Three-Month Follow-Up of Heterologous vs. Homologous Third SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Secondary Analysis of a Randomized Controlled Trial
Response to SARS-CoV-2-vaccines in kidney-transplant recipients (KTR) is severely reduced. Heterologous3rd vaccination combining mRNA and vector vaccines did not increase seroconversion at 4 weeks after vaccination, but evolution of antibody levels beyond the first month remains unknown. We have rec...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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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.2022.936126/full |
| _version_ | 1811242661357551616 |
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| author | Andreas Heinzel Eva Schrezenmeier Florina Regele Karin Hu Lukas Raab Michael Eder Christof Aigner Rhea Jabbour Constantin Aschauer Ana-Luisa Stefanski Thomas Dörner Klemens Budde Roman Reindl-Schwaighofer Rainer Oberbauer |
| author_facet | Andreas Heinzel Eva Schrezenmeier Florina Regele Karin Hu Lukas Raab Michael Eder Christof Aigner Rhea Jabbour Constantin Aschauer Ana-Luisa Stefanski Thomas Dörner Klemens Budde Roman Reindl-Schwaighofer Rainer Oberbauer |
| author_sort | Andreas Heinzel |
| collection | DOAJ |
| description | Response to SARS-CoV-2-vaccines in kidney-transplant recipients (KTR) is severely reduced. Heterologous3rd vaccination combining mRNA and vector vaccines did not increase seroconversion at 4 weeks after vaccination, but evolution of antibody levels beyond the first month remains unknown. We have recently completed a randomized-controlled trial on heterologous (Ad26COVS1) vs. homologous (BNT162b2 or mRNA-1273) 3rd vaccination in 201 KTR not developing SARS-CoV-2-spike-protein antibodies following two doses of mRNA vaccine (EurdraCT: 2021-002927-39). Here, we report seroconversion at the second follow-up at 3 months after the 3rd vaccination (prespecified secondary endpoint). In addition, higher cut-off levels associated with neutralizing capacity and protective immunity were applied (i.e., > 15, > 100, > 141, and > 264 BAU/ml). A total of 169 patients were available for the 3-month follow-up. Overall, seroconversion at 3 months was similar between both groups (45 vs. 50% for mRNA and the vector group, respectively; p = 0.539). However, when applying higher cut-off levels, a significantly larger number of individuals in the vector group reached antibody levels > 141 and > 264 BAU/ml at the 3-month follow-up (141 BAU/ml: 4 vs. 15%, p = 0.009 and 264 BAU/ml: 1 vs. 10%, p = 0.018 for mRNA vs. the vector vaccine group, respectively). In line, antibody levels in seroconverted patients further increased from month 1 to month 3 in the vector group while remaining unchanged in the mRNA group (median increase: mRNA = 1.35 U/ml and vector = 27.6 U/ml, p = 0.004). Despite a similar overall seroconversion rate at 3 months following 3rd vaccination in KTR, a heterologous 3rd booster vaccination with Ad26COVS1 resulted in significantly higher antibody levels in responders. |
| first_indexed | 2024-04-12T13:54:29Z |
| format | Article |
| id | doaj.art-e1d9ff5f208645ef9b1a599edff0a47e |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T13:54:29Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-e1d9ff5f208645ef9b1a599edff0a47e2022-12-22T03:30:25ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-07-01910.3389/fmed.2022.936126936126Three-Month Follow-Up of Heterologous vs. Homologous Third SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Secondary Analysis of a Randomized Controlled TrialAndreas Heinzel0Eva Schrezenmeier1Florina Regele2Karin Hu3Lukas Raab4Michael Eder5Christof Aigner6Rhea Jabbour7Constantin Aschauer8Ana-Luisa Stefanski9Thomas Dörner10Klemens Budde11Roman Reindl-Schwaighofer12Rainer Oberbauer13Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDepartment of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDepartment of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaResponse to SARS-CoV-2-vaccines in kidney-transplant recipients (KTR) is severely reduced. Heterologous3rd vaccination combining mRNA and vector vaccines did not increase seroconversion at 4 weeks after vaccination, but evolution of antibody levels beyond the first month remains unknown. We have recently completed a randomized-controlled trial on heterologous (Ad26COVS1) vs. homologous (BNT162b2 or mRNA-1273) 3rd vaccination in 201 KTR not developing SARS-CoV-2-spike-protein antibodies following two doses of mRNA vaccine (EurdraCT: 2021-002927-39). Here, we report seroconversion at the second follow-up at 3 months after the 3rd vaccination (prespecified secondary endpoint). In addition, higher cut-off levels associated with neutralizing capacity and protective immunity were applied (i.e., > 15, > 100, > 141, and > 264 BAU/ml). A total of 169 patients were available for the 3-month follow-up. Overall, seroconversion at 3 months was similar between both groups (45 vs. 50% for mRNA and the vector group, respectively; p = 0.539). However, when applying higher cut-off levels, a significantly larger number of individuals in the vector group reached antibody levels > 141 and > 264 BAU/ml at the 3-month follow-up (141 BAU/ml: 4 vs. 15%, p = 0.009 and 264 BAU/ml: 1 vs. 10%, p = 0.018 for mRNA vs. the vector vaccine group, respectively). In line, antibody levels in seroconverted patients further increased from month 1 to month 3 in the vector group while remaining unchanged in the mRNA group (median increase: mRNA = 1.35 U/ml and vector = 27.6 U/ml, p = 0.004). Despite a similar overall seroconversion rate at 3 months following 3rd vaccination in KTR, a heterologous 3rd booster vaccination with Ad26COVS1 resulted in significantly higher antibody levels in responders.https://www.frontiersin.org/articles/10.3389/fmed.2022.936126/fullCOVID-19kidney transplantationCOVID-19 vaccinationheterologous vaccinationthird vaccination |
| spellingShingle | Andreas Heinzel Eva Schrezenmeier Florina Regele Karin Hu Lukas Raab Michael Eder Christof Aigner Rhea Jabbour Constantin Aschauer Ana-Luisa Stefanski Thomas Dörner Klemens Budde Roman Reindl-Schwaighofer Rainer Oberbauer Three-Month Follow-Up of Heterologous vs. Homologous Third SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Secondary Analysis of a Randomized Controlled Trial Frontiers in Medicine COVID-19 kidney transplantation COVID-19 vaccination heterologous vaccination third vaccination |
| title | Three-Month Follow-Up of Heterologous vs. Homologous Third SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Secondary Analysis of a Randomized Controlled Trial |
| title_full | Three-Month Follow-Up of Heterologous vs. Homologous Third SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Secondary Analysis of a Randomized Controlled Trial |
| title_fullStr | Three-Month Follow-Up of Heterologous vs. Homologous Third SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Secondary Analysis of a Randomized Controlled Trial |
| title_full_unstemmed | Three-Month Follow-Up of Heterologous vs. Homologous Third SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Secondary Analysis of a Randomized Controlled Trial |
| title_short | Three-Month Follow-Up of Heterologous vs. Homologous Third SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Secondary Analysis of a Randomized Controlled Trial |
| title_sort | three month follow up of heterologous vs homologous third sars cov 2 vaccination in kidney transplant recipients secondary analysis of a randomized controlled trial |
| topic | COVID-19 kidney transplantation COVID-19 vaccination heterologous vaccination third vaccination |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.936126/full |
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