TY - JOUR
T1 - Immune Response to Third Dose BNT162b2 COVID-19 Vaccine Among Kidney Transplant Recipients—A Prospective Study
AU - Yahav, Dafna
AU - Rahamimov, Ruth
AU - Mashraki, Tiki
AU - Ben-Dor, Naomi
AU - Steinmetz, Tali
AU - Agur, Timna
AU - Zingerman, Boris
AU - Herman-Edelstein, Michal
AU - Lichtenberg, Shelly
AU - Ben-Zvi, Haim
AU - Bar-Haim, Erez
AU - Cohen, Hila
AU - Rotem, Shahar
AU - Elia, Uri
AU - Margalit, Ili
AU - Zvi, Benaya Rozen
N1 - Publisher Copyright:
Copyright © 2022 Yahav, Rahamimov, Mashraki, Ben-Dor, Steinmetz, Agur, Zingerman, Herman-Edelstein, Lichtenberg, Ben-Zvi, Bar-Haim, Cohen, Rotem, Elia, Margalit and Zvi.
PY - 2022/4/21
Y1 - 2022/4/21
N2 - 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.
AB - 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.
KW - COVID-19 vaccine
KW - antibody response
KW - cellular response
KW - immunosuppression reduction
KW - kidney transplant recipients
UR - http://www.scopus.com/inward/record.url?scp=85129581024&partnerID=8YFLogxK
U2 - 10.3389/ti.2022.10204
DO - 10.3389/ti.2022.10204
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C2 - 35529596
AN - SCOPUS:85129581024
SN - 0934-0874
VL - 35
JO - Transplant International
JF - Transplant International
M1 - 10204
ER -
