Very Low Immunization Rate in Kidney Transplant Recipients After One Dose of the BNT162b2 Vaccine: Beware not to Lower the Guard!

Georgery, Hélène; Devresse, Arnaud; Yombi, Jean‐Cyr; Belkhir, Leïla; Greef, Julien De; Darius, Tom; Buemi, Antoine; Scohy, Anaïs; Kabamba, Benoît; Goffin, Éric; Kanaan, Nada

doi:10.1097/tp.0000000000003818

Cited by 9 publications

(13 citation statements)

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“…After review, 105 articles were excluded owing to being a review article, case report, preprint, incorrect patient population, or duplicate cohort or having no outcomes of interest. A total of 83 studies 9 , 10 , 11 , 12 , 13 , 14 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 ...…”

Section: Resultsmentioning

confidence: 99%

“…Among the studies analyzed, the weighted mean (range) seroconversion rate after 1 dose of mRNA vaccine was 10.4% (0%-37.9%) for antispike antibodies (18 studies 12 , 33 , 35 , 37 , 40 , 41 , 42 , 44 , 48 , 51 , 52 , 55 , 57 , 69 , 71 , 76 , 103 , 105 ) and 4.1% (0%-5.9%) for neutralizing antibodies (2 studies 12 , 69 ) ( Figure 2 ). The mean (range) antibody testing time was 25.5 (21-28) days after the first dose.…”

Section: Resultsmentioning

confidence: 99%

“…After review, 105 articles were excluded owing to being a review article, case report, preprint, incorrect patient population, or duplicate cohort or having no outcomes of interest. A total of 83 studies were included in the systematic review, of which 29 studies were included in the meta-analysis (Figure 1). The characteristics of 83 included studies are described in eTable 2 in the Supplement.…”

Section: Resultsmentioning

confidence: 99%

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Immunogenicity and Risk Factors Associated With Poor Humoral Immune Response of SARS-CoV-2 Vaccines in Recipients of Solid Organ Transplant

et al. 2022

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Key Points Question What are the humoral immune response rates and risk factors associated with diminished response after COVID-19 vaccination in recipients of solid organ transplant? Findings In this systematic review and meta-analysis of 29 studies and 11 713 recipients of solid organ transplant, seroconversion rates increased with progressively increased numbers of mRNA COVID-19 vaccine doses. Older age, recent transplantation, deceased donor status, active use of antimetabolites, and recent exposure to antithymocyte globulin or rituximab were risk factors associated with diminished humoral immune response after receiving 2 doses of mRNA vaccines. Meaning These findings suggest that more efforts are needed to modulate the risk factors associated with reduced humoral responses among recipients of solid organ transplant.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…After review, 105 articles were excluded owing to being a review article, case report, preprint, incorrect patient population, or duplicate cohort or having no outcomes of interest. A total of 83 studies were included in the systematic review, of which 29 studies were included in the meta-analysis (Figure 1). The characteristics of 83 included studies are described in eTable 2 in the Supplement.…”

Section: Resultsmentioning

confidence: 99%

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Immunogenicity and Risk Factors Associated With Poor Humoral Immune Response of SARS-CoV-2 Vaccines in Recipients of Solid Organ Transplant

et al. 2022

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“…2,3 Limited data indicated that immunocompromised patients demonstrated weakened immune responses to SARS-CoV-2 vaccines. [18][19][20][21][22][23] Studies that evaluated antibody titers as proxies of postvaccine immunogenicity identified lower immune responses in some groups of persons with immune dysfunction. 18 However, it remains unclear whether such proxies of immunogenicity are associated with the real-world effectiveness of SARS-CoV-2 vaccines.…”

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confidence: 99%

Association Between Immune Dysfunction and COVID-19 Breakthrough Infection After SARS-CoV-2 Vaccination in the US

et al. 2022

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for the National COVID Cohort Collaborative (N3C) Consortium IMPORTANCE Persons with immune dysfunction have a higher risk for severe COVID-19 outcomes. However, these patients were largely excluded from SARS-CoV-2 vaccine clinical trials, creating a large evidence gap.OBJECTIVE To identify the incidence rate and incidence rate ratio (IRR) for COVID-19 breakthrough infection after SARS-CoV-2 vaccination among persons with or without immune dysfunction. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study analyzed data from the National COVID Cohort Collaborative (N3C), a partnership that developed a secure, centralized electronic medical record-based repository of COVID-19 clinical data from academic medical centers across the US. Persons who received at least 1 dose of a SARS-CoV-2 vaccine between December 10, 2020, and September 16, 2021, were included in the sample.MAIN OUTCOMES AND MEASURES Vaccination, COVID-19 diagnosis, immune dysfunction diagnoses (ie, HIV infection, multiple sclerosis, rheumatoid arthritis, solid organ transplant, and bone marrow transplantation), other comorbid conditions, and demographic data were accessed through the N3C Data Enclave. Breakthrough infection was defined as a COVID-19 infection that was contracted on or after the 14th day of vaccination, and the risk after full or partial vaccination was assessed for patients with or without immune dysfunction using Poisson regression with robust SEs. Poisson regression models were controlled for a study period (before or after [pre-or post-Delta variant] June 20, 2021), full vaccination status, COVID-19 infection before vaccination, demographic characteristics, geographic location, and comorbidity burden.RESULTS A total of 664 722 patients in the N3C sample were included. These patients had a median (IQR) age of 51 (34-66) years and were predominantly women (n = 378 307 [56.9%]). Overall, the incidence rate for COVID-19 breakthrough infection was 5.0 per 1000 person-months among fully vaccinated persons but was higher after the Delta variant became the dominant SARS-CoV-2 strain (incidence rate before vs after June 20, 2021, 2.2 [95% CI, 2.2-2.2] vs 7.3 [95% CI,] per 1000 person-months). Compared with partial vaccination, full vaccination was associated with a 28% reduced risk for breakthrough infection (adjusted IRR [AIRR], 0.72; 95% CI, 0.68-0.76). People with a breakthrough infection after full vaccination were more likely to be older and women. People with HIV infection (AIRR, 1.33; 95% CI, 1.18-1.49), rheumatoid arthritis (AIRR, 1.20; 95% CI, 1.09-1.32), and solid organ transplant (AIRR, 2.16; 95% CI, 1.96-2.38) had a higher rate of breakthrough infection.CONCLUSIONS AND RELEVANCE This cohort study found that full vaccination was associated with reduced risk of COVID-19 breakthrough infection, regardless of the immune status of patients. Despite full vaccination, persons with immune dysfunction had substantially higher risk for COVID-19 breakthrough infection than those without such a condition. For persons with immune...

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“…W e read with interest the report from Georgery et al 1 addressing the very low immunization rate of 3.8% in kidney transplant recipients (KTRs) 28 d after 1 dose of the BNT162b2 (Pfizer/BioNTech) vaccine. As addressed by the authors, this is markedly lower than what has been reported in other recent publications on mRNA vaccines (BNT162b2, Pfizer/BioNTech; mRNA-1273, Moderna) in this population.…”

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confidence: 99%

Low Immunization Rate in Kidney Transplant Recipients Also After Dose 2 of the BNT162b2 Vaccine: Continue to Keep Your Guard up!

et al. 2021

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Very Low Immunization Rate in Kidney Transplant Recipients After One Dose of the BNT162b2 Vaccine: Beware not to Lower the Guard!

Cited by 9 publications

References 5 publications

Immunogenicity and Risk Factors Associated With Poor Humoral Immune Response of SARS-CoV-2 Vaccines in Recipients of Solid Organ Transplant

Immunogenicity and Risk Factors Associated With Poor Humoral Immune Response of SARS-CoV-2 Vaccines in Recipients of Solid Organ Transplant

Association Between Immune Dysfunction and COVID-19 Breakthrough Infection After SARS-CoV-2 Vaccination in the US

Low Immunization Rate in Kidney Transplant Recipients Also After Dose 2 of the BNT162b2 Vaccine: Continue to Keep Your Guard up!

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