tetano
Editor, Senior Moderator
Eur J Heart Fail
. 2021 Apr 29.
doi: 10.1002/ejhf.2198. Online ahead of print.
Immunogenicity of the BNT162b2 mRNA Vaccine in Heart Transplanted Patients-A Prospective Cohort Study
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], Yael Shostak[SUP] 2 4 [/SUP], Barak Pertzov[SUP] 2 4 [/SUP], Noa Eliakim-Raz[SUP] 2 5 [/SUP], Galia Abed[SUP] 1 [/SUP], Miriam Abuhazira[SUP] 2 6 [/SUP], Yaron D Barac[SUP] 2 6 [/SUP], Israel Mats[SUP] 1 2 [/SUP], Mordehay Kramer[SUP] 4 5 [/SUP], Dan Aravot[SUP] 2 6 [/SUP], Ran Kornowski[SUP] 1 2 [/SUP], Tuvia Ben-Gal[SUP] 1 2 [/SUP]
Affiliations
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 1st 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 1st vaccine dose (GMT 90 (IQR 54, 229) AU/mL). Forty-nine percent of HTx recipients induced S-IgG antibodies in response to either the 1st 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 1st vaccine dose became S-IgG seropositive in response to the 2nd 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.
. 2021 Apr 29.
doi: 10.1002/ejhf.2198. Online ahead of print.
Immunogenicity of the BNT162b2 mRNA Vaccine in Heart Transplanted Patients-A Prospective Cohort Study
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], Yael Shostak[SUP] 2 4 [/SUP], Barak Pertzov[SUP] 2 4 [/SUP], Noa Eliakim-Raz[SUP] 2 5 [/SUP], Galia Abed[SUP] 1 [/SUP], Miriam Abuhazira[SUP] 2 6 [/SUP], Yaron D Barac[SUP] 2 6 [/SUP], Israel Mats[SUP] 1 2 [/SUP], Mordehay Kramer[SUP] 4 5 [/SUP], Dan Aravot[SUP] 2 6 [/SUP], Ran Kornowski[SUP] 1 2 [/SUP], Tuvia Ben-Gal[SUP] 1 2 [/SUP]
Affiliations
- PMID: 33915002
- DOI: 10.1002/ejhf.2198
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 1st 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 1st vaccine dose (GMT 90 (IQR 54, 229) AU/mL). Forty-nine percent of HTx recipients induced S-IgG antibodies in response to either the 1st 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 1st vaccine dose became S-IgG seropositive in response to the 2nd 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.