Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis

Solid organ transplant (SOT) recipients are at increased risk of COVID-19 infection because of their suppressed immunity. The available data show that COVID-19 vaccines are less effective in SOT recipients. We aimed to assess the cellular and humoral immunogenicity with an increasing the number of d...

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Main Authors: Abdulmalik S. Alotaibi, Heba A. Shalabi, Abdullah A. Alhifany, Nouf E. Alotaibi, Mohammed A. Alnuhait, Abdulrahman R. Altheaby, Abdulfattah Y. Alhazmi
Format: Article
Language:English
Published: MDPI AG 2023-06-01
Series:Vaccines
Subjects:
Online Access:https://www.mdpi.com/2076-393X/11/7/1166
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author Abdulmalik S. Alotaibi
Heba A. Shalabi
Abdullah A. Alhifany
Nouf E. Alotaibi
Mohammed A. Alnuhait
Abdulrahman R. Altheaby
Abdulfattah Y. Alhazmi
author_facet Abdulmalik S. Alotaibi
Heba A. Shalabi
Abdullah A. Alhifany
Nouf E. Alotaibi
Mohammed A. Alnuhait
Abdulrahman R. Altheaby
Abdulfattah Y. Alhazmi
author_sort Abdulmalik S. Alotaibi
collection DOAJ
description Solid organ transplant (SOT) recipients are at increased risk of COVID-19 infection because of their suppressed immunity. The available data show that COVID-19 vaccines are less effective in SOT recipients. We aimed to assess the cellular and humoral immunogenicity with an increasing the number of doses of COVID-19 vaccines in SOT recipients and to identify factors affecting vaccine response in this population. A systematic review and meta-analysis were conducted to identify ongoing and completed studies of humoral and cellular immunity following COVID-19 vaccines in SOT recipients. The search retrieved 278 results with 45 duplicates, and 43 records did not match the inclusion criteria. After title and abstract screening, we retained 189 records, and 135 records were excluded. The reasons for exclusion involved studies with immunocompromised patients (non-transplant recipients), dialysis patients, and individuals who had already recovered from SARS-CoV-2 infection. After full-text reading, 55 observational studies and randomized clinical trials (RCTs) were included. The proportion of responders appeared higher after the third, fourth, and fifth doses. The risk factors for non-response included older age and the use of mycophenolate mofetil, corticosteroids, and other immunosuppressants. This systematic review and meta-analysis demonstrates the immunogenicity following different doses of COVID-19 vaccines among SOT patients. Due to the low immunogenicity of vaccines, additional strategies to improve vaccine response may be necessary.
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spelling doaj.art-83b66fd704f8476d814726670ad8fc4e2023-11-18T21:40:33ZengMDPI AGVaccines2076-393X2023-06-01117116610.3390/vaccines11071166Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-AnalysisAbdulmalik S. Alotaibi0Heba A. Shalabi1Abdullah A. Alhifany2Nouf E. Alotaibi3Mohammed A. Alnuhait4Abdulrahman R. Altheaby5Abdulfattah Y. Alhazmi6Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi ArabiaClinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi ArabiaClinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi ArabiaClinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi ArabiaClinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi ArabiaOrgan Transplant Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi ArabiaClinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi ArabiaSolid organ transplant (SOT) recipients are at increased risk of COVID-19 infection because of their suppressed immunity. The available data show that COVID-19 vaccines are less effective in SOT recipients. We aimed to assess the cellular and humoral immunogenicity with an increasing the number of doses of COVID-19 vaccines in SOT recipients and to identify factors affecting vaccine response in this population. A systematic review and meta-analysis were conducted to identify ongoing and completed studies of humoral and cellular immunity following COVID-19 vaccines in SOT recipients. The search retrieved 278 results with 45 duplicates, and 43 records did not match the inclusion criteria. After title and abstract screening, we retained 189 records, and 135 records were excluded. The reasons for exclusion involved studies with immunocompromised patients (non-transplant recipients), dialysis patients, and individuals who had already recovered from SARS-CoV-2 infection. After full-text reading, 55 observational studies and randomized clinical trials (RCTs) were included. The proportion of responders appeared higher after the third, fourth, and fifth doses. The risk factors for non-response included older age and the use of mycophenolate mofetil, corticosteroids, and other immunosuppressants. This systematic review and meta-analysis demonstrates the immunogenicity following different doses of COVID-19 vaccines among SOT patients. Due to the low immunogenicity of vaccines, additional strategies to improve vaccine response may be necessary.https://www.mdpi.com/2076-393X/11/7/1166solid organ transplantimmunosuppressed patientshumoral and cellular immunityCOVID-19 vaccineBNT162b2 (BioNTech/Pfizer)kidney transplant
spellingShingle Abdulmalik S. Alotaibi
Heba A. Shalabi
Abdullah A. Alhifany
Nouf E. Alotaibi
Mohammed A. Alnuhait
Abdulrahman R. Altheaby
Abdulfattah Y. Alhazmi
Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis
Vaccines
solid organ transplant
immunosuppressed patients
humoral and cellular immunity
COVID-19 vaccine
BNT162b2 (BioNTech/Pfizer)
kidney transplant
title Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis
title_full Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis
title_fullStr Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis
title_full_unstemmed Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis
title_short Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis
title_sort humoral and cellular immunity following five doses of covid 19 vaccines in solid organ transplant recipients a systematic review and meta analysis
topic solid organ transplant
immunosuppressed patients
humoral and cellular immunity
COVID-19 vaccine
BNT162b2 (BioNTech/Pfizer)
kidney transplant
url https://www.mdpi.com/2076-393X/11/7/1166
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