Impaired anti-SARS-CoV-2 humoral and cellular immune response induced by Pfizer-BioNTech BNT162b2 mRNA vaccine in solid organ transplanted patients

Miele, Monica; Busà, Rosalia; Russelli, Giovanna; Sorrentino, Maria Concetta; Bella, Mariangela Di; Timoneri, Francesca; Mularoni, Alessandra; Panarello, Giovanna; Vitulo, Patrizio; Conaldi, Pier Giulio; Bulati, Matteo

doi:10.1111/ajt.16702

Cited by 72 publications

(78 citation statements)

References 6 publications

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“…They showed that only 47.5% of patients developed neutralizing antibody titers, 10-20 days after receiving the second dose (1). Similar results have been described in recent reports on SARS-CoV-2 vaccination in solid organ transplant recipients (2)(3)(4).…”

supporting

confidence: 91%

Effectiveness of SARS-CoV-2 vaccination in liver transplanted patients: The debate is open!

Guarino

Cossiga

Esposito

et al. 2022

Journal of Hepatology

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supporting

confidence: 91%

Effectiveness of SARS-CoV-2 vaccination in liver transplanted patients: The debate is open!

Guarino

Cossiga

Esposito

et al. 2022

Journal of Hepatology

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“…Two studies emphasized that the use of antimetabolites as immunosuppression was a risk factor for reduced serum conversion rates [53,54]. Only one study also analyzed T-cell response, which was described as reduced [55], and only one of the included studies considered only LT recipients [53].…”

Section: Covid-19 Vaccine Immunogenicity In Lt Recipientsmentioning

confidence: 99%

COVID-19 in Liver Transplant Recipients: A Systematic Review

Becchetti

Gschwend

Dufour

et al. 2021

JCM

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Liver transplant (LT) recipients are considered a vulnerable population amidst the COVID-19 pandemic. To date, available data have been heterogeneous and scarce. Therefore, we conducted a systematic literature review identifying English-language articles published in PubMed between November 2019 and 30th May 2021. We aimed to explore three areas: (1) outcome and clinical course; (2) immunological response after COVID-19 in LT recipients; and (3) vaccination response. After systematic selection, 35, 4, and 5 articles, respectively, were considered suitable for each area of analysis. Despite the heterogeneity of the reports included in this study, we found that gastrointestinal symptoms were common in LT recipients. The outcome of the LT population was not per se worse compared to the general population, although careful management of immunosuppressive therapy is required. While a complete therapy discontinuation is not encouraged, caution needs to be taken with use of mycophenolate mofetil (MMF), favoring tacrolimus (TAC) use. Although data conflicted about acquired immunity after SARS-CoV-2 infection, vaccine immunogenicity appeared to be low, suggesting that the level of surveillance should be kept high in this population.

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“…Indeed, studies have experimentally shown that serum from vaccinated individuals is less efficient in neutralizing viral variants [17,18]. On the other hand, post-vaccination infection may occur if vaccineinduced immunity is absent or ineffective, such as in solid organ transplant (SOT) recipients who are receiving immunosuppressive therapy [19][20][21][22][23][24]. Here we describe the characteristics of fourteen SARS-CoV-2 infections in fully vaccinated individuals at our medical center between 29 March 2021 and 29 April 2021 that represent both of these scenarios.…”

Section: Introductionmentioning

confidence: 99%

Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients

Deng

Evdokimova

O’Brien

et al. 2021

Viruses

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The pandemic of COVID-19 caused by SARS-CoV-2 infection continues to spread around the world. Vaccines that elicit protective immunity have reduced infection and mortality, however new viral variants are arising that may evade vaccine-induced immunity or cause disease in individuals who are unable to develop robust vaccine-induced responses. Investigating the role of viral variants in causing severe disease, evading vaccine-elicited immunity, and infecting vulnerable individuals is important for developing strategies to control the pandemic. Here, we report fourteen breakthrough infections of SARS-CoV-2 in vaccinated individuals with symptoms ranging from asymptomatic/mild (6/14) to severe disease (8/14). High viral loads with a median Ct value of 19.6 were detected in the nasopharyngeal specimens from subjects regardless of disease severity. Sequence analysis revealed four distinct virus lineages, including alpha and gamma variants of concern. Immunosuppressed individuals were more likely to be hospitalized after infection (p = 0.047), however no specific variant was associated with severe disease. Our results highlight the high viral load that can occur in asymptomatic breakthrough infections and the vulnerability of immunosuppressed individuals to post-vaccination infections by diverse variants of SARS-CoV-2.

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Impaired anti-SARS-CoV-2 humoral and cellular immune response induced by Pfizer-BioNTech BNT162b2 mRNA vaccine in solid organ transplanted patients

Cited by 72 publications

References 6 publications

Effectiveness of SARS-CoV-2 vaccination in liver transplanted patients: The debate is open!

Effectiveness of SARS-CoV-2 vaccination in liver transplanted patients: The debate is open!

COVID-19 in Liver Transplant Recipients: A Systematic Review

Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients

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