tetano
Editor, Senior Moderator
Eur J Cardiothorac Surg
. 2022 Mar 4;ezac145.
doi: 10.1093/ejcts/ezac145. Online ahead of print.
Improved immunogenicity following the third dose of BNT162b2 mRNA vaccine in heart transplant recipients
Aviv Avraham Shaul[SUP] 1 2 [/SUP], Osnat Itzhaki Ben Zadok[SUP] 1 2 [/SUP], Binyamin Ben-Avraham[SUP] 1 2 [/SUP], Vicky Yaari[SUP] 1 2 [/SUP], Alon Barsheshet[SUP] 1 2 [/SUP], Amos Levi[SUP] 1 2 [/SUP], Haim Ben Zvi[SUP] 2 3 [/SUP], Noa Eliakim Raz[SUP] 2 4 [/SUP], Galia Abed[SUP] 1 [/SUP], Miriam Abuhazira[SUP] 2 5 [/SUP], Mahmood Abu Akel[SUP] 1 2 [/SUP], Israel Mats[SUP] 1 2 [/SUP], Yaron D Barac[SUP] 2 5 [/SUP], Dan Aravot[SUP] 2 5 [/SUP], Ran Kornowski[SUP] 1 2 [/SUP], Tuvia Ben-Gal[SUP] 1 2 [/SUP]
Affiliations
Abstract
Objectives: The immunogenicity of two-dose severe acute respiratory syndrome coronavirus 2 vaccine is lower among heart transplant (HTx) recipients, compared with the general population. Our aim was to assess the immunogenicity of a third-dose vaccine in HTx recipients.
Methods: This is a prospective cohort study of HTx recipients who received a third dose of the BNT162b2 vaccine. Immunogenicity was assessed by serum levels of anti-spike immunoglobulin G (S-IgG), taken at baseline and 14-28 days after the third dose. Titres above 50 U/ml were interpreted positive.
Results: We Included 42 HTx recipients at a median age of 65 years [interquartile range (IQR) 58-70]. At baseline, the median of 27 days (IQR 13-42) before the third dose and the median titre of the whole group was 18 U/ml (IQR 4-130). Only 14 patients (33%) were S-IgG seropositive. After the third dose, the proportion of seropositive patients increased significantly to 57% (P = 0.05) and the median titre increased significantly to 633 U/ml (IQR 7-6104, P < 0.0001). Younger age at HTx (OR per 1-year decrease 1.07, P = 0.05), low tacrolimus serum level (OR per 1-unit decrease 2.28, P = 0.02), mammalian target of rapamycin use (OR 13.3, P = 0.003), lack of oral steroids use (OR 4.17, P = 0.04) and lack of calcineurin inhibitor use (71% of responders vs 100% non-responders received calcineurin inhibitors, P = 0.01) were predictors of seropositive result after the third dose. However, no significant association was detected following adjustment for baseline S-IgG titre.
Conclusions: Third-dose booster of BNT162b2 vaccine significantly increased immunogenicity among HTx recipients who previously received a two-dose vaccine.
Keywords: BNT162b2 vaccine; COVID-19; Heart transplantation; Severe acute respiratory syndrome coronavirus 2; Third dose.
. 2022 Mar 4;ezac145.
doi: 10.1093/ejcts/ezac145. Online ahead of print.
Improved immunogenicity following the third dose of BNT162b2 mRNA vaccine in heart transplant recipients
Aviv Avraham Shaul[SUP] 1 2 [/SUP], Osnat Itzhaki Ben Zadok[SUP] 1 2 [/SUP], Binyamin Ben-Avraham[SUP] 1 2 [/SUP], Vicky Yaari[SUP] 1 2 [/SUP], Alon Barsheshet[SUP] 1 2 [/SUP], Amos Levi[SUP] 1 2 [/SUP], Haim Ben Zvi[SUP] 2 3 [/SUP], Noa Eliakim Raz[SUP] 2 4 [/SUP], Galia Abed[SUP] 1 [/SUP], Miriam Abuhazira[SUP] 2 5 [/SUP], Mahmood Abu Akel[SUP] 1 2 [/SUP], Israel Mats[SUP] 1 2 [/SUP], Yaron D Barac[SUP] 2 5 [/SUP], Dan Aravot[SUP] 2 5 [/SUP], Ran Kornowski[SUP] 1 2 [/SUP], Tuvia Ben-Gal[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35244690
- DOI: 10.1093/ejcts/ezac145
Abstract
Objectives: The immunogenicity of two-dose severe acute respiratory syndrome coronavirus 2 vaccine is lower among heart transplant (HTx) recipients, compared with the general population. Our aim was to assess the immunogenicity of a third-dose vaccine in HTx recipients.
Methods: This is a prospective cohort study of HTx recipients who received a third dose of the BNT162b2 vaccine. Immunogenicity was assessed by serum levels of anti-spike immunoglobulin G (S-IgG), taken at baseline and 14-28 days after the third dose. Titres above 50 U/ml were interpreted positive.
Results: We Included 42 HTx recipients at a median age of 65 years [interquartile range (IQR) 58-70]. At baseline, the median of 27 days (IQR 13-42) before the third dose and the median titre of the whole group was 18 U/ml (IQR 4-130). Only 14 patients (33%) were S-IgG seropositive. After the third dose, the proportion of seropositive patients increased significantly to 57% (P = 0.05) and the median titre increased significantly to 633 U/ml (IQR 7-6104, P < 0.0001). Younger age at HTx (OR per 1-year decrease 1.07, P = 0.05), low tacrolimus serum level (OR per 1-unit decrease 2.28, P = 0.02), mammalian target of rapamycin use (OR 13.3, P = 0.003), lack of oral steroids use (OR 4.17, P = 0.04) and lack of calcineurin inhibitor use (71% of responders vs 100% non-responders received calcineurin inhibitors, P = 0.01) were predictors of seropositive result after the third dose. However, no significant association was detected following adjustment for baseline S-IgG titre.
Conclusions: Third-dose booster of BNT162b2 vaccine significantly increased immunogenicity among HTx recipients who previously received a two-dose vaccine.
Keywords: BNT162b2 vaccine; COVID-19; Heart transplantation; Severe acute respiratory syndrome coronavirus 2; Third dose.