dialysis Subcommittee. Clin J Am Soc Nephrol. 2021 Mar 12
Perl J, Thomas D, Tang Y, Yeung A, Ip J, Oliver M, Blake P. COVID-19 Among Adults Receiving Home Versus In-Center Dialysis. Clin J Am Soc Nephrol. 2021 Jun 4
Blake PG, Hladunewich HA, Oliver MJ. Covid-19 Vaccine Imperatives in people on maintenance dialysis. Clin J Am Soc Nephrol. 2021 Jul 2.
Sniekers DC, Jung JK, Blake PG, Cooper R, Leis JA, Muller MP, Padure V, Holm P, Yeung A, Taji L, McFarlane P, Oliver MJ. Province-wide Prevalence Testing for SARS-CoV-2 of In-Centre Hemodialysis Patients and Staff in Ontario, Canada: A Cross-Sectional Study. Canadian Journal of Kidney Health and Disease. 2021 Jul 11 In Press
Michelle Hladunewich
Michelle Hladunewich
Professor – University of Toronto
Staff Nephrologist – Sunnybrook Health Sciences Centre
Chief of Medicine – Sunnybrook Health Sciences Centre
Medical Lead – Glomerulonephritis and Specialty Clinics – Ontario Renal Network, Ontario Health
Contact info
Michelle.hladunewich@sunnybrook.ca
Key words
Chronic kidney disease
Dialysis
SARS-CoV-2
Covid-19
Vaccine
Research interests
Outcomes for individuals with glomerulonephritis
Pregnancy outcomes for women with chronic kidney disease
Prevention of kidney failure
Publications
Yau K, Abe KT, Naimark D, Oliver MJ, Perl J, Leis J, Bolotin S, Tran V, Mullin S, Shadowitz E, Garnham-Takaoka J, De Launay K, Takaoka A, Straus SE, McGreer AJ, Chan CT, Colwill K, Gingras AC, Hladunewich MA. Evaluation of the SARS-CoV-2 Antibody Response to the BNT162b2 Vaccine in Patients Undergoing Dialysis. JAMA Network. 2021 Jun 30. In Press.
Blake PG, Hladunewich HA, Oliver MJ. Covid-19 Vaccine Imperatives in people on maintenance dialysis. Clin J Am Soc Nephrol. 2021 Jul 2.
Moran SM, Barbour S, Dipchand C, Garland JS, Hladunewich MA, Jauhal A, Kappel JE, Levin A, Pandeya S, Reich HN, Thanabalasingam S, Thomas D, Ma JC, White C. Management of patients with glomerulonephritis during the COVID-19 pandemic: Recommendations from the Canadian Society of Nephrology COVID-19 Raid Response Team. Can J Kidney Health Dis. Nov 2020
Determining the safety and effectiveness of COVID-19 vaccination in the chronic kidney disease population
Chronic kidney disease (CKD) affects more than 10 per cent of Canadians. CKD patients, especially those receiving dialysis, are highly susceptible to infections, and SARS-CoV-2 infections in this group have been more severe than in the general population leading to frequent hospitalizations and higher mortality rates. Often, people with CKD have a weaker response to traditional vaccines so they may remain vulnerable to COVID-19. This study, called Determining the safety and effectiveness of COVID-19 vaccine in the chronic kidney disease population, aims to determine if COVID-19 vaccines generate adequate immune response in this population and whether the vaccines prevent COVID-19 infection.
This study is following CKD patients in Ontario and British Columbia, provinces that have well-established renal (kidney) agencies that track SARS-CoV-2 infection and COVID-19 vaccination in people with CKD. Researchers are working with researchers at the University of Toronto and the University of British Columbia to measure the antibody response to COVID-19 vaccination in 2,500 CKD patients. CKD patients are followed up with serological testing at five time points during the year after the most recent vaccine dose received. This allows researchers to capture immunity before and after each vaccination and determine how long the immune response lasts over time. Researchers are also looking at whether COVID-19 vaccination prevents a SARS-CoV-2 infection and COVID-related hospitalizations and death at different time points after vaccination. They will also review vaccine safety by determining if CKD patients experience any side effects or serious adverse events after receiving the vaccines. Finally, a smaller group of patients has been enrolled in a trial aiming at studying whether heterologous vaccination for the third dose may result in greater vaccine-induced immune responses.
The study results will be shared with patients and healthcare providers within renal programs across Canada, and researchers will work with the Kidney Foundation of Canada, the Canadian Society of Nephrology, CanSolve CKD and public health organizations to increase the reach of the study results.
Results: Determining the safety and effectiveness of COVID-19 vaccination in the chronic kidney disease population
Mario Ostrowski
Mario Ostrowski
Professor of Medicine and Immunology
Infectious Diseases Clinician, St. Michael’s Hospital, Unity Health
Professor of Medicine, Infectious diseases consultant
Key words
HIV COVID-19 SARS-CoV-2
T cells
vaccines
Research interests
Immunoregulation
T cell biology
Vaccines
Antigen presentation
Publications
Law JC, Koh WH, Budylowski P, Lin J, Yue F, Abe KT, Rathod B, Girard M, Li Z, Rini JM, Mubareka S, McGeer A, Chan AK, Gingras AC, Watts TH, A Ostrowski M. Systematic examination of antigen-specific recall T cell responses to SARS-CoV-2 versus influenza virus reveals a distinct inflammatory profile. J Immunol. 2021 Jan 1;206(1):37-50. doi:10.4049/jimmunol.2001067. Epub 2020 Nov 18. PMID:33208459; PMCID: PMC7750861.
Isho B, Abe KT, Zuo M, Jamal AJ, Rathod B, Wang JH, Li Z, Chao G, Rojas OL, Bang YM, Pu A, Christie-Holmes N, Gervais C, Ceccarelli D, Samavarchi-Tehrani P, Guvenc F, Budylowski P, Li A, Paterson A, Yue FY, Marin LM, Caldwell L, Wrana JL, Colwill K, Sicheri F, Mubareka S, Gray-Owen SD, Drews SJ, Siqueira WL, Barrios-Rodiles M, Ostrowski M, Rini JM, Durocher Y, McGeer AJ, Gommerman JL, Gingras AC. Persistence of serum and saliva antibody responses to SARS-CoV-2 spike antigens in COVID-19 patients. Sci Immunol. 2020 Oct 8;5(52):eabe5511. doi: 10.1126/sciimmunol.abe5511. PMID: 33033173.
Abe KT, Li Z, Samson R, Samavarchi-Tehrani P, Valcourt EJ, Wood H, Budylowski P, Dupuis AP 2nd, Girardin RC, Rathod B, Wang JH, Barrios-Rodiles M, Colwill K, McGeer AJ, Mubareka S, Gommerman JL, Durocher Y, Ostrowski M, McDonough KA, Drebot MA, Drews SJ, Rini JM, Gingras AC. A simple protein-based surrogate neutralization assay for SARS-CoV-2. JCI Insight. 2020 Oct 2;5(19):e142362. doi: 10.1172/jci.insight.142362. PMID: 32870820; PMCID: PMC7566699.
Vaccines in a Time of Dual Pandemic: COVID-19 Vaccine in People with HIV
For people with HIV infection (PWH), the advent of combined anti-retroviral therapy (cART) meant remarkable improvements to their quality of life. PWH are required to take cART medication daily for life, and while cART can significantly improve immunity, some PWH do not have the same level of immunity against infection as people who don’t have HIV. What’s more, PWH aged 55 and older who are on cART have greater immunity problems because of the effects of both HIV and aging on their immune systems.
Some recent studies have shown that PWH can be more susceptible to COVID-19 infection and can experience more severe COVID-19 illness, so there is an urgent need to vaccinate this population. This study, called Vaccines in a Time of Dual Pandemic: COVID-19 Vaccine in People with HIV, is investigating whether PWH 55 years and older receiving COVID-19 vaccines develop levels of immunity comparable to people without HIV infection.
After their first vaccination at baseline, participants are followed for one year to assess the immune response induced by the first, second and third doses of vaccine. We are looking at whether PWH can produce significant antibodies to protect against the SARS-CoV-2 virus, and if they do not respond to COVID-19 vaccines in the same way as other groups, what are the reasons behind this. Researchers are also determining if their blood can neutralize variant viruses.
PWH have a reservoir of HIV in their body which persists throughout life which is why they take cART medication. Previous studies have shown that since vaccines stimulate the immune system, they can potentially make the HIV reservoir bigger. This study is looking at whether COVID-19 vaccines can affect the HIV reservoir.
The results of the research will determine if changes are required to how vaccines are administered for PWH.
