Predictive factors of response to 3<sup>rd</sup> dose of COVID-19 mRNA vaccine in kidney transplant recipients

Charmetant, Xavier; Espi, M.; Barba, Thomas; Ovize, Anne; Morélon, Emmanuel; Thaunat, Olivier

doi:10.1101/2021.08.23.21262293

Cited by 4 publications

(2 citation statements)

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“…Although this increase was less marked in the KT group, it is noteworthy that the percentage of KT patients with high-antibody titers increased from 3% after the second dose to about 50% after the third dose. These findings are in agreement with those described by Charmetant et al, 16 who reported a rise in titers in 42% of KT recipients who received the third dose of the vaccine.…”

Section: Discussionsupporting

confidence: 93%

“…The booster dose among solid organ transplant recipients has been reported to produce an increase in seroconversion rates. 13,[15][16][17][18] However, in most studies published to date, the cellular and humoral responses are not assessed together nor compared with nontransplanted chronic renal patients. In this study, we assess the evolution of the humoral and cellular response 6 mo after the second dose of vaccine and the response after a third dose, focusing on the KT population in comparison with patients on hemodialysis, patients on peritoneal dialysis (PD), and healthy controls.…”

Section: Introductionmentioning

confidence: 99%

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Dynamics of Humoral and Cellular Responses in Renal Transplant Recipients Receiving 3 Doses of SARS-CoV-2 mRNA Vaccine

et al. 2022

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Background. The original SARS-CoV-2 vaccination regimen (2 doses) induces insufficient short-term response in kidney transplant (KT) recipients. This study assessed the response to a third dose and the long-term immunogenicity after 2 doses in KT. Methods. We analyzed the dynamics of the humoral and cellular response by monitoring SARS-CoV-2 IgG antibodies against the Spike-protein (IgG-Spike) and QuantiFERON SARS-CoV-2 IFN-γ release assay 6 mo after the second dose (T2) and 28 d after the third dose of mRNA vaccines (T3) to KT and controls (dialysis patients and healthy individuals). Results. At T2, the percentage of IgG-Spike+ KT and dialysis patients decreased (KT 65.8%–52.6%, hemodialysis 92.6–81.5%, and peritoneal dialysis 100%–90%), whereas 100% of healthy controls remained positive. About the cellular response, the percentage of responders decreased in all groups, especially in KT (22.4%–9.2%, P = 0.081). At T3, 92% of KT, 94%–98% of dialysis patients, and 100% of healthy controls were IgG-Spike+. In terms of antibody titers, patients and controls showed a reduction between T2 and T3 and about 80% of dialysis patients and 100% of controls achieved high titers after the third dose (>1479.5 Binding Antibody Units/mL), whereas this percentage was only 50% in KT. With respect to the cellular response, only KT displayed a significant rise after the third dose. Conclusions. The third dose of mRNA vaccine improves both humoral and cellular responses, but less effectively in KT compared with dialysis patients and healthy controls.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Dynamics of Humoral and Cellular Responses in Renal Transplant Recipients Receiving 3 Doses of SARS-CoV-2 mRNA Vaccine

et al. 2022

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Efficacy and safety of booster vaccination against SARS-CoV-2 in dialysis and renal transplant patients: systematic review and meta-analysis

Taheri

2023

Int Urol Nephrol

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Introduction Patients under renal replacement therapy are at an increased risk of severe infection with SARS-CoV-2, and have been known to have impaired response to standard vaccination. This systematic review and meta-analysis aims at evaluating the efficacy of booster dose vaccination in this population. Methods A systematic review has been conducted to find trials on the booster dose vaccination in kidney transplant recipients (KTRs) or patients under dialysis. Data of seroconversion rates at different timepoints, especially 1 month prior and post-booster dose vaccination have been collected and analyzed. Effects of different factors including type of renal replacement therapy (RRT), vaccine type and brands, magnitude of response to the standard vaccination, and immunosuppression drugs on the response rates have been investigated. Meta-analyses were performed using software Stata v.17. Results Overall 58 studies were included. Both RRT patient subgroups represented significant seroconversion, post- (versus pre-) booster dose vaccination, but only in KTRs the booster dose seroconversion surpassed that of the standard protocol. T-cell response was also significantly augmented after booster vaccination, with no difference between the RRT subgroups. mRNA and vector vaccine types had comparable immunogenicity when employed as boosters, both significantly higher than the inactivated virus vaccine, with no significant disparity regarding the vaccine brands. Patients with poor response to standard vaccination had a significant response to booster dose, with dialysis patients having stronger response. The differential effects of vaccine types and brands in the poor responders was similar to that of the overall RRT population. No rejection episodes or graft failure post-booster vaccination was reported. Conclusion In patients under RRT, booster dose vaccination against SARS-CoV-2 is safe and efficacious determined by significant seroconversion, and therefore, it should be considered to be implemented in all these patients. Since in the KTR patients, the third dose vaccination significantly increased the seroconversion rates even beyond that of the standard protocol, three dose vaccine doses is recommended to be recognized as the standard vaccination protocol in this population. The same recommendation could be considered for dialysis patients, due to their augmented risk of breakthrough infection. Supplementary Information The online version contains supplementary material available at 10.1007/s11255-023-03471-x.

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COVID-19 vaccination in kidney transplant recipients

2021

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Predictive factors of response to 3^rd dose of COVID-19 mRNA vaccine in kidney transplant recipients

Cited by 4 publications

References 16 publications

Dynamics of Humoral and Cellular Responses in Renal Transplant Recipients Receiving 3 Doses of SARS-CoV-2 mRNA Vaccine

Dynamics of Humoral and Cellular Responses in Renal Transplant Recipients Receiving 3 Doses of SARS-CoV-2 mRNA Vaccine

Efficacy and safety of booster vaccination against SARS-CoV-2 in dialysis and renal transplant patients: systematic review and meta-analysis

COVID-19 vaccination in kidney transplant recipients

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Predictive factors of response to 3rd dose of COVID-19 mRNA vaccine in kidney transplant recipients

Cited by 4 publications

References 16 publications

Dynamics of Humoral and Cellular Responses in Renal Transplant Recipients Receiving 3 Doses of SARS-CoV-2 mRNA Vaccine

Dynamics of Humoral and Cellular Responses in Renal Transplant Recipients Receiving 3 Doses of SARS-CoV-2 mRNA Vaccine

Efficacy and safety of booster vaccination against SARS-CoV-2 in dialysis and renal transplant patients: systematic review and meta-analysis

COVID-19 vaccination in kidney transplant recipients

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Predictive factors of response to 3^rd dose of COVID-19 mRNA vaccine in kidney transplant recipients