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. 2022 Apr 21:35:10204.
doi: 10.3389/ti.2022.10204. eCollection 2022.

Immune Response to Third Dose BNT162b2 COVID-19 Vaccine Among Kidney Transplant Recipients-A Prospective Study

Dafna Yahav  1   2 , Ruth Rahamimov  2   3   4 , Tiki Mashraki  3   4 , Naomi Ben-Dor  2   3 , Tali Steinmetz  2   3 , Timna Agur  2   3 , Boris Zingerman  2   3 , Michal Herman-Edelstein  2   3 , Shelly Lichtenberg  2   3 , Haim Ben-Zvi  2   5 , Erez Bar-Haim  6 , Hila Cohen  6 , Shahar Rotem  6 , Uri Elia  6 , Ili Margalit  1   2 , Benaya Rozen Zvi  2   3
Affiliations

Immune Response to Third Dose BNT162b2 COVID-19 Vaccine Among Kidney Transplant Recipients-A Prospective Study

Dafna Yahav et al. Transpl Int. .

Abstract

Immune response to two SARS-CoV-2 mRNA vaccine doses among kidney transplant recipients (KTRs) is limited. We aimed to evaluate humoral and cellular response to a third BNT162b2 dose. In this prospective study, 190 KTRs were evaluated before and ∼3 weeks after the third vaccine dose. The primary outcomes were anti-spike antibody level >4160 AU/ml (neutralization-associated cutoff) and any seropositivity. Univariate and multivariate analyses were conducted to identify variables associated with antibody response. T-cell response was evaluated in a subset of participants. Results were compared to a control group of 56 healthcare workers. Among KTRs, we found a seropositivity rate of 70% (133/190) after the third dose (37%, 70/190, after the second vaccine dose); and 27% (52/190) achieved levels above 4160 AU/ml after the third dose, compared to 93% of controls. Variables associated with antibody response included higher antibody levels after the second dose (odds ratio [OR] 30.8 per log AU/ml, 95% confidence interval [CI]11-86.4, p < 0.001); and discontinuation of antimetabolite prior to vaccination (OR 9.1,95% CI 1.8-46.5, p = 0.008). T-cell response was demonstrated in 13% (7/53). In conclusion, third dose BNT162b2 improved immune response among KTRs, however 30% still remained seronegative. Pre-vaccination temporary immunosuppression reduction improved antibody response.

Keywords: COVID-19 vaccine; antibody response; cellular response; immunosuppression reduction; kidney transplant recipients.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Antibody response rates following second and third dose among kidney transplant recipients and controls–cut-off at 50 AU/ml.
FIGURE 2
FIGURE 2
Antibody response rates following second and third dose among kidney transplant recipients and controls–cut-off at 4160 AU/ml.
FIGURE 3
FIGURE 3
Log transformed antibody levels before and after third vaccine dose among KTR and control. KTR, kidney transplant recipient; “Baseline”—levels as tested after second vaccine dose. “After booster”—after third vaccine dose.
See this image and copyright information in PMC

References

    1. American Society of Transplantation. COVID-19: Vaccine FAQ Sheet [Internet]. United States: American Society of Transplantation; (2020). Available from: https://www.myast.org/covid-19-vaccine-faq-sheet (cited Sep 26, 2021).
    1. Rozen-Zvi B, Yahav D, Agur T, Zingerman B, Ben-Zvi H, Atamna A, et al. Antibody Response to mRNA SARS-CoV-2 Vaccine Among Kidney Transplant Recipients - Prospective Cohort Study. Clin Microbiol Infect (2021) 27:1173.e1–1173.e4. 10.1016/j.cmi.2021.04.028 - DOI - PMC - PubMed
    1. Boyarsky BJ, Werbel WA, Avery RK, Tobian AAR, Massie AB, Segev DL, et al. Antibody Response to 2-Dose SARS-CoV-2 mRNA Vaccine Series in Solid Organ Transplant Recipients. JAMA (2021) 325(21):2204–6. 10.1001/jama.2021.7489 - DOI - PMC - PubMed
    1. Crespo M, Barrilado-Jackson A, Padilla E, Eguía J, Echeverria-Esnal D, Cao H, et al. Negative Immune Responses to Two-Dose mRNA COVID-19 Vaccines in Renal Allograft Recipients Assessed with Simple Antibody and Interferon Gamma Release Assay Cellular Monitoring. Am J Transpl (2022) 22:786–800. 10.1111/ajt.16854 - DOI - PMC - PubMed
    1. Stumpf J, Siepmann T, Lindner T, Karger C, Schwöbel J, Anders L, et al. Humoral and Cellular Immunity to SARS-CoV-2 Vaccination in Renal Transplant versus Dialysis Patients: A Prospective, Multicenter Observational Study Using mRNA-1273 or BNT162b2 mRNA Vaccine. The Lancet Reg Health - Europe (2021) 9:100178. 10.1016/j.lanepe.2021.100178 - DOI - PMC - PubMed