Benefits of Inactivated Vaccine and Viral Vector Vaccine Immunization on Covid-19 Infection in Kidney Transplant Recipients

ABSTRACT

Purpose: Most developing countries do not have access to high-efficiency mRNA vaccine. In Thailand, the first and most available vaccines were inactivated, and later on, viral vector vaccine. Here, we reported the efficacy of inactivated and viral vector vaccine in preventing severe disease and death in kidney transplant recipients. Method(s) This is a retrospective study comprised 45 kidney transplant recipients with Covid-19 infection. Patients were classified into 2 groups based on vaccination status before COVID-19 infection. Patients in group 1 were vaccinated with either inactivated or viral vector vaccine and patients in group 2 were unvaccinated. Group 1 was also subdivided into fully and partially vaccinated. All patients received the same standard of care. Outcomes of interest were rate of death, pneumonia and requirement of oxygen therapy. Result(s) There were 23 patients (51%) in group 1 [7 fully vaccinated (5 inactivated, 2 viral vector), 16 partially vaccinated (all viral vector)] and 22 patients (49%) in group 2. All of baseline characteristics including recipient factors, donor factors, immunologic factors and immunosuppressive regimens were similar between groups except only mean recipient age was older in group 1 (55 +/- 11 years in group 1 VS 48 +/- 15 years in group 2, p = 0.035). Of 45 patients in this study, 11 patients died (24%). Significantly more death occurred in group 2. Three patients (all partially vaccinated) and 8 patients died in group 1 and group 2 respectively (13% VS 36%, p = 0.03). No patient receiving full vaccination died. Pneumonia developed equally in both groups (70% VS 71%, p = 0.89). There was a trend toward less oxygen requirement in group 1 (50% VS 74% p = 0.10) as well as less ventilator requirement (9% VS 19% p = 0.48). Conclusion(s) Inactivated and viral vector COVID-19 vaccines have good efficacy in mortality reduction in kidney transplant recipients. Even partial vaccination can exert some protection against death. However, to achieve better prevention, full vaccination should be encouraged to all kidney transplant recipients.