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. 2021 Sep 1;105(9):2119-2123.
doi: 10.1097/TP.0000000000003824.

Immunogenicity and Reactogenicity After SARS-CoV-2 mRNA Vaccination in Kidney Transplant Recipients Taking Belatacept

Michael T Ou  1 , Brian J Boyarsky  1 , Teresa P Y Chiang  1 , Sunjae Bae  1 , William A Werbel  2 , Robin K Avery  2 , Aaron A R Tobian  3 , Allan B Massie  1 , Dorry L Segev  1   4 , Jacqueline M Garonzik-Wang  1
Affiliations

Immunogenicity and Reactogenicity After SARS-CoV-2 mRNA Vaccination in Kidney Transplant Recipients Taking Belatacept

Michael T Ou et al. Transplantation. .

Abstract

Background: Belatacept may impair humoral immunity, impacting the effectiveness of SARS-CoV-2 mRNA vaccines in transplant recipients. We investigated immunogenicity after SARS-CoV-2 mRNA vaccines in kidney transplant recipients who are and are not taking belatacept.

Methods: Participants were recruited between December 9, 2020, and April 1, 2021. Blood samples were collected after dose 1 and dose 2 (D1, D2) and analyzed using either an anti-SARS-CoV-2 enzyme immunoassay against the S1 domain of the SARS-CoV-2 spike protein or immunoassay against the receptor-binding domain of the SARS-CoV-2 spike protein. Stabilized inverse probability of treatment weights was used to compare immunogenicity, and a weighted logistics regression was used to calculate fold change of positive response.

Results: Among the 609 participants studied, 24 (4%) were taking belatacept. After dose 1, 0/24 (0%) belatacept patients had detectable antibodies, compared with 77 of 568 (14%) among the equivalent nonbelatacept population (P = 0.06). After dose 2, 1/19 (5%) belatacept patients had detectable antibodies, compared with 190/381 (50%) among the equivalent nonbelatacept population (P < 0.001). Belatacept use was associated with 16.7-fold lower odds of having a positive post-D2 titer result (P < 0.01).

Conclusions: Additional measures need to be explored to protect kidney transplant recipients taking belatacept. Best safety practices should be continued despite vaccination among this population.

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Conflict of interest statement

DISCLOSURES

The authors of this manuscript have the following conflicts of interest to disclose as described by Transplantation: Dorry L. Segev, MD PhD has the following financial disclosures: consulting and speaking honoraria from Sanofi, Novartis, CSL Behring, Jazz Pharmaceuticals, Veloxis, Mallincrodt, Thermo Fisher Scientific. Robin Avery, MD has the following financial disclosures: study/grant support from Aicuris, Astellas, Chimerix, Merck, Oxford Immunotec, Qiagen, and Takeda/Shire.

Figures

Figure 1.
Figure 1.
The development of adverse systems after each SARS-CoV-2 mRNA vaccine dose in kidney transplant recipients taking belatacept. N= 24, dose 1; 19 dose 2
See this image and copyright information in PMC

References

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