SARS-CoV-2 messenger RNA vaccine antibody response and reactogenicity in heart and lung transplant recipients.
J Heart Lung Transplant
; 40(12): 1579-1588, 2021 12.
Article
in English
| MEDLINE | ID: covidwho-1347615
ABSTRACT
BACKGROUND:
While several studies have observed that solid organ transplant recipients experience diminished antibody responses to SARS-CoV-2 mRNA vaccination, data specific to heart and lung transplant (HT/LT) recipients remains sparse.METHODS:
US adult HT and LT recipients completed their vaccine series between January 7 and April 10, 2021. Reactogencity and SARS-CoV-2 anti-spike antibody were assessed after a priming dose (D1) and booster dose (D2). Modified Poisson regression with robust variance estimator was used to evaluate associations between participant characteristics and antibody development.RESULTS:
Of 134 heart recipients, there were 38% non-responders (D1-/D2-), 48% booster responders (D1-/D2+), and 14% priming dose responders (D1+/D2+). Of 103 lung recipients, 64% were non-responders, 27% were booster responders, and 9% were priming dose responders. Lung recipients were less likely to develop antibodies (p < .001). Priming dose antibody response was associated with younger recipient age (p = .04), transplant-to-vaccination time ≥6 years (p < .01), and lack of anti-metabolite maintenance immunosuppression (p < .001). Pain at injection site was the most commonly reported reaction (85% after D1, 76% after D2). Serious reactions were rare, the most common being fatigue (2% after D1 and 3% after D2). No serious adverse events were reported.CONCLUSIONS:
HT and LT recipients experienced diminished antibody response following vaccination; reactogenicity was comparable to that of the general population. LT recipients may exhibit a more impaired antibody response than HT recipients. While current recommendations are to vaccinate eligible candidates and recipients, further studies characterizing the cell-mediated immune response and clinical efficacy of these vaccines in this population are needed.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Heart Transplantation
/
Kidney Transplantation
/
Immunogenicity, Vaccine
/
BNT162 Vaccine
/
2019-nCoV Vaccine mRNA-1273
/
Antibodies, Viral
Type of study:
Experimental Studies
/
Prognostic study
Topics:
Vaccines
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Heart Lung Transplant
Journal subject:
Cardiology
/
Transplantation
Year:
2021
Document Type:
Article
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