Assessment of Antibody-Titer Changes after Second and Third Severe Acute Respiratory Syndrome Coronavirus 2 mRNA Vaccination in Japanese Post-Kidney-Transplant Patients

Abstract

Post-renal-transplant patients have a relatively low antibody-acquisition rate following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccination. In this study, antibody titers were measured 5–6 months and 3 weeks to 3 months after the second and third SARS-CoV-2 mRNA vaccinations, respectively. Post-renal-transplant patients visiting our hospital who had received three SARS-CoV-2 mRNA vaccine doses were included in the study. SARS-CoV-2 immunoglobulin G antibody titers were measured three times: between 3 weeks and 3 months after the second vaccination, 5–6 months after the second vaccination, and between 3 weeks and 3 months after the third vaccination. A total of 62 (40 men and 22 women) were included, 44 of whom (71.0%) were antibody positive after their third vaccination. On comparing the antibody-acquired and antibody-non-acquired groups, body mass index (BMI, odds ratio [OR]: 1.44, 95% confidence interval [CI]: 1.07–1.93, p < 0.05) and the estimated glomerular filtration rate (eGFR, OR: 1.14, 95% CI: 1.06–1.24, p < 0.01) were associated with antibody acquisition. Therefore, in Japanese post-kidney-transplant patients, increases in the antibody-acquisition rate and absolute antibody titer after the third vaccination were observed, with BMI and eGFR associated with the antibody-acquisition rate.

Changes in antibody titer after four and five doses of the SARS‐CoV‐2 vaccine in Japanese post‐kidney transplant patients

“…The antibody acquisition rate and antibody titer increased with each additional dose, indicating the effectiveness of the additional vaccination. Although we do not present data on neutralizing antibodies in this study, a correlation between anti‐spike antibodies and neutralizing antibodies was shown in a previous report [17]. In our study population, patients with symptoms of SARS‐CoV‐2 infection, such as fever and respiratory symptoms, were excluded, and the results exhibited a strong correlation between anti‐spike antibodies and neutralizing antibodies.…”

“…In univariate analysis, antibody titer was used as a binary variable and factors associated with antibody acquisition were analyzed by the Whitney U test. Factors associated with antibody acquisition were analyzed by multivariate logistic regression analysis with age, gender, BMI, and eGFR as independent variables [16,17]. Statistical significance was set as p < 0.05.…”

“…A previous study reported changes in antibody titer from the second to the third dose of the SARS‐CoV‐2 mRNA vaccine in post‐kidney transplant patients in Japan [16, 17]. The antibody acquisition rate was significantly lower in post‐kidney transplant patients compared with healthy subjects, but an increase in antibody acquisition rate was observed after the third vaccination.…”

Assessing antiviral treatment efficacy and risk factors for severe COVID-19 in kidney transplant recipients during the Omicron subvariant-dominant period: a retrospective study

“…Several previous reports have shown low rates of antibody acquisition and antibody production capacity from vaccination in KTRs [ 3 , 41 ]. However, Fujieda et al recently reported that three doses of the SARS-CoV-2 vaccine significantly increased antibody acquisition by 71% in KTRs, suggesting the importance of additional doses in KTRs [ 42 ]. The cohort of KTRs with COVID-19 in the current study had a high overall vaccination rate, with more than 90% of patients receiving 3 or more doses of the vaccine.…”