Kinetics of antibody response to influenza vaccination in renal transplant recipients

Abstract

Annual vaccination is routinely used in organ transplant recipients for immunization against seasonal influenza. However, detailed analysis of the kinetics of vaccine-induced immune responses in this population is lacking. In this study, we investigated the kinetics of vaccine strains-specific antibody responses to trivalent influenza vaccine in a group of renal transplant recipients and a control group. First, we found that the geometric mean hemagglutination inhibition titer against all 3 vaccine strains in the transplant cohort was significantly low when compared to control subjects. Next, whereas the control group sera showed significantly higher HA-specific IgG and isotype IgG1 antibodies at all four time points, a similar increase in the transplant group was delayed until day 28. Interestingly, within the transplant group, subjects receiving belatacept/MMF/prednisone-based regimen had significantly lower levels of total IgG and HA-specific IgG when compared to tacrolimus/MMF/prednisone-based regimen. Even though IgG-ASC response in both cohorts peaked at day 7 post-vaccination, the frequency of IgG-ASC was significantly low in the transplant group. Taken together, our studies show delayed kinetics and lower levels of influenza vaccine-specific antibody responses in renal transplant recipients and, more importantly, indicate the need to probe and improve current vaccination strategies in renal transplant recipients.

Influence of immunosuppression on seroconversion against SARS‐CoV‐2 in two kidney transplant recipients

“…Multiple other studies in the kidney transplant population support the negative association between MMF and seroconversion following different vaccines 15‐17 . Furthermore, when it does occur the magnitude of antibody response is decreased and peak antibody response is delayed in transplant recipients on MMF‐containing regimens compared to non‐immunosuppressed controls 18 . Based on these findings and our usual management of transplant recipients with severe viral infection, we have implemented routine temporary cessation of MMF in patients who test positive for SARS‐CoV‐2 by RT‐PCR.…”

Influenza‐specific IgG1+ memory B‐cell numbers increase upon booster vaccination in healthy adults but not in patients with predominantly antibody deficiency

“…Furthermore, the majority are CD27 + and this fraction was increased following booster vaccination. Previously, IgG1 was shown to be the predominant IgG subclass produced in serum in healthy controls post‐influenza vaccination 59,60 . IgG1 is important for complement fixation and viral neutralisation 48,61,62 .…”

“…Previously, IgG1 was shown to be the predominant IgG subclass produced in serum in healthy controls post-influenza vaccination. 59,60 IgG1 is important for complement fixation and viral neutralisation. 48,61,62 However, it is unknown whether a predominant IgG1 Bmem cell response is desirable for influenza vaccination and whether it provides the best protection.…”

Persistent viral shedding despite seroconversion in a kidney transplant recipient with severe extrapulmonary COVID-19

“…Indeed, IS can reduce the vaccine-specific antibody response in RT recipients after influenza vaccination. 14 Whether this is also true for SARS-CoV-2 infection is not known at this time.…”