Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine Type
BackgroundWhile anti-SARS-CoV-2 vaccination success in kidney transplant recipients (KTR) after two doses and 1273-mRNA was associated with higher seroconversion rates compared to BNT162b2-mRNA in our “DIA-Vacc Study” (NCT04799808), it remains unclear whether this may also be the case in non-respond...
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.910987/full |
| _version_ | 1817975997802217472 |
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| author | Julian Stumpf Julian Stumpf Jörg Schwöbel Claudia Karger Holger Schirutschke René Mauer Anna Klimova Torsten Tonn Torsten Tonn Christian Hugo Christian Hugo |
| author_facet | Julian Stumpf Julian Stumpf Jörg Schwöbel Claudia Karger Holger Schirutschke René Mauer Anna Klimova Torsten Tonn Torsten Tonn Christian Hugo Christian Hugo |
| author_sort | Julian Stumpf |
| collection | DOAJ |
| description | BackgroundWhile anti-SARS-CoV-2 vaccination success in kidney transplant recipients (KTR) after two doses and 1273-mRNA was associated with higher seroconversion rates compared to BNT162b2-mRNA in our “DIA-Vacc Study” (NCT04799808), it remains unclear whether this may also be the case in non-responding KTR after a third vaccination dose.Materials and MethodsNon-responding KTR (after two mRNA vaccinations) were investigated 4.5–6 months after study enrollment at first vaccination. One hundred sixty-six of 193 received a third vaccination between 3.5 and 5 months after the initial study enrollment and were always investigated 4 weeks later, exploring humoral immune response (ELISA) and specific cellular responses (interferon-γ release assay). Sixty-seven of 193 measurements in KTR were done immediately before the third vaccination or in KTR without further vaccination at 4.5–6 months.ResultsOf 193 KTR with no initial immune response 4 weeks after the second vaccination, 106/87 were immunized twice with 1273-mRNA/BNT162b2-mRNA, respectively. Additional mRNA booster vaccination led to positive seroconversion rates of 30–50%, while 16% of the initial non-responders demonstrated a delayed seroconversion without any booster vaccination. Using logistic regression analysis, a positive IgG response after the third vaccination was 23% more likely if the primary vaccine type was 1273-mRNA compared to BNT162b2-mRNA (OR = 4.420, 95% CI [1.208–16.173], p = 0.025). Primary vaccine type, a weak anti-SpikeS1 IgG response 4 weeks after second vaccination (3.2–35.2 BAU/ml, p < 0.001) and a lack of MMF/MPA as part of the immunosuppressive treatment (trend, p = 0.06) but no other variables studied correlated with seroconversion success.ConclusionThis observational study adds important evidence toward using 1273-mRNA as the primary mRNA vaccine type for immunosuppressed KTR. |
| first_indexed | 2024-04-13T21:56:45Z |
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| id | doaj.art-c5ebb9f20edb41a2b72dd7f55343c441 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-13T21:56:45Z |
| publishDate | 2022-07-01 |
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| series | Frontiers in Medicine |
| spelling | doaj.art-c5ebb9f20edb41a2b72dd7f55343c4412022-12-22T02:28:13ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-07-01910.3389/fmed.2022.910987910987Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine TypeJulian Stumpf0Julian Stumpf1Jörg Schwöbel2Claudia Karger3Holger Schirutschke4René Mauer5Anna Klimova6Torsten Tonn7Torsten Tonn8Christian Hugo9Christian Hugo10Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, GermanyKuratorium für Heimdialyse (KfH)-Nierenzentrum Dresden, Dresden, GermanyDialysezentrum Chemnitz, Chemnitz, GermanyKuratorium für Heimdialyse (KfH)-Nierenzentrum am Klinikum St. Georg, Leipzig, GermanyPatienten-Heimversorgung Gemeinnützige Stiftung (PHV) Dialysezentrum Dresden Friedrichstadt, Dresden, GermanyFaculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, GermanyNational Center for Tumor Diseases Dresden, Dresden, GermanyInstitute for Transfusion Medicine, German Red Cross Blood Donation Service North-East, Dresden, GermanyFaculty of Medicine Carl Gustav Carus, Transfusion Medicine, Technische Universität Dresden, Dresden, GermanyMedizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, GermanyKuratorium für Heimdialyse (KfH)-Nierenzentrum Dresden, Dresden, GermanyBackgroundWhile anti-SARS-CoV-2 vaccination success in kidney transplant recipients (KTR) after two doses and 1273-mRNA was associated with higher seroconversion rates compared to BNT162b2-mRNA in our “DIA-Vacc Study” (NCT04799808), it remains unclear whether this may also be the case in non-responding KTR after a third vaccination dose.Materials and MethodsNon-responding KTR (after two mRNA vaccinations) were investigated 4.5–6 months after study enrollment at first vaccination. One hundred sixty-six of 193 received a third vaccination between 3.5 and 5 months after the initial study enrollment and were always investigated 4 weeks later, exploring humoral immune response (ELISA) and specific cellular responses (interferon-γ release assay). Sixty-seven of 193 measurements in KTR were done immediately before the third vaccination or in KTR without further vaccination at 4.5–6 months.ResultsOf 193 KTR with no initial immune response 4 weeks after the second vaccination, 106/87 were immunized twice with 1273-mRNA/BNT162b2-mRNA, respectively. Additional mRNA booster vaccination led to positive seroconversion rates of 30–50%, while 16% of the initial non-responders demonstrated a delayed seroconversion without any booster vaccination. Using logistic regression analysis, a positive IgG response after the third vaccination was 23% more likely if the primary vaccine type was 1273-mRNA compared to BNT162b2-mRNA (OR = 4.420, 95% CI [1.208–16.173], p = 0.025). Primary vaccine type, a weak anti-SpikeS1 IgG response 4 weeks after second vaccination (3.2–35.2 BAU/ml, p < 0.001) and a lack of MMF/MPA as part of the immunosuppressive treatment (trend, p = 0.06) but no other variables studied correlated with seroconversion success.ConclusionThis observational study adds important evidence toward using 1273-mRNA as the primary mRNA vaccine type for immunosuppressed KTR.https://www.frontiersin.org/articles/10.3389/fmed.2022.910987/fullrevaccinationkidney transplant recipient (KTR)SARS-CoV-2humoral response1273-mRNABNT162b2-mRNA |
| spellingShingle | Julian Stumpf Julian Stumpf Jörg Schwöbel Claudia Karger Holger Schirutschke René Mauer Anna Klimova Torsten Tonn Torsten Tonn Christian Hugo Christian Hugo Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine Type Frontiers in Medicine revaccination kidney transplant recipient (KTR) SARS-CoV-2 humoral response 1273-mRNA BNT162b2-mRNA |
| title | Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine Type |
| title_full | Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine Type |
| title_fullStr | Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine Type |
| title_full_unstemmed | Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine Type |
| title_short | Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine Type |
| title_sort | anti sars cov 2 revaccination success in kidney transplant recipients with no initial humoral response is linked to primary vaccine type |
| topic | revaccination kidney transplant recipient (KTR) SARS-CoV-2 humoral response 1273-mRNA BNT162b2-mRNA |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.910987/full |
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