Comparison of antibody response to SARS-CoV-2 after two doses of inactivated virus and BNT162b2 mRNA vaccines in kidney transplant

Abstract

Background Antibody response against SARS-CoV-2 after mRNA or adenoviral vector based vaccines is weak in kidney transplant (KT) patients. However, few studies have focused on humoral response after inactivated virus-based vaccines in KT. Here, we compare antibody response following vaccination with inactivated virus (Coronavacࣨ) and BNT162b2 mRNA. Methods A national multicenter cross-sectional study was conducted. The study group was composed of patients from all KT centers in Uruguay, vaccinated between May 1st-May 31st (Coronavacࣨ n = 245 and BNT162b2 n = 39). Control group was constituted by 82 healthy individuals. Participants had no prior confirmed COVID-19 test. Blood samples were collected between 30 and 40 days after second dose. Serum specific IgG antibodies against Receptor Binding Domain (RBD) of SARS-CoV-2 Spike protein were determined using COVID-19 IgG QUANT ELISA Kit. Results Only 29% of KT recipients showed seroconversion [36.5% BNT162b2, 27.8% inactivated virus, p = 0.248] in comparison to 100% in healthy control with either vaccine. Antibody levels against RBD were higher with BNT162b mRNA than with inactivated virus [173 (73–554) and 29 (11–70) BAU/mL, p < 0.034] in KT and 10 times lower than healthy control [inactivated virus: 308 (209–335) and BNT162b2: 2638 (2608–3808) BAU/mL, p < 0.034]. In multivariate analysis, variables associated with negative humoral response were age, triple immunosuppression, eGFR and time post-KT. Conclusion Seroconversion was low in KT patients after vaccination with both platforms. Antibody levels against SARS-CoV-2 were lower with inactivated virus than BNT162b mRNA. These findings support the need of strategies to improve immunogenicity in KT recipients after two doses of either vaccine.

Humoral Response to mRNA-1273 SARS-CoV-2 Vaccine in Peritoneal Dialysis Patients: Is Boostering After Six Months Adequate?

“…In the current study, we confirmed that a lower Davies Comorbidity Score correlates to higher antibody levels. In accordance with recently published data on patients after kidney transplantation (17) and those with diabetes (18), our mixed model analysis for repeated measurement identified a higher GFR to be associated with higher antibody levels in PD patients. Impairment of kidney function as well as the presence of co-morbidities have been reported as factors altering the immune system and influencing immune responses to vaccines and pathogens (3,19).…”

Differences in clinical outcomes of COVID-19 among vaccinated and unvaccinated kidney transplant recipients

“…BNT162b2 and CoronaVac are well tolerated and protective against COVID-19 in healthy adults. However, in kidney transplant recipients, mRNA based BNT162b2 has been shown to induce a higher nucleocapsid antibody response and T cell response than the inactivated vaccine, CoronoVac [17] . Also, the antibody response persists longer in BNT162b2 and is more effective against the omicron variant than the CoronoVac in healthy population [18] .…”

Kinetics of the Neutralizing and Spike SARS-CoV-2 Antibodies following the Sinovac Inactivated Virus Vaccine Compared to the Pfizer mRNA Vaccine in Singapore

“…The lower antibody titers elicited by inactivated virus vaccines would be of even greater clinical concern for certain vulnerable groups of patients. For example, in immunosuppressed kidney transplant patients, the response to the different types of vaccine also showed a similar pattern, with 36.5%/27.8% of patients seroconverting post-mRNA/inactivated virus vaccination, with greater post-mRNA vaccination antibody levels (median 173 (mRNA) and 29 (inactivated virus) BAU/mL, p < 0.034) [ 24 ]. Similarly, in a study examining multiple sclerosis patients treated with disease modifying therapy, the inactivated vaccine only resulted in a seroconversion rate of 64.9%, much less than the 81.2% seroconversion rate of the mRNA vaccine [ 25 ].…”