Antibody Response to a Fourth Dose of a SARS-CoV-2 Vaccine in Solid Organ Transplant Recipients

Abstract Background While it is presumed that immunosuppressed patients, such as solid organ transplant recipients on immunosuppression, are at greater risk from SARS-CoV-2 infection than the general population, the antibody response to infection in this patient population has not been studied. Methods In this report, we follow the anti-SARS-CoV-2 antibody levels in patients with COVID-19 who are undergoing exogenous immunosuppression. Specifically, we studied the antibody response of three solid organ transplant recipient patients, three patients who take daily inhaled fluticasone, and a patient on etanercept and daily inhaled fluticasone, and compared them to five patients not on exogenous immunosuppression. Results We found that the solid organ transplant patients on full immunosuppression are at risk of having a delayed antibody response and poor outcome. We did not find evidence that inhaled steroids nor etanercept predispose patients to delayed immune response to SARS-CoV-2. Conclusion The data presented here suggest that solid organ transplant recipients may be good candidates for early targeted intervention against SARS-CoV-2.

Download Full-text

Efficacy and Safety of Third Dose of the COVID-19 Vaccine among Solid Organ Transplant Recipients: A Systemic Review and Meta-Analysis

Vaccines ◽

10.3390/vaccines10010095 ◽

2022 ◽

Vol 10 (1) ◽

pp. 95

Author(s):

Orly Efros ◽

Roi Anteby ◽

Mirit Halfon ◽

Eshcar Meisel ◽

Eyal Klang ◽

...

Keyword(s):

Antibody Response ◽

Organ Transplant ◽

Vaccine Dose ◽

Solid Organ Transplant ◽

Solid Organ ◽

Efficacy And Safety ◽

Transplant Recipients ◽

Organ Transplant Recipients ◽

The Third ◽

Solid Organ Transplant Recipients

Solid organ transplant recipients were demonstrated to have reduced antibody response to the first and second doses of the COVID-19 mRNA vaccine. This review evaluated published data on the efficacy and safety of the third dose among solid organ transplant recipients. We performed a systematic search of PubMed, EMBASE, and Web of Science to retrieve studies evaluating the efficacy of the third dose of anti-SARS-CoV-2 vaccines in adult solid organ transplant recipients. Serologic response after the third vaccine was pooled using inverse variance and generalized linear mixed and random-effects models. Seven studies met our inclusion criteria. A total of 853 patients received the third dose. Except for one randomized controlled trial, all studies were retrospective in design. Following the third COVID-19 vaccine dose, antibody response occurred in 6.4–69.2% of patients. The pooled proportion of antibody response rate after the third vaccine was 50.3% (95% confidence interval (CI): 37.1–63.5, I2 = 90%). Five papers reported the safety profile. No severe adverse events were observed after the third vaccine dose. In conclusion, a third dose of the SARS-CoV-2 mRNA vaccine in solid organ transplant recipients is associated with improved immunogenicity and appears to be safe. Nevertheless, a significant portion of patients remain seronegative.

Download Full-text