tetano
Editor, Senior Moderator
Transplantation
. 2022 Aug 5.
doi: 10.1097/TP.0000000000004260. Online ahead of print.
Immunogenicity After a Heterologous BNT262b2 Versus Homologous Booster in Kidney Transplant Recipients Receiving 2 Doses of CoronaVac Vaccine: A Prospective Cohort Study
José Medina-Pestana[SUP] 1 [/SUP], Laila Almeida Viana[SUP] 1 [/SUP], Monica Rika Nakamura[SUP] 1 [/SUP], Elizabeth França Lucena[SUP] 1 [/SUP], Celso Francisco Hernandes Granato[SUP] 2 [/SUP], Yasmim Cardoso Dreige[SUP] 1 [/SUP], Laysla Verhalen Pouzo Amorim[SUP] 1 [/SUP], Charles Yea Zen Chow[SUP] 1 [/SUP], Renato Demarchi Foresto[SUP] 1 [/SUP], Lucio Roberto Requião-Moura[SUP] 1 [/SUP], Helio Tedesco-Silva[SUP] 1 [/SUP], Marina Pontello Cristelli[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Comparative studies of third heterologous doses following the CoronaVac vaccine against coronavirus disease 2019 (COVID-19) in kidney transplant recipients are lacking.
Methods: This prospective, single-center cohort study included kidney transplant recipients without previous COVID-19. Patients received a third heterologous (BNT162b2 mRNA) or homologous dose at least 4 wk after 2 doses of the CoronaVac vaccine. Immunoglobulin G antibody response and seroprevalence for neutralizing anti-severe acute respiratory syndrome coronavirus 2 antibodies immediately before and 28 d after third doses were compared between the groups.
Results: There were 307 patients in the heterologous group and 777 in the homologous group. Patients in the heterologous group were older (54 versus 50 y; P < 0.0001), with a longer time since transplant (11 versus 6 y; P < 0.0001). Immediately before the third dose, immunoglobulin G seroprevalence (36% versus 34%; P = 0.597) and antibody titers (246 versus 268 AU/mL; P = 0.279) were similar. After booster, seroconversion was higher in the heterologous group (49% versus 32%; P < 0.0001), resulting in a higher seroprevalence (67% versus 55%; P = 0.0003); however, 42% of all patients remained seronegative. Antibody titers after booster in seropositive patients were higher in the heterologous group (7771 versus 599 AU/mL; P < 0.0001). These results persisted after adjusting for confounding variables. Lastly, a similar proportion of patients became seropositive for neutralizing antibodies (98% versus 94%; P = 0.098).
Conclusions: In kidney transplant recipients fully vaccinated with CoronaVac, a third dose with an mRNA vaccine produced a higher seroconversion rate and antibody titers than a third homologous dose. However, both boosters achieved equivalent seroprevalence for neutralizing antibodies. The high proportion of still seronegative patients indicates the need for alternative strategies of protection.
. 2022 Aug 5.
doi: 10.1097/TP.0000000000004260. Online ahead of print.
Immunogenicity After a Heterologous BNT262b2 Versus Homologous Booster in Kidney Transplant Recipients Receiving 2 Doses of CoronaVac Vaccine: A Prospective Cohort Study
José Medina-Pestana[SUP] 1 [/SUP], Laila Almeida Viana[SUP] 1 [/SUP], Monica Rika Nakamura[SUP] 1 [/SUP], Elizabeth França Lucena[SUP] 1 [/SUP], Celso Francisco Hernandes Granato[SUP] 2 [/SUP], Yasmim Cardoso Dreige[SUP] 1 [/SUP], Laysla Verhalen Pouzo Amorim[SUP] 1 [/SUP], Charles Yea Zen Chow[SUP] 1 [/SUP], Renato Demarchi Foresto[SUP] 1 [/SUP], Lucio Roberto Requião-Moura[SUP] 1 [/SUP], Helio Tedesco-Silva[SUP] 1 [/SUP], Marina Pontello Cristelli[SUP] 1 [/SUP]
Affiliations
- PMID: 35939382
- DOI: 10.1097/TP.0000000000004260
Abstract
Background: Comparative studies of third heterologous doses following the CoronaVac vaccine against coronavirus disease 2019 (COVID-19) in kidney transplant recipients are lacking.
Methods: This prospective, single-center cohort study included kidney transplant recipients without previous COVID-19. Patients received a third heterologous (BNT162b2 mRNA) or homologous dose at least 4 wk after 2 doses of the CoronaVac vaccine. Immunoglobulin G antibody response and seroprevalence for neutralizing anti-severe acute respiratory syndrome coronavirus 2 antibodies immediately before and 28 d after third doses were compared between the groups.
Results: There were 307 patients in the heterologous group and 777 in the homologous group. Patients in the heterologous group were older (54 versus 50 y; P < 0.0001), with a longer time since transplant (11 versus 6 y; P < 0.0001). Immediately before the third dose, immunoglobulin G seroprevalence (36% versus 34%; P = 0.597) and antibody titers (246 versus 268 AU/mL; P = 0.279) were similar. After booster, seroconversion was higher in the heterologous group (49% versus 32%; P < 0.0001), resulting in a higher seroprevalence (67% versus 55%; P = 0.0003); however, 42% of all patients remained seronegative. Antibody titers after booster in seropositive patients were higher in the heterologous group (7771 versus 599 AU/mL; P < 0.0001). These results persisted after adjusting for confounding variables. Lastly, a similar proportion of patients became seropositive for neutralizing antibodies (98% versus 94%; P = 0.098).
Conclusions: In kidney transplant recipients fully vaccinated with CoronaVac, a third dose with an mRNA vaccine produced a higher seroconversion rate and antibody titers than a third homologous dose. However, both boosters achieved equivalent seroprevalence for neutralizing antibodies. The high proportion of still seronegative patients indicates the need for alternative strategies of protection.