End-stage renal disease patients experience uremia-driven immune compromise characterized by complex alterations of both innate and adaptive immunity, and results in higher susceptibility to infection and lower response to vaccination. This immune compromise, coupled with greater risk of exposure to infectious disease at hemodialysis (HD) centers, motivates an examination of immune response to the COVID-19 mRNA-based BTN162b2 vaccine. We performed gene expression profiling by RNA-seq across 6 time points to assess vaccine response in healthy controls and hemodialysis patients over time. Overall design: mRNA extracted from peripheral blood mononuclear cells of healthy controls and hemodialysis patients receiving the BTN162b2 vaccine were sequenced and compared. We assessed differences in gene expression across time points between and within the two groups.