Waning of vaccine-induced immunity to measles in kidney transplanted children

Abstract

Vaccine-preventable diseases are a significant cause of morbidity and mortality in solid organ transplant recipients who undergo immunosuppression after transplantation. Data on immune responses and long-term maintenance after vaccinations in such population are still limited.We cross-sectionally evaluated the maintenance of immune response to measles vaccine in kidney transplanted children on immunosuppressive therapy. Measles-specific enzyme-linked immunosorbent assay and B-cell enzyme-linked immunosorbent spot were performed in 74 kidney transplant patients (Tps) and in 23 healthy controls (HCs) previously vaccinated and tested for humoral protection against measles. The quality of measles antibody response was measured by avidity test. B-cell phenotype, investigated via flow cytometry, was further correlated to the ability of Tps to maintain protective humoral responses to measles over time.We observed the loss of vaccine-induced immunity against measles in 19% of Tps. Nonseroprotected children showed signs of impaired B-cell distribution as well as immune senescence and lower antibody avidity. We further reported as time elapsed between vaccination and transplantation, as well as the vaccine administration during dialysis are clinical factors affecting the maintenance of the immune memory response against measles.Tps present both quantitative and qualitative alterations in the maintenance of protective immunity to measles vaccine. Prospective studies are needed to optimize the vaccination schedules in kidney transplant recipients in order to increase the immunization coverage over time in this population.

Acquired hypogammaglobulinemia and pathogen‐specific antibody depletion after solid organ transplantation in human immunodeficiency virus infection: A brief report

“…These antibodies usually persist for decades if not lifelong. Likewise, Rocca and co‐workers documented the loss of protective antibodies to measles in 19% of 74 kidney transplanted children . This suggests that pre‐transplant vaccination will not eliminate all vaccine‐preventable diseases.…”

“…In these ill populations, responses may also be lower than that seen for controls pre‐transplant. Furthermore, even with pre‐transplant vaccination, pathogen‐specific antibodies can be lost, although the risk factors for this antibody loss and reverse seroconversion are unknown …”

Current perspectives in assessing humoral immunity after measles vaccination

“…A study assessing B cell compartment immunity in 70 HIV-1-infected children established the importance of early antiretroviral therapy for the maintenance of long-term immunity (measles-specific memory B cell frequencies and protective measles antibody titers) after routine vaccinations [96]. Similarly, other conditions associated with immunosuppression (e.g., transplantation and primary immunodeficiencies) often lead to impaired development and/or waning of measles vaccine-induced immunity [97–99]. Monitoring of measles immunity in such cases is critical for the optimization of population vaccination strategies and maintenance of long-term protection against measles.…”

Towards Precision Vaccines: Lessons From the Second International Precision Vaccines Conference

“…However, research in the past decade has led to the switching of vaccine development from empirical to a personalized vaccinology approach, which promises to advance effective treatments for VPs. Dr. Palma’s laboratory has made several observations emphasizing that correlates of protection in individuals with transplants ( 17 ) or chronic conditions (such as HIV-infection) are significantly different from the healthy individuals ( 18 – 20 ). In conclusion, he highlighted the virtuous circle of precision vaccinology which involves data collection from existing cohorts, data modeling of VPs, development of a harmonized OMICs platform, vaccine trials in VPs and identification of novel biomarkers of immunogenicity and safety to tailor vaccine intervention to those who may most benefit from its considerable promise ( 21 ).…”