Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant Patients
Purpose: COVID-19 causes high mortality in Lung Transplant (LTx) patients, therefore vaccination in this population is potentially life-saving. However, the antibody response is impaired after three vaccinations in LTx patients. We questioned whether this response might be increased, and therefore s...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/12/4125 |
| _version_ | 1797594041996541952 |
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| author | Johanna van Gemert Fleur Steenberg Coretta van Leer-Buter Huib Kerstjens Willie Steenhuis Onno Akkerman Erik Verschuuren Tji Gan |
| author_facet | Johanna van Gemert Fleur Steenberg Coretta van Leer-Buter Huib Kerstjens Willie Steenhuis Onno Akkerman Erik Verschuuren Tji Gan |
| author_sort | Johanna van Gemert |
| collection | DOAJ |
| description | Purpose: COVID-19 causes high mortality in Lung Transplant (LTx) patients, therefore vaccination in this population is potentially life-saving. However, the antibody response is impaired after three vaccinations in LTx patients. We questioned whether this response might be increased, and therefore studied the serological IgG antibody response across up to five doses of the SARS-CoV-2 vaccine. In addition, risk factors for non-response were investigated. Methods: In this large retrospective cohort study, antibody responses were assessed after 1–5 mRNA-based SARS-CoV-2 vaccines in all LTx patients between February 2021 and September 2022. A positive vaccine response was defined as an IgG level ≥ 300 BAU/mL. Positive antibody responses due to COVID-19 infection were excluded from the analysis. Outcome and clinical parameters were compared between responders and non-responders, and multivariable logistic regression analysis was performed to determine the risk factors for vaccine-response failure. Results: The antibody responses of 292 LTx patients were analyzed. Positive antibody response to 1–5 SARS-CoV-2 vaccinations occurred in 0%, 15%, 36%, 46%, and 51%, respectively. During the study period, 146/292 (50%) of the vaccinated individuals tested positive for SARS-CoV-2 infection. The COVID-19-related mortality was 2.7% (4/146), and all four patients were non-responders. Risk factors associated with non-response to SARS-CoV-2 vaccines in univariable analyses were age (<i>p</i> = 0.004), chronic kidney disease (CKD) (<i>p</i> = 0.006), and shorter time since transplantation (<i>p</i> = 0.047). In the multivariable analysis, they were CKD (<i>p</i> = 0.043), and shorter time since transplantation (<i>p</i> = 0.028). Conclusion: A two- to five-dose regime of SARS-CoV-2 vaccines in LTx patients increases the probability of vaccine response and results in a cumulative vaccine response in 51% of the LTx population. LTx patient antibody response to SARS-CoV-2 vaccinations is therefore impaired, especially in patients shortly after LTx, patients with CKD, and the elderly. |
| first_indexed | 2024-03-11T02:18:03Z |
| format | Article |
| id | doaj.art-16a6291700934de8904e2c0fe7174ecb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T02:18:03Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-16a6291700934de8904e2c0fe7174ecb2023-11-18T11:01:18ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011212412510.3390/jcm12124125Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant PatientsJohanna van Gemert0Fleur Steenberg1Coretta van Leer-Buter2Huib Kerstjens3Willie Steenhuis4Onno Akkerman5Erik Verschuuren6Tji Gan7Department of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Virology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsPurpose: COVID-19 causes high mortality in Lung Transplant (LTx) patients, therefore vaccination in this population is potentially life-saving. However, the antibody response is impaired after three vaccinations in LTx patients. We questioned whether this response might be increased, and therefore studied the serological IgG antibody response across up to five doses of the SARS-CoV-2 vaccine. In addition, risk factors for non-response were investigated. Methods: In this large retrospective cohort study, antibody responses were assessed after 1–5 mRNA-based SARS-CoV-2 vaccines in all LTx patients between February 2021 and September 2022. A positive vaccine response was defined as an IgG level ≥ 300 BAU/mL. Positive antibody responses due to COVID-19 infection were excluded from the analysis. Outcome and clinical parameters were compared between responders and non-responders, and multivariable logistic regression analysis was performed to determine the risk factors for vaccine-response failure. Results: The antibody responses of 292 LTx patients were analyzed. Positive antibody response to 1–5 SARS-CoV-2 vaccinations occurred in 0%, 15%, 36%, 46%, and 51%, respectively. During the study period, 146/292 (50%) of the vaccinated individuals tested positive for SARS-CoV-2 infection. The COVID-19-related mortality was 2.7% (4/146), and all four patients were non-responders. Risk factors associated with non-response to SARS-CoV-2 vaccines in univariable analyses were age (<i>p</i> = 0.004), chronic kidney disease (CKD) (<i>p</i> = 0.006), and shorter time since transplantation (<i>p</i> = 0.047). In the multivariable analysis, they were CKD (<i>p</i> = 0.043), and shorter time since transplantation (<i>p</i> = 0.028). Conclusion: A two- to five-dose regime of SARS-CoV-2 vaccines in LTx patients increases the probability of vaccine response and results in a cumulative vaccine response in 51% of the LTx population. LTx patient antibody response to SARS-CoV-2 vaccinations is therefore impaired, especially in patients shortly after LTx, patients with CKD, and the elderly.https://www.mdpi.com/2077-0383/12/12/4125COVID-19vaccinelung transplantation |
| spellingShingle | Johanna van Gemert Fleur Steenberg Coretta van Leer-Buter Huib Kerstjens Willie Steenhuis Onno Akkerman Erik Verschuuren Tji Gan Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant Patients Journal of Clinical Medicine COVID-19 vaccine lung transplantation |
| title | Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant Patients |
| title_full | Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant Patients |
| title_fullStr | Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant Patients |
| title_full_unstemmed | Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant Patients |
| title_short | Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant Patients |
| title_sort | increasing antibody responses to five doses of sars cov 2 mrna vaccine in lung transplant patients |
| topic | COVID-19 vaccine lung transplantation |
| url | https://www.mdpi.com/2077-0383/12/12/4125 |
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