Immunogenicity of COVID-19 vaccines in solid organ transplant recipients: a systematic review and meta-analysis

Chen, Xinpei; Luo, De; Mei, Bingjie; Du, Juan; Liu, Xiangdong; Xie, Hui; Liu, Lin; Su, Song; Mai, Gang

doi:10.1016/j.cmi.2022.12.004

Cited by 33 publications

(38 citation statements)

References 107 publications

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“…Limitations of this study include a low number of volunteers, that some volunteers failed to respond at follow-up, and the lack of data on B and T cell responses, which may provide antibodyindependent protection. Recently, a meta-analysis showed that booster vaccination enhances the immunogenicity of COVID-19 vaccines in SOTRs, however, a significant share of the recipients still has not built a detectable humoral immune response after the 3rd dose (21). Our results are also in line with studies in other groups at high risk of developing COVID-19 such as haemodialysis (HD) patients.…”

Section: Discussionsupporting

confidence: 87%

“…Recently, a meta-analysis showed that booster vaccination enhances the immunogenicity of COVID-19 vaccines in SOTRs, however, a significant share of the recipients still has not built a detectable humoral immune response after the 3rd dose ( 21 ). Our results are also in line with studies in other groups at high risk of developing COVID-19 such as haemodialysis (HD) patients.…”

Section: Discussionmentioning

confidence: 99%

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Impact of homologous and heterologous boosters in neutralizing antibodies titers against SARS-CoV-2 Omicron in solid-organ transplant recipients

et al. 2023

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IntroductionBooster doses of SARS-CoV-2 vaccines improve seroconversion rates in solid organ transplant recipients (SOTRs) but the impact of homologous and heterologous booster doses in neutralizing antibody (NAb) titers and their ability to interfere with the variant of concern Omicron are not well studied.MethodsWe designed a prospective, open-label, observational clinical cohort study. 45 participants received two doses of BNT162b2 or CoronaVac (21-day or 28-day intervals, respectively) followed by a first and second booster with BNT162b2 (5-month apart each) and we analyzed the neutralizing antibody titers against SARSCoV-2 D614G (B.1 lineage) and Omicron (BA.1 lineage).ResultsOur results show that SOTRs receiving an initial two-dose scheme of CoronaVac or BNT162b2 generate lower NAbs titers against the ancestral variant of SARS-CoV-2 when compared with healthy controls. Although these NAb titers were further decreased against the SARS-CoV-2 Omicron, a single BNT162b2 booster in both groups was sufficient to increase NAb titers against the variant of concern. More importantly, this effect was only observed in those participants responding to the first two shots but not in those not responding to the initial vaccination scheme.DiscussionThe data provided here demonstrate the importance of monitoring antibody responses in immunocompromised subjects when planning booster vaccination programs in this risk group.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Impact of homologous and heterologous boosters in neutralizing antibodies titers against SARS-CoV-2 Omicron in solid-organ transplant recipients

et al. 2023

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“…35 A recent meta-analysis confirmed that the seropositivity rate significantly increases upon booster uptake, although the figure remains below that of nontransplant controls. 10 We explored the clinical determinants of the magnitude of postbooster cell-mediated responses. Previous SOT and Caucasian ethnicity were associated with lower numbers of IFN-γ-producing SFUs.…”

Section: Discussionmentioning

confidence: 99%

“…3-8 This progress has occurred despite the lower immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in SOT recipients in comparison with the nonimmunocompromised population. 9,10…”

mentioning

confidence: 99%

“…[3][4][5][6][7][8] This progress has occurred despite the lower immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in SOT recipients in comparison with the nonimmunocompromised population. 9,10 The emergence in November 2021 of the Omicron VoC (Pango lineage B.1.1.529) represented a turning point in the pandemic. 11 With >15 mutations within the spike receptorbinding domain (RBD), this variant exhibits increased transmissibility and capacity for immune evasion.…”

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confidence: 99%

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Cell-mediated and Neutralizing Antibody Responses to the SARS-CoV-2 Omicron BA.4/BA.5–adapted Bivalent Vaccine Booster in Kidney and Liver Transplant Recipients

Fernández-Ruiz,

Almendro-Vázquez,

Redondo

et al. 2023

Transplantation Direct

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Background. The immunogenicity elicited by the Omicron BA.4/BA.5–adapted bivalent booster vaccine after solid organ transplantation (SOT) has not been characterized. Methods. We assessed cell-mediated and neutralizing IgG antibody responses against the BA.4/BA.5 spike receptor-binding domain at baseline and 2 wk after the administration of an mRNA-based bivalent (ancestral strain and BA.4/BA.5 subvariants) vaccine among 30 SOT recipients who had received ≥3 monovalent vaccine doses. Previous coronavirus disease 2019 history was present in 46.7% of them. We also recruited a control group of 19 nontransplant healthy individuals. Cell-mediated immunity was measured by fluorescent ELISpot assay for interferon (IFN)-γ secretion, whereas the neutralizing IgG antibody response against the BA.4/BA.5 spike receptor-binding domain was quantified with a competitive ELISA. Results. The median number of BA.4/BA.5 spike–specific IFN-γ–producing spot-forming units (SFUs) increased from baseline to 2 wk postbooster (83.8 versus 133.0 SFUs/106 peripheral blood mononuclear cells; P = 0.0017). Seropositivity rate also increased (46.7%–83.3%; P = 0.001), as well as serum neutralizing activity (4.2%–78.3%; P < 0.0001). Patients with no prior coronavirus disease 2019 history experienced higher improvements in cell-mediated and neutralizing responses after booster vaccination. There was no correlation between BA.4/BA.5 spike–specific IFN-γ–producing SFUs and neutralizing activity. Nontransplant controls showed more robust postbooster cell-mediated immunity than SOT recipients (591.1 versus 133.0 IFN-γ–producing SFUs/106 peripheral blood mononuclear cells; P < 0.0001), although no differences were observed for antibody responses in terms of postbooster seropositivity rates or neutralizing activity. Conclusions. Booster with the BA.4/BA.5–adapted bivalent vaccine generated strong subvariant-specific responses among SOT recipients. Booster-induced cell-mediated immunity, however, remained lower than in immunocompetent individuals.

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Seroconversion after SARS‐CoV‐2 vaccination is protective against severe COVID‐19 disease in heart transplant recipients

Kugler,

Vári,

Veres

et al. 2023

Immunity Inflam & Disease

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BackgroundHeart transplant (HTX) recipients are prone to develop complications after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Vaccination is often ineffective due to weaker immunogenicity. In this high‐volume single‐center study, we aimed to determine factors influencing seroconversion after vaccination and predictors of severe SARS‐CoV‐2 infection.MethodsTwo hundred twenty‐nine HTX recipients were enrolled. Type of the first two vaccine doses included messenger RNA (mRNA), vector, and inactivated vaccines. We carried out analyses on seroconversion after the second and third doses of vaccination and on severity of infection. Antispike protein SARS‐CoV‐2 immunoglobulin G (IgG) was measured after the second and third vaccines and serostatus was defined. Effect of the first two vaccine doses was studied on patients who did not suffer SARS‐CoV‐2 infection before antibody measurement (n = 175). The effectivity of the third vaccine was evaluated among seronegative recipients after the second vaccine (n = 53). Predictors for severe infection defined as pneumonia, hospitalization or death were assessed in all patients who contracted SARS‐CoV‐2 infection (n = 92).Results62% of the recipients became seropositive after the second vaccination. Longer time between HTX and vaccination (odds ratio [OR]: 2.35) and mRNA vaccine (OR: 4.83) were predictors of seroconversion. 58% of the nonresponsive patients became seropositive after receiving the third vaccine. Male sex increased the chance of IgG production after the third dose (OR: 5.65). Clinical course of SARS‐CoV‐2 infection was severe in 32%. Of all parameters assessed, only seropositivity before infection was proven to have a protective effect against severe infection (OR: 0.11).ConclusionsWe found that longer time since HTX, mRNA vaccine type, and male sex promoted seroconversion after SARS‐CoV‐2 vaccination in HTX recipients. Seropositivity—but not the number of vaccine doses—seemed to be protective against severe SARS‐CoV‐2 infection. Screening of HTX patients for anti‐SARS‐COV‐2 antibodies may help to identify patients at risk for severe infection.

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Immunogenicity of COVID-19 vaccines in solid organ transplant recipients: a systematic review and meta-analysis

Cited by 33 publications

References 107 publications

Impact of homologous and heterologous boosters in neutralizing antibodies titers against SARS-CoV-2 Omicron in solid-organ transplant recipients

Impact of homologous and heterologous boosters in neutralizing antibodies titers against SARS-CoV-2 Omicron in solid-organ transplant recipients

Cell-mediated and Neutralizing Antibody Responses to the SARS-CoV-2 Omicron BA.4/BA.5–adapted Bivalent Vaccine Booster in Kidney and Liver Transplant Recipients

Seroconversion after SARS‐CoV‐2 vaccination is protective against severe COVID‐19 disease in heart transplant recipients

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