Fourth BNT162b2 vaccination neutralization of omicron infection after heart transplantation

Peled, Yael; Afek, Arnon; Nemet, Ital; Rahav, Galia; Raanani, Ehud; Patel, J.; Mandelboim, Michal

doi:10.1016/j.healun.2022.04.014

Cited by 12 publications

(31 citation statements)

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“…Our findings are in line with two recent studies. They reported, 3 weeks after vaccination, that additional third and fourth boosters of BNT162b2 vaccine improved the magnitude of IgG anti-RBD SARS-CoV-2 antibody response in seropositive HT recipients and the proportion of IgG responsive patients increase to 57 and 80%, respectively, compared to the range achieved after the two primary doses (19,20,32). Moreover, in our study, a large proportion of patients, more than eighty percent, with a high antibody response had a positive T-cell response.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, we reported a T cell response in 40.6% of HT patients, and nearly half of the HT patients who had received a third dose of the vaccine had a positive cellular response at a time-lapse of 3–5 months after the last vaccination. In previous studies, T cell response in HT subjects was measured only shortly after vaccination (2–3 weeks) ( 19 – 21 ). It was shown that most HT patients did not exhibit T-cell response, after the first and second doses ( 21 ) but the proportion of T-cell response was found to increase to 50–75% few weeks after the third dose and the fourth dose in a small group of patients ( 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, T cell response in HT subjects was measured only shortly after vaccination (2–3 weeks) ( 19 – 21 ). It was shown that most HT patients did not exhibit T-cell response, after the first and second doses ( 21 ) but the proportion of T-cell response was found to increase to 50–75% few weeks after the third dose and the fourth dose in a small group of patients ( 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…It is recognized that immunosuppressed patients such as transplant recipients tend to have a blunted immune response to vaccines. In previous studies, T cell response was measured 2-3 weeks after vaccination in small groups of HT subjects, the proportion of positive T-cell responders seems to increase with the number of doses (19)(20)(21). A protective virus neutralization titer level is not yet established and the level of efficient T-cell response to induce protection after vaccination is unknown.…”

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confidence: 99%

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Humoral and cellular immune response after severe acute respiratory syndrome coronavirus 2 messenger ribonucleic acid vaccination in heart transplant recipients: An observational study in France

Casenaz¹,

Grosjean²,

Aho-Glélé³

et al. 2022

Front. Med.

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IntroductionHeart transplant (HT) recipients have a high risk of developing severe COVID-19. Immunoglobulin G antibodies are considered to provide protective immunity and T-cell activity is thought to confer protection from severe disease. However, data on T-cell response to mRNA vaccination in a context of HT remains limited.MethodsIn 96 HT patients, a IFN-γ release assay and an anti-Spike antibody test were used to evaluate the ability of SARS-CoV-2 mRNA vaccines to generate cellular and humoral immune response. Blood samples were collected few weeks to 7 months after vaccination. Multiple fractional polynomial and LASSO regression models were used to define predictors of T-cell response.ResultsThree to five months after vaccination, three doses of vaccine induced a positive SARS-CoV-2 T-cell response in 47% of recipients and a positive humoral response in 83% of recipients, 11.1% of patients remained negative for both T and B cell responses. Three doses were necessary to reach high IgG response levels (>590 BAU/mL), which were obtained in a third of patients. Immunity was greatly amplified in the group who had three vaccine doses plus COVID-19 infection.ConclusionOur study revealed that T and B immunity decreases over time, leading us to suggest the interest of a booster vaccination at 5 months after the third dose. Moreover, a close follow-up of immune response following vaccination is needed to ensure ongoing immune protection. We also found that significant predictors of higher cellular response were infection and active smoking, regardless of immunosuppressive treatment with mycophenolate mofetil (MMF).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Humoral and cellular immune response after severe acute respiratory syndrome coronavirus 2 messenger ribonucleic acid vaccination in heart transplant recipients: An observational study in France

Casenaz¹,

Grosjean²,

Aho-Glélé³

et al. 2022

Front. Med.

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“…Data on the effectiveness of the fourth vaccine dose among SOT patients are limited. Peled et al reported an improved immune response among heart transplant (HT) recipients after the fourth BNT162b2 vaccine dose (positive immune response improved from 61.4% to 80.7% before and after the fourth dose, respectively) [15]. The fourth dose also improved the immune response among kidney transplant (KT) recipients.…”

Section: Introductionmentioning

confidence: 99%

High Immune Response Rate to the Fourth Boost of the BNT162b2 Vaccine against the Omicron Variants of Concern among Liver Transplant Recipients

Davidov

Indenbaum

Atari

et al. 2022

Viruses

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The immune response of liver transplant (LT) recipients to a third dose of the BNT162b2 mRNA vaccine significantly waned after four months. We aimed to evaluate the immune response and breakthrough infection rates of a fourth dose against the Omicron variants among LT recipients. LT recipients who had no past or active SARS-CoV-2 infection and received three doses of the BNT162b2mRNA vaccine were included. Of the 73 LT recipients, 50 (68.5%) received a fourth dose. The fourth dose was associated with a significantly higher positive immune response than the third dose. Receptor-binding domain (RBD) IgG and Omicron BA.1 and BA.2 neutralizing antibodies were determined at a median of 132 and 29 days after the third and fourth vaccines. They were 345 binding antibody units per milliliter (BAU/mL) vs. 2118 BAU/mL (p < 0.0001), 10 vs. 87 (p < 0.0001), and 15 vs. 149 (p = 0.001), respectively. Breakthrough infections were documented among nine (18%) LT recipients after the fourth dose and among seven (30.4%) patients following the third dose (p = 0.2); 93.5% of breakthrough infections were mild. The infection rate after the fourth dose was higher among diabetic vs. nondiabetic recipients (33.3% vs. 6.9%, respectively; p = 0.02). Further studies are needed to evaluate additional factors influencing the breakthrough infection rate among LT recipients.

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Immunogenicity, clinical efficacy and safety of additional second COVID‐19 booster vaccines against Omicron and its subvariants: A systematic review

Chenchula,

Chandra,

Adusumilli

et al. 2024

Reviews in Medical Virology

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The Omicron variant of severe acute respiratory syndrome coronavirus 2 is a new variant of concern (VOC) and an emerging subvariant that exhibits heightened infectivity, transmissibility, and immune evasion, escalating the incidence of moderate to severe coronavirus disease 2019 (COVID‐19). It resists monoclonal antibodies and diminishes vaccine efficacy. Notably, new sublineages have outpaced earlier predominant sublineages. Although the primary vaccination series and initial boosters were robust against previous VOCs, their efficacy waned against Omicron and its subvariants. In this systematic review, we assessed real‐world evidence on the immunogenicity, clinical efficacy, and safety of a second booster or fourth COVID‐19 vaccine dose against the Omicron VOC and its subvariants. A comprehensive literature search was conducted in Medline/PubMed, Google Scholar, bioRxiv, and medRxiv, and relevant studies published between 2022 and 30 May 2023 were reviewed. We found a total of 40 relevant articles focusing on a second booster dose for COVID‐19, including clinical trials and observational studies, involving 3,972,856 patients. The results consistently revealed that an additional second booster dose restored and prolonged waning immunity, activating both humoral and cellular responses against Omicron and its subvariants. A second booster treatment correlated with enduring protection against COVID‐19, notably preventing substantial symptomatic disease and mortality associated with severe Omicron infection. Both monovalent messenger RNA (mRNA) and nonmRNA vaccines demonstrated similar efficacy and safety, with bivalent mRNA vaccines exhibiting broader protection against emerging subvariants of Omicron. The safety profiles of second booster were favourable with only mild systemic and local symptoms reported in some recipients. In conclusion, this systematic review underscores the additional COVID‐19 vaccine boosters, particularly with bivalent or multivalent mRNA vaccines, for countering the highly infectious emerging subvariants of Omicron.

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Fourth BNT162b2 vaccination neutralization of omicron infection after heart transplantation

Cited by 12 publications

References 10 publications

Humoral and cellular immune response after severe acute respiratory syndrome coronavirus 2 messenger ribonucleic acid vaccination in heart transplant recipients: An observational study in France

Humoral and cellular immune response after severe acute respiratory syndrome coronavirus 2 messenger ribonucleic acid vaccination in heart transplant recipients: An observational study in France

High Immune Response Rate to the Fourth Boost of the BNT162b2 Vaccine against the Omicron Variants of Concern among Liver Transplant Recipients

Immunogenicity, clinical efficacy and safety of additional second COVID‐19 booster vaccines against Omicron and its subvariants: A systematic review

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