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. 2022 Jun 9:13:922042.
doi: 10.3389/fmicb.2022.922042. eCollection 2022.

Long-Term Humoral Response After a Second Dose of SARS-CoV-2 mRNA Vaccine in Japanese Kidney Transplant Recipients

Yutaro Ohki  1 , Mayuko Kawabe  1 , Izumi Yamamoto  1 , Haruki Katsumata  1 , Yasuyuki Nakada  1 , Akimitsu Kobayashi  1 , Fumihiko Urabe  2 , Jun Miki  2 , Hiroki Yamada  2 , Takahiro Kimura  2 , Nanae Matsuo  1 , Yudo Tanno  1 , Tetsuya Horino  3 , Ichiro Ohkido  1 , Hiroyasu Yamamoto  1 , Takashi Yokoo  1
Affiliations

Long-Term Humoral Response After a Second Dose of SARS-CoV-2 mRNA Vaccine in Japanese Kidney Transplant Recipients

Yutaro Ohki et al. Front Microbiol. .

Abstract

Background: The mortality rate due to COVID-19 in kidney transplant recipients (KTRs) is 16.8 to 32%. Vaccination against COVID-19 is expected to contribute to the prevention of infection, severe disease, and mortality; however, it has been reported that the humoral response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine in KTRs is poor. Vaccination strategies against COVID-19 vary from country to country, and in Japan, the third dose is given 6 months after the second dose. Few studies have evaluated long-term humoral responses after the second dose of SARS-CoV-2 mRNA vaccine. In addition, the superiority of BNT162b2 vaccine and mRNA-1,273 vaccine in KTRs regarding humoral response is controversial.

Methods: Ninety-four KTRs were administered a second dose of the BNT162b2 or mRNA-1,273 vaccines, and anti-spike (anti-S) and anti-nucleocapsid (anti-N) SARS-CoV-2 antibody levels were measured 5 months (149.2 ± 45.5 days) later. The cutoff value of anti-S antibodies was defined ≥50 AU/ml and 1.4 Index for anti-N antibodies. The primary outcome was the rate of seropositivity, and factors associated with an appropriate humoral response were assessed by univariate and multivariate analysis.

Results: Of 94 KTRs, only 45 (47.9%) patients were positive for anti-S antibodies. The median anti-S SARS-CoV-2 IgG antibody titers was 35.3 (Interquartile range 3.8 to 159.7). Anti-N SARS-CoV-2 IgG antibodies in all patients were < 1.4 Index. Response to SARS-CoV-2 mRNA vaccines were 43.2 and 65% for BNT162b2 and mRNA-1,273, respectively (p = 0.152). In comparison with high-dose, low-dose of mycophenolic acid was a robust factor associated with an adequate humoral response.

Conclusion: The long-term humoral response after a second dose of SARS-CoV-2 mRNA vaccine in Japanese KTRs was poor. In comparison with high-dose, low-dose mycophenolic acid was related to an appropriate humoral response. Five months is too long to wait for a 3rd dose after 2nd dose of SARS-CoV-2 vaccine in KTRs. In this cohort, there was no statistical difference in humoral response to the BNT162b2 and mRNA-1,273 vaccines. Additional large observational studies and meta-analyses are needed to clarify the factors related to an appropriate humoral immune response to COVID-19 vaccination.

Keywords: COVID-19; SARS-CoV-2 vaccine; anti-S SARS-CoV-2 IgG antibody titers; humoral response; kidney transplant recipients.

PubMed Disclaimer

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
The relationship between SARS-CoV-2 IgG II antibody titers and times post second vaccine (days). The red and blue dots show mRNA-1,273 and BNT162b2, respectively. There is no statistical difference between two vaccines (p = 0.09).
See this image and copyright information in PMC

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