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A third dose of SARS-CoV-2 vaccine increases neutralizing antibodies against variants of concern in solid organ transplant recipients.
Karaba, Andrew H; Zhu, Xianming; Liang, Tao; Wang, Kristy H; Rittenhouse, Alex G; Akinde, Olivia; Eby, Yolanda; Ruff, Jessica E; Blankson, Joel N; Abedon, Aura T; Alejo, Jennifer L; Cox, Andrea L; Bailey, Justin R; Thompson, Elizabeth A; Klein, Sabra L; Warren, Daniel S; Garonzik-Wang, Jacqueline M; Boyarsky, Brian J; Sitaras, Ioannis; Pekosz, Andrew; Segev, Dorry L; Tobian, Aaron A R; Werbel, William A.
  • Karaba AH; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Zhu X; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Liang T; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Wang KH; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Rittenhouse AG; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Akinde O; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Eby Y; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Ruff JE; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Blankson JN; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Abedon AT; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Alejo JL; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Cox AL; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Bailey JR; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
  • Thompson EA; Bloomberg Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Klein SL; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Warren DS; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Garonzik-Wang JM; Bloomberg Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Boyarsky BJ; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Sitaras I; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
  • Pekosz A; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Segev DL; Department of Surgery, University of Wisconsin School of Medicine and Health, Madison, Wisconsin.
  • Tobian AAR; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Werbel WA; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
Am J Transplant ; 22(4): 1253-1260, 2022 04.
Article in English | MEDLINE | ID: covidwho-1583700
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ABSTRACT
Vaccine-induced SARS-CoV-2 antibody responses are attenuated in solid organ transplant recipients (SOTRs) and breakthrough infections are more common. Additional SARS-CoV-2 vaccine doses increase anti-spike IgG in some SOTRs, but it is uncertain whether neutralization of variants of concern (VOCs) is enhanced. We tested 47 SOTRs for clinical and research anti-spike IgG, pseudoneutralization (ACE2 blocking), and live-virus neutralization (nAb) against VOCs before and after a third SARS-CoV-2 vaccine dose (70% mRNA, 30% Ad26.COV2.S) with comparison to 15 healthy controls after two mRNA vaccine doses. We used correlation analysis to compare anti-spike IgG assays and focused on thresholds associated with neutralization. A third SARS-CoV-2 vaccine dose increased median total anti-spike (1.6-fold), pseudoneutralization against VOCs (2.5-fold vs. Delta), and neutralizing antibodies (1.4-fold against Delta). However, neutralization activity was significantly lower than healthy controls (p < .001); 32% of SOTRs had zero detectable nAb against Delta after third vaccination compared to 100% for controls. Correlation with nAb was seen at anti-spike IgG >4 Log10 (AU/ml) on the Euroimmun ELISA and >4 Log10 (AU/ml) on the MSD research assay. These findings highlight benefits of a third vaccine dose for some SOTRs and the need for alternative strategies to improve protection in a significant subset of this population.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / COVID-19 Type of study: Experimental Studies / Prognostic study Topics: Vaccines / Variants Limits: Humans Language: English Journal: Am J Transplant Journal subject: Transplantation Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / COVID-19 Type of study: Experimental Studies / Prognostic study Topics: Vaccines / Variants Limits: Humans Language: English Journal: Am J Transplant Journal subject: Transplantation Year: 2022 Document Type: Article