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Poor humoral and T-cell response to two-dose SARS-CoV-2 messenger RNA vaccine BNT162b2 in cardiothoracic transplant recipients.
Schramm, René; Costard-Jäckle, Angelika; Rivinius, Rasmus; Fischer, Bastian; Müller, Benjamin; Boeken, Udo; Haneya, Assad; Provaznik, Zdenek; Knabbe, Cornelius; Gummert, Jan.
  • Schramm R; Klinik für Thorax- und Kardiovaskularchirurgie, Herz und Diabeteszentrum NRW, Universitätsklinik, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany.
  • Costard-Jäckle A; Klinik für Thorax- und Kardiovaskularchirurgie, Herz und Diabeteszentrum NRW, Universitätsklinik, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany. Ajaeckle@hdz-nrw.de.
  • Rivinius R; Klinik für Kardiologie, Angiologie Und Pneumologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany.
  • Fischer B; Institut für Transfusions- Und Labormedizin, Herz Und Diabeteszentrum NRW, Universitätsklinik, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany.
  • Müller B; Institut für Transfusions- Und Labormedizin, Herz Und Diabeteszentrum NRW, Universitätsklinik, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany.
  • Boeken U; Klinik für Herzchirurgie, Universitätsklinikum Düsseldorf, Heinrich Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
  • Haneya A; Klinik für Herznahe- und Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
  • Provaznik Z; Klinik für Herz-, Thorax- Und Herznahe Gefäßchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
  • Knabbe C; Institut für Transfusions- Und Labormedizin, Herz Und Diabeteszentrum NRW, Universitätsklinik, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany.
  • Gummert J; Klinik für Thorax- und Kardiovaskularchirurgie, Herz und Diabeteszentrum NRW, Universitätsklinik, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany.
Clin Res Cardiol ; 110(8): 1142-1149, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1303315
ABSTRACT

AIMS:

Immunocompromised patients have been excluded from studies of SARS-CoV-2 messenger RNA vaccines. The immune response to vaccines against other infectious agents has been shown to be blunted in such patients. We aimed to analyse the humoral and cellular response to prime-boost vaccination with the BNT162b2 vaccine (Pfizer-BioNTech) in cardiothoracic transplant recipients. METHODS AND

RESULTS:

A total of 50 transplant patients [1-3 years post heart (42), lung (7), or heart-lung (1) transplant, mean age 55 ± 10 years] and a control group of 50 healthy staff members were included. Blood samples were analysed 21 days after the prime and the boosting dose, respectively, to quantify anti-SARS-CoV-2 spike protein (S) immunoglobulin titres (tested by Abbott, Euroimmun and RocheElecsys Immunoassays, each) and the functional inhibitory capacity of neutralizing antibodies (Genscript). To test for a specific T-cell response, heparinized whole blood was stimulated with SARS-CoV-2 specific peptides, covering domains of the viral spike, nucleocapsid and membrane protein, and the interferon-γ release was measured (QuantiFERON Monitor ELISA, Qiagen). The vast majority of transplant patients (90%) showed neither a detectable humoral nor a T-cell response three weeks after the completed two-dose BNT162b2 vaccination; these results are in sharp contrast to the robust immunogenicity seen in the control group 98% exhibited seroconversion after the prime dose already, with a further significant increase of IgG titres after the booster dose (average > tenfold increase), a more than 90% inhibition capability of neutralizing antibodies as well as evidence of a T-cell responsiveness.

CONCLUSIONS:

The findings of poor immune responses to a two-dose BNT162b2 vaccination in cardiothoracic transplant patients have a significant impact for organ transplant recipients specifically and possibly for immunocompromised patients in general. It urges for a review of future vaccine strategies in these patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heart Transplantation / Lung Transplantation / Immunity, Humoral / Immunogenicity, Vaccine / COVID-19 Vaccines / COVID-19 / Immunity, Cellular / Immunosuppressive Agents Type of study: Experimental Studies / Observational study Topics: Vaccines Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Clin Res Cardiol Journal subject: Cardiology Year: 2021 Document Type: Article Affiliation country: S00392-021-01880-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heart Transplantation / Lung Transplantation / Immunity, Humoral / Immunogenicity, Vaccine / COVID-19 Vaccines / COVID-19 / Immunity, Cellular / Immunosuppressive Agents Type of study: Experimental Studies / Observational study Topics: Vaccines Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Clin Res Cardiol Journal subject: Cardiology Year: 2021 Document Type: Article Affiliation country: S00392-021-01880-5