Antibody response to the messenger RNA‐1273 vaccine (Moderna) in liver transplant recipients

Abstract

Different reports have shown the clinical and serologic response to the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) messenger RNA (mRNA) vaccines in preventing coronavirus disease 2019 (COVID‐19) in the general population, but few studies have examined these responses in transplant recipients. We assessed the vaccine immunogenicity of two doses (100 μg) of the mRNA‐1273 vaccine (Moderna) administered with a 28‐day interval in liver transplant recipients (LTRs) at follow‐up at the Marques de Valdecilla University Hospital. LTRs without a history of COVID‐19 infection were tested for SARS‐CoV‐2 immunoglobulin G (IgG) antibodies directed against the spike protein (S) a median of 43 days after receiving the second Moderna vaccine dose. Clinical data, including immunosuppressive regimen and routine laboratory data, were obtained from the medical record of each patient up to 3 months before the date of the first vaccination. Factors associated with serologic response were evaluated through logistic regression. In total, 129 LTRs who had anti‐S results were included. Most patients were men (n = 99; 76.7%) with a median age of 63 years (interquartile range, 56–68). Alcohol (43.4%) and chronic hepatitis C (18.6%) were the most frequent causes of liver transplantation. A positive anti‐S IgG response was observed in 113 LTRs (87.6%; 95% confidence interval [CI], 80.8–92.2). A strong inverse relationship between mycophenolate mofetil use and serologic response was found (odds ratio, 0.07; 95% CI, 0.02–0.26; p = 0.001). Conclusion: Most LTRs develop an immunological response to the Moderna SARS‐CoV‐2 mRNA‐based vaccine. An immunosuppressive regimen that includes mycophenolate predicts a weak serologic response.

Humoral and Cellular Immune Response After Third and Fourth SARS-CoV-2 mRNA Vaccination in Liver Transplant Recipients

“…This is in line with our previous results in LTRs after 2 doses of SARS-CoV-2 vaccines 3 and with those reported for other patient cohorts receiving immunosuppression. 4,[17][18][19] Moreover, a low eGFR was also demonstrated to be a negative predictor for response to a third SARS-CoV-2 vaccination. 20 In contrast to previous studies after 2 vaccinations, we could not detect a significantly lower median antibody level in patients on more than 1 immunosuppressive agent.…”

Heterologous adenovirus‐vector/messenger RNA regimen is associated with improved severe acute respiratory syndrome coronavirus 2 humoral response in liver transplant recipients

“…The most relevant factors influencing a negative humoral response in our study are consistent with previous and include the use of MMF and increased BMI. [8][9][10][20][21][22] The effectiveness of the Covid-19 vaccine depends on multiple factors related to patients, vaccine types, and immunosuppression characteristics. We constructed a nomogram capable of predicting the probability of developing antibody response that could be of relevance in clinical practice.…”

Antibody response to the messenger RNA corona virus disease 2019 vaccine in liver transplant recipients

“…Asymptomatic infection is not rare, [ 2 ] and it must be ruled out in any investigation of the novel COVID‐19 vaccine's efficacy. The immunologic response reported in the current investigation by Cuadrado et al [ 1 ] could be influenced by asymptomatic infection before and after immunization.…”

“…We would like to share ideas on the article “Antibody response to the messenger RNA‐1273 vaccine (Moderna) in liver transplant recipients.” [ 1 ] Most liver transplant recipients generate an immune response to the Moderna severe acute respiratory syndrome coronavirus 2 messenger RNA‐based vaccine, and a limited serologic response is predicted by an immunosuppressive regimen that includes mycophenolate. [ 1 ] We agree that the immunologic response to the corona virus disease 2019 (COVID‐19) vaccine may differ from that of a healthy person. Immunosuppressive medication may have an impact on vaccination immunologic response.…”