Assessment of 4 Doses of SARS-CoV-2 Messenger RNA–Based Vaccine in Recipients of a Solid Organ Transplant

Abstract

This case series study assesses whether a fourth dose of a SARS-CoV-2 messenger RNA (mRNA)–based vaccine is associated with improved anti–SARS-CoV-2 antibody response in solid organ transplant recipients in France.

Inferior humoral and sustained cellular immunity against wild-type and omicron variant of concern in hemodialysis patients immunized with 3 SARS-CoV-2 vaccine doses compared with 4 doses

“…In line with the improved seroconversion rate in transplant patients 3 , 4 , 5 , our data demonstrate an improved omicron-specific humoral immunity following fourth mRNA vaccination dose as compared to three-dose vaccination regimen in hemodialysis patients. Even though adequate neutralization titers have been observed following third dose, the significant titer decline observed in follow up justifies the fourth dose in this vulnerable population subgroup.…”

A fourth dose of the mRNA-1273 SARS-CoV-2 vaccine improves serum neutralization against the Delta variant in kidney transplant recipients

“…This report did not provide data on the neutralizing activity – which has been shown to be highly predictive of immune protection against symptomatic SARS-CoV-2 infection. 8 In another cohort of 37 patients, Kamar et al 9 assessed antibody response, neutralizing activity, and T cell response; a slight improvement of humoral response was observed. In the work by Kamar et al, 9 86% of the study patients (32 out of 37) had no immune response after three doses.…”

“… 8 In another cohort of 37 patients, Kamar et al 9 assessed antibody response, neutralizing activity, and T cell response; a slight improvement of humoral response was observed. In the work by Kamar et al, 9 86% of the study patients (32 out of 37) had no immune response after three doses. Conversely, 87% of our study participants (58 out of 67) showed a weak antibody response after three doses.…”

Humoral and Cellular Immune Responses of Solid Organ Transplant Patients on Belatacept to Three Doses of mRNA-Based Anti-SARS-CoV-2 Vaccine

“…In a previously study in SOT recipients followed in our center, the seroconversion rate of the SOT recipients not treated with belatacept was 66.4% after three doses of the mRNA vaccine [ 6 ]. In addition, in healthy controls, antibody concentrations at 1 month after two doses of the BNT162b2 vaccine were greater than 140 BAU/mL (median, 1309 BAU/mL (range, 457–7605 BAU/mL)) and NAb titers were greater than 64 IU/mL (median 128 (range, 64–512 IU/mL)) [ 11 ]. The cellular responses of the belatacept-treated patients appeared to be lower than those of the 20 healthy controls.…”