Occurrence of severe COVID-19 in vaccinated transplant patients

Predictive factors of response to 3rd dose of COVID-19 mRNA vaccine in kidney transplant recipients

“…However, after the "standard" 2 doses of mRNA vaccine only few KTRs develop appropriate levels of anti-receptor binding domain of spike protein (RBD) IgG [6][7][8] , which are responsible for the neutralization of the virus and the protection against COVID-19 9 . Accordingly, we and others have reported cases of vaccinated KTRs with (sometime severe forms of) COVID-19 10,11 .…”

The Importance of RNA-Based Vaccines in the Fight against COVID-19: An Overview

“…Thus, Broseta et al [159] analyzed the evolution of IgG antibodies after the first dose of mRNA-1273 in 78 dialysis-dependent chronic kidney disease patients, showing that there was an increase in patients with a detectable immune response as the weeks progressed (8 weeks of evaluation), indicating that mRNA-1273 is also likely effective in this group. It was noteworthy, however, that relative to the general population, patients who received a kidney transplant had a lower response even after administration of the two doses of mRNA-1273, with this likely being associated with the use of high doses of immunosuppressants [160,161]. A single dose of mRNA-1273 was found to be more likely to induce the antibody response than BNT162b2 in solid-organ transplant recipients [162].…”

COVID-19 vaccination in kidney transplant recipients

“…Although in the general population both BNT162b2 and mRNA-1273 vaccines induce robust titres of anti-spike IgGs that confer >94% protection against severe COVID-19, many independent studies (Supplementary Table 1 ) have reported that only 4–48% of kidney transplant recipients have detectable anti-spike IgGs after receiving two vaccine doses. Consequently, severe cases of COVID-19 still occur in vaccinated transplant recipients 6 , which demonstrates that they are insufficiently protected by the current ‘standard’ COVID-19 vaccination approach. Kidney transplant recipients who have not been previously infected with SARS-CoV-2 are more likely to generate anti-spike IgGs if vaccination is performed late after transplantation (probably owing to lower levels of immunosuppression), if they have a high glomerular filtration rate and if circulating anti-spike IgGs are detectable after the first dose of vaccine.…”