tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2023 Apr 13;10(5)
fad200.
doi: 10.1093/ofid/ofad200. eCollection 2023 May. Immunogenicity, Safety, and Breakthrough Severe Acute Respiratory Syndrome Coronavirus 2 Infections After Coronavirus Disease 2019 Vaccination in Organ Transplant Recipients: A Prospective Multicenter Canadian Study
Dima Kabbani[SUP] 1 [/SUP], Demitra M Yotis[SUP] 2 [/SUP], Victor H Ferreira[SUP] 3 [/SUP], Sarah Shalhoub[SUP] 4 [/SUP], Sara Belga[SUP] 5 [/SUP], Varalika Tyagi[SUP] 1 [/SUP], Matthew Ierullo[SUP] 3 [/SUP], Vathany Kulasingam[SUP] 6 [/SUP], Marie-Josée Hébert[SUP] 2 7 [/SUP], Lori West[SUP] 2 8 9 [/SUP], Jean-Sébastien Delisle[SUP] 2 10 11 [/SUP], Normand Racine[SUP] 12 [/SUP], Sacha A De Serres[SUP] 13 [/SUP], Héloïse Cardinal[SUP] 10 [/SUP], Mélanie Dieudé[SUP] 2 14 15 16 [/SUP], Atul Humar[SUP] 3 [/SUP], Deepali Kumar[SUP] 3 [/SUP]
Affiliations
Background: Solid organ transplant (SOT) recipients are at risk for severe coronavirus disease 2019 (COVID-19), despite vaccination. Our study aimed to elucidate COVID-19 vaccine immunogenicity and evaluate adverse events such as hospitalization, rejection, and breakthrough infection in a SOT cohort.
Methods: We performed a prospective, observational study on 539 adult SOT recipients (age ≥18 years old) recruited from 7 Canadian transplant centers. Demographics including transplant characteristics, vaccine types, and immunosuppression and events such as hospitalization, infection, and rejection were recorded. Follow ups occurred every 4-6 weeks postvaccination and at 6 and 12 months from first dose. Serum was processed from whole blood to measure anti-receptor binding domain (RBD) antibodies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein to assess immunogenicity.
Results: The COVID-19 vaccines were found to be safe in SOT recipients with low rates of rejection requiring therapy (0.7%). Immunogenicity improved after the third vaccine dose, yet 21% developed no anti-RBD response. Factors such as older age, lung transplantation, chronic kidney disease, and shorter duration from transplant were associated with decreased immunogenicity. Patients with at least 3 doses were protected from hospitalization when experiencing breakthrough infections. Significantly increased anti-RBD levels were observed in patients who received 3 doses and had breakthrough infection.
Conclusions: Three or four doses of COVID-19 vaccines were safe, increased immunogenicity, and protected against severe disease requiring hospitalization. Infection paired with multiple vaccinations significantly increased anti-RBD response. However, SOT populations should continue to practice infection prevention measures, and they should be prioritized for SARS-CoV-2 pre-exposure prophylactics and early therapeutics.
Keywords: SARS-CoV-2; solid organ transplant; vaccines.
. 2023 Apr 13;10(5)
fad200.doi: 10.1093/ofid/ofad200. eCollection 2023 May. Immunogenicity, Safety, and Breakthrough Severe Acute Respiratory Syndrome Coronavirus 2 Infections After Coronavirus Disease 2019 Vaccination in Organ Transplant Recipients: A Prospective Multicenter Canadian Study
Dima Kabbani[SUP] 1 [/SUP], Demitra M Yotis[SUP] 2 [/SUP], Victor H Ferreira[SUP] 3 [/SUP], Sarah Shalhoub[SUP] 4 [/SUP], Sara Belga[SUP] 5 [/SUP], Varalika Tyagi[SUP] 1 [/SUP], Matthew Ierullo[SUP] 3 [/SUP], Vathany Kulasingam[SUP] 6 [/SUP], Marie-Josée Hébert[SUP] 2 7 [/SUP], Lori West[SUP] 2 8 9 [/SUP], Jean-Sébastien Delisle[SUP] 2 10 11 [/SUP], Normand Racine[SUP] 12 [/SUP], Sacha A De Serres[SUP] 13 [/SUP], Héloïse Cardinal[SUP] 10 [/SUP], Mélanie Dieudé[SUP] 2 14 15 16 [/SUP], Atul Humar[SUP] 3 [/SUP], Deepali Kumar[SUP] 3 [/SUP]
Affiliations
- PMID: 37213422
- PMCID: PMC10199121
- DOI: 10.1093/ofid/ofad200
Background: Solid organ transplant (SOT) recipients are at risk for severe coronavirus disease 2019 (COVID-19), despite vaccination. Our study aimed to elucidate COVID-19 vaccine immunogenicity and evaluate adverse events such as hospitalization, rejection, and breakthrough infection in a SOT cohort.
Methods: We performed a prospective, observational study on 539 adult SOT recipients (age ≥18 years old) recruited from 7 Canadian transplant centers. Demographics including transplant characteristics, vaccine types, and immunosuppression and events such as hospitalization, infection, and rejection were recorded. Follow ups occurred every 4-6 weeks postvaccination and at 6 and 12 months from first dose. Serum was processed from whole blood to measure anti-receptor binding domain (RBD) antibodies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein to assess immunogenicity.
Results: The COVID-19 vaccines were found to be safe in SOT recipients with low rates of rejection requiring therapy (0.7%). Immunogenicity improved after the third vaccine dose, yet 21% developed no anti-RBD response. Factors such as older age, lung transplantation, chronic kidney disease, and shorter duration from transplant were associated with decreased immunogenicity. Patients with at least 3 doses were protected from hospitalization when experiencing breakthrough infections. Significantly increased anti-RBD levels were observed in patients who received 3 doses and had breakthrough infection.
Conclusions: Three or four doses of COVID-19 vaccines were safe, increased immunogenicity, and protected against severe disease requiring hospitalization. Infection paired with multiple vaccinations significantly increased anti-RBD response. However, SOT populations should continue to practice infection prevention measures, and they should be prioritized for SARS-CoV-2 pre-exposure prophylactics and early therapeutics.
Keywords: SARS-CoV-2; solid organ transplant; vaccines.