tetano
Editor, Senior Moderator
ESC Heart Fail
. 2022 Jan 3.
doi: 10.1002/ehf2.13798. Online ahead of print.
Six-months immunogenicity of BNT162b2 mRNA vaccine in heart transplanted and ventricle assist device-supported patients
Osnat Itzhaki Ben Zadok[SUP] 1 2 [/SUP], Aviv A Shaul[SUP] 1 2 [/SUP], Binyamin Ben-Avraham[SUP] 1 2 [/SUP], Vicky Yaari[SUP] 1 2 [/SUP], Haim Ben Zvi[SUP] 2 3 [/SUP], Noa Eliakim-Raz[SUP] 2 4 [/SUP], Dafna Yahav[SUP] 2 4 [/SUP], Galia Abed[SUP] 1 [/SUP], Miriam Abuhazira[SUP] 2 5 [/SUP], Yaron D Barac[SUP] 2 5 [/SUP], Israel Mats[SUP] 1 2 [/SUP], Tzippy Shochat[SUP] 6 [/SUP], Dan Aravot[SUP] 2 5 [/SUP], Ran Kornowski[SUP] 1 2 [/SUP], Tuvia Ben-Gal[SUP] 1 2 [/SUP]
Affiliations
Abstract
Aims: To assess the 6 months immunogenicity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine in a population of heart transplanted (HTx) recipients and left ventricular assist device (LVAD)-supported patients.
Methods and results: A prospective single-centre cohort study of HTx recipients and LVAD-supported patients who received a two-dose SARSCoV-2 mRNA vaccine (BNT162b2, Pfizer-BioNTech). Whole blood for anti-spike IgG (S-IgG) antibodies were drawn at 6 months after the first vaccine dose. S-IgG data at 6 weeks were available for a subgroup of HTx recipients. S-IgG ≥ 50 AU/mL were interpreted positive. The cohort included 53 HTx recipients and 18 LVAD-supported patients. The median time from HTx or LVAD implantation to the 1[SUP]st[/SUP] vaccine dose was 90 (IQR 30, 172) months and 22 (IQR 6, 78) months, respectively. The seropositivity rates of S-IgG antibodies and their titre levels in HTx recipients and LVAD-supported patients were 45% and 83% respectively, (P = 0.006), and 35 (IQR 7, 306) AU/mL and 311 (IQR 86, 774) AU/mL, respectively, (P = 0.006). Reduced SARSCoV-2 vaccine immunogenicity in HTx recipients was associated with older age [odds ratio (OR) 0.917 confidence interval (CI 0.871, 0.966), P = 0.011] and with the use of anti-metabolites-based immunosuppressive regimens [OR 0.224 (CI 0.065, 0.777), P = 0.018]. mTOR inhibitors were associated with higher immunogenicity [OR 3.1 (CI 1.01, 9.65), P = 0.048]. Out of 13 HTx recipients who were S-IgG seropositive at 6 weeks after the first vaccine dose, 85% remained S-IgG seropositive at 6 month follow-up.
Conclusions: At 6 months post-vaccination, S-IgG immunogenicity in HTx recipients is low, particularly in older HTx recipients and in those treated with anti-metabolites drugs.
Keywords: COVID-19; Heart transplantation; Left ventricular assist device; SARS-CoV-2; Vaccine.
. 2022 Jan 3.
doi: 10.1002/ehf2.13798. Online ahead of print.
Six-months immunogenicity of BNT162b2 mRNA vaccine in heart transplanted and ventricle assist device-supported patients
Osnat Itzhaki Ben Zadok[SUP] 1 2 [/SUP], Aviv A Shaul[SUP] 1 2 [/SUP], Binyamin Ben-Avraham[SUP] 1 2 [/SUP], Vicky Yaari[SUP] 1 2 [/SUP], Haim Ben Zvi[SUP] 2 3 [/SUP], Noa Eliakim-Raz[SUP] 2 4 [/SUP], Dafna Yahav[SUP] 2 4 [/SUP], Galia Abed[SUP] 1 [/SUP], Miriam Abuhazira[SUP] 2 5 [/SUP], Yaron D Barac[SUP] 2 5 [/SUP], Israel Mats[SUP] 1 2 [/SUP], Tzippy Shochat[SUP] 6 [/SUP], Dan Aravot[SUP] 2 5 [/SUP], Ran Kornowski[SUP] 1 2 [/SUP], Tuvia Ben-Gal[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34981657
- DOI: 10.1002/ehf2.13798
Abstract
Aims: To assess the 6 months immunogenicity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine in a population of heart transplanted (HTx) recipients and left ventricular assist device (LVAD)-supported patients.
Methods and results: A prospective single-centre cohort study of HTx recipients and LVAD-supported patients who received a two-dose SARSCoV-2 mRNA vaccine (BNT162b2, Pfizer-BioNTech). Whole blood for anti-spike IgG (S-IgG) antibodies were drawn at 6 months after the first vaccine dose. S-IgG data at 6 weeks were available for a subgroup of HTx recipients. S-IgG ≥ 50 AU/mL were interpreted positive. The cohort included 53 HTx recipients and 18 LVAD-supported patients. The median time from HTx or LVAD implantation to the 1[SUP]st[/SUP] vaccine dose was 90 (IQR 30, 172) months and 22 (IQR 6, 78) months, respectively. The seropositivity rates of S-IgG antibodies and their titre levels in HTx recipients and LVAD-supported patients were 45% and 83% respectively, (P = 0.006), and 35 (IQR 7, 306) AU/mL and 311 (IQR 86, 774) AU/mL, respectively, (P = 0.006). Reduced SARSCoV-2 vaccine immunogenicity in HTx recipients was associated with older age [odds ratio (OR) 0.917 confidence interval (CI 0.871, 0.966), P = 0.011] and with the use of anti-metabolites-based immunosuppressive regimens [OR 0.224 (CI 0.065, 0.777), P = 0.018]. mTOR inhibitors were associated with higher immunogenicity [OR 3.1 (CI 1.01, 9.65), P = 0.048]. Out of 13 HTx recipients who were S-IgG seropositive at 6 weeks after the first vaccine dose, 85% remained S-IgG seropositive at 6 month follow-up.
Conclusions: At 6 months post-vaccination, S-IgG immunogenicity in HTx recipients is low, particularly in older HTx recipients and in those treated with anti-metabolites drugs.
Keywords: COVID-19; Heart transplantation; Left ventricular assist device; SARS-CoV-2; Vaccine.