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. 2025 Apr 25;25(1):606.
doi: 10.1186/s12879-024-10377-1.

Long-term immune response after SARS-CoV2 vaccination in solid organ transplant recipients

Cecilia Bonazzetti  1   2 , Alice Toschi  1 , Dino Gibertoni  3 , Natascia Caroccia  2 , Michela Di Chiara  2 , Silvia Vituliano  1 , Federica Lanna  4 , Alessandro Croci  1 , Beatrice Tazza  2 , Armando Amicucci  1 , Maria Cristina Morelli  5 , Giorgia Comai  1   6 , Elena Salvaterra  7 , Luciano Potena  8 , Pierluigi Viale  1   2 , Maddalena Giannella  9   10   11 , Tiziana Lazzarotto  1   4
Affiliations

Long-term immune response after SARS-CoV2 vaccination in solid organ transplant recipients

Cecilia Bonazzetti et al. BMC Infect Dis. .

Abstract

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccination in solid organ transplant (SOT) recipients is associated with suboptimal antibody response (AbR) favouring breakthrough infection (BI). The role of cell-mediated immunity (CMI) remains uncertain.

Methods: Single-center prospective longitudinal cohort study of adult SOT recipients monitored for both AbR and CMI at 6 ± 2 months after booster dosage of SARS-CoV-2 vaccine. Primary end-point was BI diagnosis and CMI was the main risk factor. Relationship between CMI and BI was investigated by bivariate tests and multivariable logistic regression.

Results: CMI was performed in 139 patients. In 66 patients BI was documented before CMI, thus 73 (33 kidney, 24 liver, 14 lung, 2 heart) were analysed. The first 2 vaccine doses consisted of BNT162b2 and mRNA-1273 in 69.1% and 30.9% of cases, respectively. Whereas mRNA-1273 was used as for third dose in 91.2% of patients. At a median of 215 (IQR 181-252) days after booster dose, 40 (54.8%) patients displayed both AbR and CMI, 21 (28.8%) only AbR and 12 (16.4%) neither AbR or CMI; there were no patients showing negative AbR and positive CMI. Overall, 22 (30.1%) patients reported BI with no significant differences between those with positive vs. negative CMI (59.1% vs. 40.9%, p = 0.798), confirmed by multiple logistic regression after adjusting for age, type of vaccine and organs, high AbR and time from transplant.

Conclusion: Our data suggest that in the solid organ transplant population of our cohort, cell-mediated immunity does not appear to be a strong predictor of BI.

Keywords: Solid organ transplant; Antibody response; Cellular mediated immunity; Sars-CoV2 vaccine.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the local institutional review board ethics committee “Comitato Etico Area Vasta Emilia Centro (AVEC)”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. Informed consent was obtained before enrollment. This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References

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