Pediatr Transplant
. 2024 Feb;28(1):e14671.
doi: 10.1111/petr.14671. Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients
John McAteer 1 2 , Divya D Kalluri 3 , Rivka R Abedon 3 , Caroline X Qin 3 , Scott R Auerbach 4 , Olga Charnaya 2 , Lara A Danziger-Isakov 5 , Noelle H Ebel 6 , Amy G Feldman 7 , Evelyn K Hsu 8 , Saeed Mohammad 9 , Emily R Perito 10 , Ashley M Thomas 11 , Teresa P Y Chiang 12 , Jacqueline M Garonzik-Wang 13 , Dorry L Segev 12 , William A Werbel 3 , Douglas B Mogul 11
Affiliations
Background: Adolescent solid organ transplant recipients (aSOTRs) who received three doses of the COVID-19 mRNA vaccine experience high seroconversion rates and antibody persistence for up to 3 months. Long-term antibody durability beyond this timeframe following three doses of the SARS-CoV-2 mRNA vaccine remains unknown. We describe antibody responses 6 months following the third vaccine dose (D3) of the BNT162b2 mRNA vaccination among aSOTRs.
Methods: Participants in a multi-center, observational cohort who received the third dose of the vaccine were analyzed for antibodies to the SARS-CoV-2 spike protein receptor-binding domain (Roche Elecsys anti-SARS-CoV-2-S positive: ≥0.8, maximum: >2500 U/mL). Samples were collected at 1-, 3-, and 6-months post-D3. Participants were surveyed at each timepoint and at 12-months post-D3.
Results: All 34 participants had positive anti-RBD antibody titers 6 months post-D3. Variations in titers occurred between 3 and 6 months post-D3, with 8/28 (29%) having decreased antibody levels at 6 months compared to 3 months and 2/28 (7%) reporting increased titers at 6 months. The remaining 18/28 (64%) had unchanged antibody titers compared to 3-month post-D3 levels. A total of 4/34 (12%) reported breakthrough infection within 6 months and 3/32 (9%) reported infection after 6-12 months following the third dose of the SARS-CoV-2 mRNA vaccine.
Conclusions: The results suggest that antibody durability persists up to 6 months following three doses of the SARS-CoV-2 mRNA in aSOTRs. Demography and transplant characteristics did not differ for those who experienced antibody weaning. Breakthrough infections did occur, reflecting immune-evasive nature of novel variants such as Omicron.
Keywords: COVID-19; SARS-CoV-2; adolescent solid organ transplant recipients; antibody; durability; mRNA vaccination; pediatric.
. 2024 Feb;28(1):e14671.
doi: 10.1111/petr.14671. Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients
John McAteer 1 2 , Divya D Kalluri 3 , Rivka R Abedon 3 , Caroline X Qin 3 , Scott R Auerbach 4 , Olga Charnaya 2 , Lara A Danziger-Isakov 5 , Noelle H Ebel 6 , Amy G Feldman 7 , Evelyn K Hsu 8 , Saeed Mohammad 9 , Emily R Perito 10 , Ashley M Thomas 11 , Teresa P Y Chiang 12 , Jacqueline M Garonzik-Wang 13 , Dorry L Segev 12 , William A Werbel 3 , Douglas B Mogul 11
Affiliations
- PMID: 38317335
- DOI: 10.1111/petr.14671
Background: Adolescent solid organ transplant recipients (aSOTRs) who received three doses of the COVID-19 mRNA vaccine experience high seroconversion rates and antibody persistence for up to 3 months. Long-term antibody durability beyond this timeframe following three doses of the SARS-CoV-2 mRNA vaccine remains unknown. We describe antibody responses 6 months following the third vaccine dose (D3) of the BNT162b2 mRNA vaccination among aSOTRs.
Methods: Participants in a multi-center, observational cohort who received the third dose of the vaccine were analyzed for antibodies to the SARS-CoV-2 spike protein receptor-binding domain (Roche Elecsys anti-SARS-CoV-2-S positive: ≥0.8, maximum: >2500 U/mL). Samples were collected at 1-, 3-, and 6-months post-D3. Participants were surveyed at each timepoint and at 12-months post-D3.
Results: All 34 participants had positive anti-RBD antibody titers 6 months post-D3. Variations in titers occurred between 3 and 6 months post-D3, with 8/28 (29%) having decreased antibody levels at 6 months compared to 3 months and 2/28 (7%) reporting increased titers at 6 months. The remaining 18/28 (64%) had unchanged antibody titers compared to 3-month post-D3 levels. A total of 4/34 (12%) reported breakthrough infection within 6 months and 3/32 (9%) reported infection after 6-12 months following the third dose of the SARS-CoV-2 mRNA vaccine.
Conclusions: The results suggest that antibody durability persists up to 6 months following three doses of the SARS-CoV-2 mRNA in aSOTRs. Demography and transplant characteristics did not differ for those who experienced antibody weaning. Breakthrough infections did occur, reflecting immune-evasive nature of novel variants such as Omicron.
Keywords: COVID-19; SARS-CoV-2; adolescent solid organ transplant recipients; antibody; durability; mRNA vaccination; pediatric.