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SARS-CoV-2 messenger RNA vaccine antibody response and reactogenicity in heart and lung transplant recipients.
Hallett, Andrew M; Greenberg, Ross S; Boyarsky, Brian J; Shah, Pali D; Ou, Michael T; Teles, Aura T; Krach, Michelle R; López, Julia I; Werbel, William A; Avery, Robin K; Bae, Sunjae; Tobian, Aaron A; Massie, Allan B; Higgins, Robert S D; Garonzik-Wang, Jacqueline M; Segev, Dorry L; Bush, Errol L.
  • Hallett AM; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Greenberg RS; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Boyarsky BJ; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Shah PD; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Ou MT; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Teles AT; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Krach MR; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • López JI; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Werbel WA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Avery RK; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Bae S; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Tobian AA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
  • Massie AB; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Higgins RSD; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Garonzik-Wang JM; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Segev DL; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
  • Bush EL; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: errol.bush@jhu.edu.
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heart Transplantation / Kidney Transplantation / Immunogenicity, Vaccine / 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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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heart Transplantation / Kidney Transplantation / Immunogenicity, Vaccine / 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