Impaired Humoral Response to Third Dose of BNT162b2 mRNA COVID-19 Vaccine Despite Detectable Spike Protein–specific T cells in Lung Transplant Recipients

Havlin, Jan; Skotnicová, Aneta; Dvořáčková, Eliška; Hubáček, Pavel; Svorcova, Monika; Lašťovička, Jan; Šedivá, Anna; Kalina, Tomáš; Lischke, Robert

doi:10.1097/tp.0000000000004021

Cited by 26 publications

(26 citation statements)

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“…Indeed, the observed serologic response in lung transplant recipients after two doses of an mRNA-based SARS-CoV-2 vaccine is poor [ 1 ]. It is recommended to give a third vaccine dose to all solid organ transplant recipients [ 2 ], but there are few reports on the serologic response to a third vaccine dose in lung transplant recipients specifically [ [3] , [4] , [5] ]. We previously reported on the serologic response to two doses of an mRNA-based SARS-CoV-2 vaccine in 91 lung transplant recipients [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Serologic response to a third dose of an mRNA-based SARS-CoV-2 vaccine in lung transplant recipients

Hoffman

Meek

Rijkers

et al. 2022

Transplant Immunology

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Section: Introductionmentioning

confidence: 99%

Serologic response to a third dose of an mRNA-based SARS-CoV-2 vaccine in lung transplant recipients

Hoffman

Meek

Rijkers

et al. 2022

Transplant Immunology

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“…In addition, the duration of detectable immune responses was comparable to that in a healthy population ( 14 – 16 ). Therefore, the biological drugs used to treat the patients in this study are different from other immunomodulatory drugs, which have been shown to compromise the immunogenicity of the COVID-19 vaccine ( 51 – 53 ).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Durability of mRNA Vaccine-Induced SARS-CoV-2-Specific Humoral and Cellular Immunity in Severe Asthma Patients on Biological Therapy

et al. 2022

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Coronavirus disease 2019 (COVID-19) vaccines effectively elicit humoral and cellular immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthy populations. This immunity decreases several months after vaccination. However, the efficacy of vaccine-induced immunity and its durability in patients with severe asthma on biological therapy are unknown. In this study, we evaluated the effectiveness and durability of mRNA vaccine-induced SARS-CoV-2-specific humoral and cellular immunity in severe asthma patients on biological therapy. The study included 34 patients with severe asthma treated with anti-IgE (omalizumab, n=17), anti-IL5 (mepolizumab, n=13; reslizumab, n=3), or anti-IL5R (benralizumab, n=1) biological therapy. All patients were vaccinated with two doses of the BNT162b2 mRNA vaccine with a 6-week interval between the doses. We found that this COVID-19 vaccination regimen elicited SARS-CoV-2-specific humoral and cellular immunity, which had significantly declined 6 months after receipt of the second dose of the vaccine. The type of biological treatment did not affect vaccine-elicited immunity. However, patient age negatively impacted the vaccine-induced humoral response. On the other hand, no such age-related impact on vaccine-elicited cellular immunity was observed. Our findings show that treatment of patients with severe asthma with biological therapy does not compromise the effectiveness or durability of COVID-19 vaccine-induced immunity.

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“…In a randomized trial, a third dose of mRNA vaccine in 120 SOTRs had substantially higher immunogenicity than a placebo [ 14 ]. In contrast, in a small study population, Havlin et al showed impaired humoral responses to the third dose (13%), despite detectable specific T cells responses [ 24 ]. In the study published by Hoffman et al, a humoral response after the third dose was detected in 62% LuTRs [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Immune Response after mRNA COVID-19 Vaccination in Lung Transplant Recipients: A 6-Month Follow-Up

et al. 2022

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Background and objective: This prospective cohort study analyzed the immune response to COVID-19 mRNA vaccines in lung transplant recipients (LuTRs) compared to healthy controls (HCs) at a 6-month follow-up. Methods: After the first two doses of either BNT162b2 or mRNA-1273, SARS-CoV-2 antibodies were measured in LuTRs (n = 57) and sex- and age-matched HCs (n = 57). Antibody kinetics during a 6-month follow-up and the effect of a third vaccine dose were evaluated. Humoral responses were assessed using the Elecsys® Anti-SARS-CoV-2 S immunoassay. In 16 LuTRs, SARS-CoV-2-specific T cell responses were quantified using IFN-γ ELISpot assays. Results: Seroconversion rates were 94% and 100% after the first and second vaccine dose, respectively, in HCs, while only 19% and 56% of LuTRs developed antibodies. Furthermore, 22 of 24 LuTRs who received the third vaccine dose showed seroconversion (five of seven primary non-responders and 17 of 17 primary responders). A T cell response against SARS-CoV-2-spike S1 and/or S2 was detected in 100% (16/16) of HCs and 50% (8/16) of LuTRs. Conclusions: The data suggest that LuTRs have reduced humoral and cellular immune responses after two doses of COVID-19 mRNA vaccination when compared to HCs. A third dose may be of substantial benefit.

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Impaired Humoral Response to Third Dose of BNT162b2 mRNA COVID-19 Vaccine Despite Detectable Spike Protein–specific T cells in Lung Transplant Recipients

Abstract: J.H. and T.K. had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis, and they participated in drafting of the article, statistical analysis, and data visualization.

Cited by 26 publications

References 5 publications

Serologic response to a third dose of an mRNA-based SARS-CoV-2 vaccine in lung transplant recipients

Serologic response to a third dose of an mRNA-based SARS-CoV-2 vaccine in lung transplant recipients

Effectiveness and Durability of mRNA Vaccine-Induced SARS-CoV-2-Specific Humoral and Cellular Immunity in Severe Asthma Patients on Biological Therapy

Immune Response after mRNA COVID-19 Vaccination in Lung Transplant Recipients: A 6-Month Follow-Up

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