Update on Coronavirus 2019 Vaccine Guidelines for Transplant Recipients

Kute, Vivek B.; Meshram, Hari Shankar; Sharma, Ashish; Chaudhury, Arpita Ray; Sudhindran, S.; Gokhale, AllaGopala Krishna; Hote, Milind Padmakar; Guleria, Randeep; Rana, Devinder Singh; Prakash, Jai; Ramesh, Vasanthi

doi:10.1016/j.transproceed.2021.09.007

Cited by 17 publications

(7 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…People with kidney diseases, such as chronic kidney disease, on maintenance haemodialysis, or KTRs, are at a much higher risk of complications and death following COVID-19 [ 6 , 7 ]. Considering the enhanced risk of organ dysfunction and mortality, it is strongly recommended to prioritise the COVID-19 vaccination of KTRs patients [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Antibody Response to ChAdOx1 nCoV-19 (AZD1222) Vaccine in Kidney Transplant Recipients

et al. 2022

View full text Add to dashboard Cite

Kidney transplant recipients (KTRs) are at a much higher risk of complications and death following COVID-19 and are poor vaccine responders. The data are limited on the immune response to Covishield® in KTRs. We prospectively recruited a cohort of 67 KTRs aged >18 between April 2021 and December 2021. Each participant was given two intramuscular doses of Covishield®, each of 0.5 mL, at an interval of 12 weeks. A blood specimen of 5.0 mL was collected from each participant at two points within a few days before administering the first dose of the vaccine and at any time between 4–12 weeks after administering the second dose. The sera were tested for anti-RBD antibody (ARAb) titre and neutralising antibody (NAb). An ACE2 competition assay was used as a proxy for virus neutralization. According to the prior COVID-19 infection, participants were grouped as (i) group A: prior symptomatic COVID-19 infection, (ii) group B: prior asymptomatic COVID-19 infection as evidenced by detectable ARAb in the prevaccination specimen, (iii) Group C: no prior infection with COVID-19, (iv) group D: Unclassified, i.e., participants had no symptoms suggestive of COVID-19, but their prevaccination specimen was not available for ARAb testing before vaccination. Fifty of sixty-seven participants (74.6%) provided paired specimens (group A 14, group B 27, and group C 9) and 17 participants (25.4%) provided only postvaccination specimens (group D). In the overall cohort (n = 67), 91% and 77.6% of participants developed ARAb and NAb, respectively. Their ARAb titre and NAb proportion were 2927 (520–7124) U/mL and 87.9 (24.4–93.2) %, respectively. Their median ARAb titre increased 65.6 folds, from 38.2 U/mL to 3137 U/mL. Similarly, the proportion of participants with NAb increased from 56% to 86%, and the NAb proportion raised 2.7 folds, from 23% to 91%. A comparison of vaccine response between the study groups showed that all those with or without prior COVID-19 infection showed a significant rise in ARAb titre (p < 0.05) and NAb proportion (p < 0.05) after the two doses of vaccine administration. The median value of folds rise in anti-RBD and NAb between groups A and B were comparable. Hence, ARAb is present in more than 3/4th of KTRs before the ChAdOx1 vaccine in India. The titer of ARAb and the proportion of NAb significantly increased after the two doses of the ChAdOx1 vaccine in KTRs.

show abstract

Section: Introductionmentioning

confidence: 99%

Antibody Response to ChAdOx1 nCoV-19 (AZD1222) Vaccine in Kidney Transplant Recipients

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The participants had received two doses of the vaccineat 13 weeks. 13,14 The 36 pairs of sera, collected after 11 weeks [5][6][7][8][9][10][11][12][13][14][15][16][17][18] of administration of second dose of the vaccine, were tested for ASAb and NAb. Following vaccination, 97% had ASAb and ASAb titer was 9405 (1635-25,000), whereas 83% of participants had NAb and NAb percentage was 96.4% (59.6-98.1%).…”

Section: Resultsmentioning

confidence: 99%

“…[6][7][8][9] Considering the high risk for COVID-19 infection and death following illness, it is strongly recommended to vaccinate the patients with CKD, particularly those on RRT. 10,11 The ChAdOx1 nCoV-19 vaccine (AZD1222), developed at Oxford University, consist of a replication-deficient chimpanzee adenoviral vector ChAdOx1 containing the SARS-CoV-2 spike protein gene and has shown promising protective efficacy in large human trials. 12,13 In India, this vaccine is available under the brand name Covishield ® , and over 2 billion doses have been administered to date.…”

Section: Introductionmentioning

confidence: 99%

Antibody response to ChAdOx1 nCoV‐19 (Covishield®) vaccine in people on maintenance hemodialysis

Bhaduaria

Tiwari

Goel

et al. 2023

Seminars in Dialysis

View full text Add to dashboard Cite

Introduction: People on renal replacement therapy (RRT) have a high risk of COVID‐19 infection and subsequent death. COVID‐19 vaccination is strongly recommended for those on RRT. Data are limited on the immune response of the ChAdOx1 nCoV‐19/AZD1222 (Covishield®) vaccine in patients on RRT. Methods: A prospective cohort of adult (age > 18 years), on RRT in the form of hemodialysis were included and received two intramuscular doses of Covishield®. A blood specimen of 5.0 mL was collected at two time points, within a few days before administering the first dose of the vaccine and at 4–16 weeks after the second dose. According to their prior COVID‐19 infection status, the participants were grouped as (i) prior symptomatic COVID‐19 infection, (ii) prior asymptomatic COVID‐19 infection, and (iii) no prior COVID‐19 infection. Results: A large proportion (81%) of participants had anti‐spike antibodies (ASAb) before vaccination, and a reasonable proportion (30%) also had neutralizing antibodies (NAb). The titer of ASAb was relatively low (207 U/mL) before vaccination. The ASAb titer (9405 [1635–25,000] U/mL) and percentage of NAb (96.4% [59.6–98.1%]) were markedly increased following the administration of two doses of the vaccine. The participants' prior COVID‐19 exposure status did not influence the rise in ASAb titer and NAb percentage. Further, administering two doses of the Covishield vaccine helps them achieve a high ASAb titer. Conclusion: Two doses of ChAdOx1 nCoV‐19/AZD1222 (Covishield®) vaccine, given 12 weeks apart, achieve a high titer of ASAb and a high percentage of NAb in people on hemodialysis.

show abstract

“…In the most recent recommendation, third dose is theoretically suggested, but that was not yet available in many countries. 10 , 11 A previous study with different type of vaccines had shown, that 67% of the solid organ transplanted (SOT) patients (especially liver and kidney recipients) remains negative after a booster vaccine which was given in a median of 67 days. 12 Most studies dealing with mRNA‐based vaccinations in SOT recipient, and contribute to a small number of lung transplant patients.…”

Section: Discussionmentioning

confidence: 99%

“…No serious side effects of vaccination were observed. In the most recent recommendation, third dose is theoretically suggested, but that was not yet available in many countries 10,11 . A previous study with different type of vaccines had shown, that 67% of the solid organ transplanted (SOT) patients (especially liver and kidney recipients) remains negative after a booster vaccine which was given in a median of 67 days 12 .…”

Section: Discussionmentioning

confidence: 99%

Serological findings following the second and third SARS‐CoV‐2 vaccines in lung transplant recipients

Bárczi

Varga

Nagy

et al. 2022

Immunity Inflam & Disease

View full text Add to dashboard Cite

Introduction Lung transplant recipients (LuTX) represent a vulnerable population for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Even though many vaccines are already developed, more clinical data need to support effective immunological response in immunocompromised patients. Methods Stable LuTX recipients with no medical history of coronavirus disease (COVID‐19) were enrolled. Currently available messenger RNA (mRNA) (BNT162b2‐mRNA, mRNA‐1273) and non‐mRNA (ChAdOx1, BBIBP‐CorV) vaccines were given according to availability, boosters were all mRNA‐based. SARS‐CoV‐2 Spike1 immunoglobulin G (IgG) antibody titer was evaluated before and 2 weeks after second and third dose. Difference between mRNA versus non‐mRNA vaccines was assessed. RESULTS Forty‐one patients (49% men, age 48.4 ± 13.8 years) received two doses of SARS‐CoV‐2 vaccines: 23 of mRNA, 18 of non‐mRNA, and 24/41 (58%) received a third dose. Median 92 months passed since transplantation, and serum level of tacrolimus was median 5.5 ng/ml. Positive serology was found in 37% of all patients after the second dose, 86% had mRNA vaccine. After the third dose, 29% became positive who had no antibody before. Significantly higher level of antibody was found after the second mRNA than non‐mRNA vaccines (2.2 vs. 1568.8 U/ml, respectively, p = .002). 6/23 (26%) patients received two doses of mRNA vaccine developed COVID‐19 after the second injection in an average of 178 days, half of them recovered, half of them died in intensive care unit (ICU). 3/6 (50%) patients with two doses mRNA and recovered from COVID‐19 had significantly higher level of antibody (average 20847.3 U/ml) than without infection. After the booster vaccine, 1/24 (4%) developed infection. Conclusion Immunosuppression therapy may induce a weaker SARS‐CoV‐2 response in LuTX recipients; therefore, third dose is a priority in transplanted patients. The highest antibody level was measured recovering from COVID after two doses. Our data confirm that booster mRNA vaccine could increase antibody levels, even if immunization was started with non‐mRNA vaccine.

show abstract

Update on Coronavirus 2019 Vaccine Guidelines for Transplant Recipients

Cited by 17 publications

References 35 publications

Antibody Response to ChAdOx1 nCoV-19 (AZD1222) Vaccine in Kidney Transplant Recipients

Antibody Response to ChAdOx1 nCoV-19 (AZD1222) Vaccine in Kidney Transplant Recipients

Antibody response to ChAdOx1 nCoV‐19 (Covishield®) vaccine in people on maintenance hemodialysis

Serological findings following the second and third SARS‐CoV‐2 vaccines in lung transplant recipients

Contact Info

Product

Resources

About