SARS-CoV-2 Messenger RNA Vaccine Immunogenicity in Solid Organ Transplant Recipients With Prior COVID-19

Boyarsky, Brian J.; Barbur, Iulia; Chiang, Teresa Po‐Yu; Ou, Michael T.; Greenberg, Ross S.; Teles, Aura T.; Krach, Michelle; López, Julia I; Garonzik-Wang, Jacqueline M; Avery, Robin K.; Massie, Allan B.; Segev, Dorry L.; Werbel, William A

doi:10.1097/tp.0000000000003900

Cited by 21 publications

(20 citation statements)

References 5 publications

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“…Thus, as previously observed in healthcare workers and other transplanted patient cohorts [35,36], SARS-CoV-2 NT Abs level against delta variant was observed in SARS-CoV-2 recovered subjects but not in naïve subjects, suggesting that the hybrid immunization might also improve the overall response against the delta variant that is now widely spread in our country. On the other hand, SARS-CoV-2 T-cell response against delta variant was similar to that observed against the reference strain, not only for SARS-CoV-2 recovered but also for SARS-CoV-2 naïve SOTRs, suggesting that conserved epitopes might stimulate a T-cell response against different strains.…”

Section: Discussionsupporting

confidence: 81%

Immune Response to BNT162b2 in Solid Organ Transplant Recipients: Negative Impact of Mycophenolate and High Responsiveness of SARS-CoV-2 Recovered Subjects against Delta Variant

et al. 2021

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The immunogenicity of severe acute respiratory syndrome 2 virus (SARS-CoV-2) vaccines in immunocompromised patients remains to be further explored. Here, we evaluated the immunogenicity elicited by complete vaccination with BNT162b2 vaccine in solid organ transplant recipients (SOTRs). A cohort of 110 SOTRs from Northern Italy were vaccinated with two doses of BNT162b2 mRNA vaccine and prospectively monitored at baseline and after 42 days. Both SARS-CoV-2 naïve and recovered subjects were included. Humoral response elicited by vaccination, including SARS-CoV-2 neutralizing antibodies (SARS-CoV-2 NT Abs), was evaluated; additionally, ex-vivo ELISpot assay was performed for the quantification of Spike-specific T-cell response. Results were compared with those obtained in a cohort of healthy subjects. In a subset of patients, humoral and T-cell responses against delta variant were also evaluated. Less than 20% of transplanted subjects developed a positive humoral and cell-mediated response after complete vaccination schedule. Overall, median levels of immune response elicited by vaccination were significantly lower with respect to controls in SARS-CoV-2 naïve transplant, but not in SARS-CoV-2 recovered transplanted patients. Additionally, a significant impairment of both humoral and cell-mediated response was observed in mycophenolate-treated patients. Positive delta-SARS-CoV-2 NT Abs levels were detected in almost all the SARS-CoV-2 recovered subjects but not in previously uninfected patients. Our study supports previous observations of a low level of seroconversion after vaccination in transplanted patients.

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Section: Discussionsupporting

confidence: 81%

Immune Response to BNT162b2 in Solid Organ Transplant Recipients: Negative Impact of Mycophenolate and High Responsiveness of SARS-CoV-2 Recovered Subjects against Delta Variant

et al. 2021

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“…This showed that excellent infection-neutralizing capacity against all variants of concern, including omicron, developed after either two vaccinations in convalescents or a third vaccination in twice-vaccinated, COVID-19-naive individuals [ 308 ]. Similar findings were observed in a SOT cohort, showing higher antibody responses in previously infected versus naïve individuals after their first vaccination [ 309 ]. A small study comparing neutralizing antibody responses, including those against the variant omicron, showed that even triple-vaccinated kidney and heart transplant recipients had lower neutralizing antibody titers compared to previously infected and twice-vaccinated individuals [ 310 ].…”

Section: Prevention Of Sars-cov-2 Infection and Covid-19supporting

confidence: 85%

Impact of COVID-19 on the liver and on the care of patients with chronic liver disease, hepatobiliary cancer, and liver transplantation: An updated EASL position paper

Marjot

Eberhardt

Böettler

et al. 2022

Journal of Hepatology

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“… 19 The study also showed that two injections, 21 days apart, provided more protection than one, and that the immune response to the vaccines was influenced by changes in the immune system related to age. 20 Implementation of a third injection in immunocompromised individuals and older individuals has been adopted by several health authorities, including in Israel, 21 22 23 with observed real world data in our population.…”

Section: Discussionmentioning

confidence: 84%

Elapsed time since BNT162b2 vaccine and risk of SARS-CoV-2 infection: test negative design study

Israel

Merzon

Schäffer

et al. 2021

BMJ

121

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Objectives To determine whether time elapsed since the second injection of the Pfizer-BioNTech BNT162b2 mRNA vaccine was significantly associated with the risk of covid-19 infection after vaccination in people who received two vaccine injections. Design Test negative design study. Setting Electronic health records of a large state mandated healthcare organisation, Israel. Participants Adults aged ≥18 years who had received a reverse transcription polymerase chain reaction (RT-PCR) test between 15 May 2021 and 17 September 2021, at least three weeks after their second vaccine injection, had not received a third vaccine injection, and had no history of covid-19 infection. Main outcome measures Positive result for the RT-PCR test. Individuals who tested positive for SARS-CoV-2 and controls were matched for week of testing, age category, and demographic group (ultra-orthodox Jews, individuals of Arab ancestry, and the general population). Conditional logistic regression was adjusted for age, sex, socioeconomic status, and comorbid conditions. Results 83 057 adults received an RT-PCR test for SARS-CoV-2 during the study period and 9.6% had a positive result. Time elapsed since the vaccine injection was significantly longer in individuals who tested positive (P<0.001). Adjusted odds ratio for infection at time intervals >90 days since vaccination were significantly increased compared with the reference of <90 days: 2.37 (95% confidence interval 1.67 to 3.36) for 90-119 days, 2.66 (1.94 to 3.66) for 120-149 days, 2.82 (2.07 to 3.84) for 150-179 days, and 2.82 (2.07 to 3.85) for ≥180 days (P<0.001 for each 30 day interval). Conclusions In this large population of adults tested for SARS-CoV-2 by RT-PCR after two doses of mRNA BNT162b2 vaccine, a gradual increase in the risk of infection was seen for individuals who received their second vaccine dose after at least 90 days.

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SARS-CoV-2 Messenger RNA Vaccine Immunogenicity in Solid Organ Transplant Recipients With Prior COVID-19

Cited by 21 publications

References 5 publications

Immune Response to BNT162b2 in Solid Organ Transplant Recipients: Negative Impact of Mycophenolate and High Responsiveness of SARS-CoV-2 Recovered Subjects against Delta Variant

Immune Response to BNT162b2 in Solid Organ Transplant Recipients: Negative Impact of Mycophenolate and High Responsiveness of SARS-CoV-2 Recovered Subjects against Delta Variant

Impact of COVID-19 on the liver and on the care of patients with chronic liver disease, hepatobiliary cancer, and liver transplantation: An updated EASL position paper

Elapsed time since BNT162b2 vaccine and risk of SARS-CoV-2 infection: test negative design study

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