Eur J Heart Fail . Immunogenicity of the BNT162b2 mRNA Vaccine in Heart Transplanted Patients-A Prospective Cohort Study

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Eur J Heart Fail


. 2021 May 8.
doi: 10.1002/ejhf.2199. Online ahead of print.
Immunogenicity of the BNT162b2 mRNA Vaccine in Heart Transplanted Patients-A Prospective Cohort Study


Osnat Itzhaki Ben Zadok ^{1 2} , Aviv A Shaul ^{1 2} , Binyamin Ben-Avraham ^{1 2} , Vicky Yaari ^{1 2} , Haim Ben Zvi ^{2 3} , Yael Shostak ^{2 4} , Barak Pertzov ^{2 4} , Noa Eliakim-Raz ^{2 5} , Galia Abed ¹ , Miriam Abuhazira ^{2 6} , Yaron D Barac ^{2 6} , Israel Mats ^{1 2} , Mordehay Kramer ^{4 5} , Dan Aravot ^{2 6} , Ran Kornowski ^{1 2} , Tuvia Ben-Gal ^{1 2}



Affiliations

• PMID: 33963635
• DOI: 10.1002/ejhf.2199

Abstract

Aims: To assess the short-term immunogenicity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine in a population of heart transplanted (HTx) recipients.
Methods: A prospective single-center cohort study of HTx recipients who received a 2-dose SARSCoV-2 mRNA vaccine (BNT162b2, Pfizer-BioNTech). Whole blood for anti-spike IgG (S-IgG) antibodies were drawn at days 21-26 and at days 35-40 after the first vaccine dose. Geometric mean titers (GMT) ?50 AU/mL were interpreted positive.
Results: Included were 42 HTx recipients at a median age of 61 (IQR 44, 69) years. Median time from HTx to the 1^st vaccine dose was 9.1 (IQR 2.6, 14) years. Only 15% of HTx recipients demonstrated the presence of positive S-IgG antibody titers in response to the 1^st vaccine dose (GMT 90 (IQR 54, 229) AU/mL). Forty-nine percent of HTx recipients induced S-IgG antibodies in response to either the 1^st or the full 2-dose vaccine schedule (GMT 426 (IQR 106, 884) AU/mL). Older age (68 (IQR 59, 70) years vs. 46 (IQR 34, 63) years, p=0.034) and anti-metabolites-based immunosuppression protocols (89% vs. 44%, p=0.011) were associated with low immunogenicity. Importantly, 36% of HTx recipients who were non-responders to 1^st vaccine dose became S-IgG seropositive in response to the 2^nd vaccine dose.
Discussion: Approximately a half of HTx recipients did not generate S-IgG antibodies following SARSCoV-2 2-dose vaccine. The generally achieved protection from SARSCoV-2 mRNA vaccination should be regarded with caution in the population of HTx recipients. The possible benefit of additive vaccine doses should be further studied.

Keywords: COVID-19; Heart Transplantation; SARS-CoV-2; Vaccine.