Three Doses of an mRNA Covid-19 Vaccine in Solid-Organ Transplant Recipients

International audienceA weak immune response to two doses of vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed in recipients of solid-organ transplants. Severe cases of coronavirus disease 2019 (Covid-19) have also been reported in transplant recipients who had received two doses of vaccine. These reports prompted the French National Authority for Health to recommend the use of a third dose in immunosuppressed patients. Here, we report the humoral response in a group of 101 consecutive solid-organ transplant recipients (mean [±SD] age, 58±2 years; 69% were men) who were given three doses of the messenger RNA vaccine BNT162b2 (Pfizer–BioNTech). The group included 78 kidney-transplant recipients, 12 liver-transplant recipients, 8 lung-transplant or heart-transplant recipients, and 3 pancreas-transplant recipients

Assessment of 4 Doses of SARS-CoV-2 Messenger RNA–Based Vaccine in Recipients of a Solid Organ Transplant

International audienceThis case series study assesses whether a fourth dose of a SARS-CoV-2 messenger RNA (mRNA)–based vaccine is associated with improved anti–SARS-CoV-2 antibody response in solid organ transplant recipients in France

Efficiency of a boost with a third dose of anti‐SARS‐CoV‐2 messenger RNA‐based vaccines in solid organ transplant recipients

International audienceA weak humoral response to two-doses of SARS-CoV-2 vaccine was observed in solid organ transplant (SOT) patients. Preliminary reports suggested the usefulness of a boost with a third dose. Herein, we report the humoral response in 396 SOT patients (mean age 59 ± 15 years, 65% men) who were given three doses messenger RNA-based vaccine (BNT162b2 vaccine [Pfizer-BioNTech]) (Table S1). Of these, 101 were included in our previous report.3 The two first doses were given one month apart, and the third dose was administered 59 (IQR25-75: 47–67) days after the second dose, that is, once the third dose was recommended by the French National Authority for Health. Anti-SARS-CoV-2 spike protein total antibodies were assessed the day of vaccination before the injection using either the Wantai enzyme-linked immunosorbent assay test (Beijing Wantai Biological Pharmacy Enterprise) (228 patients, 57.6%), or another anti-SARS-CoV-2 spike protein assay (n = 168) (Table S2). According to French law (loi Jardé), anonymous retrospective studies do not require institutional review board approval

Safety and Immunogenicity of Anti–SARS-CoV-2 Messenger RNA Vaccines in Recipients of Solid Organ Transplants

International audienceBackground: Recipients of solid organ transplant (SOT) are a high-risk group for severe SARS-CoV-2 infection. The mortality rate of patients with SOT during the COVID-19 pandemic has been reported to be approximately 20% (1). The anti–SARS-CoV-2 vaccines represent a hope to protect this population against this life-threatening infection.Objective: To assess the humoral response to messenger RNA (mRNA)–based vaccination in recipients of SOT.Methods: All patients with heart, kidney, liver, or pancreas transplants from the Midi-Pyrénées region (southwest France) are followed in our department. When the vaccination campaign started (7 January 2021), these patients were invited via text message, e-mail, or transplant patients' associations to be vaccinated. Patients were asked to register via a dedicated telephone number or website. They were vaccinated consecutively according to their registration date. According to the recommendations of the Francophone Society of Transplantation, anti–SARS-CoV-2 spike protein antibodies were monitored before and after vaccination. We used the SARS-CoV-2 total antibodies enzyme-linked immunosorbent assay test (Beijing Wantai Biological Pharmacy Enterprise) (80% of patients) or another validated anti–SARS-CoV-2 spike protein assay. According to French law (loi Jardé), anonymous retrospective studies do not require institutional review board approval.Findings: By 16 April 2021, 950 patients of the 2666 from our cohort had received at least 1 dose of an mRNA vaccine (BNT162b2 vaccine [Pfizer-BioNTech], n = 942; mRNA-1273 vaccine [Moderna], n = 8) and had anti–SARS-CoV-2 antibodies monitored. Fifty patients had vaccination without monitoring of antibodies, 80 patients are planned to be vaccinated within the next month, and 257 patients declined the vaccine. We had no feedback from the remaining 1329 patients

Humoral and Cellular Immune Responses of Solid Organ Transplant Patients on Belatacept to Three Doses of mRNA-Based Anti-SARS-CoV-2 Vaccine

International audienceBackground: Two doses of anti-SARS-CoV-2 mRNA-based vaccines are poorly immunogenic in solid organ transplant recipients (SOT). Methods: In total, 68 belatacept-treated SOT recipients followed at the Toulouse University Hospital were investigated. They were given three injections of the BNT162b2 mRNA COVID-19 vaccine. Their humoral response was assessed by determining anti-spike antibodies and neutralizing antibodies. The T-cell responses were assessed using an enzyme-linked immunospot assay that measured the interferon-γ produced by specific SARS-CoV-2 T-cells in a subgroup of 17 patients. Results: Only 23.5% of these patients developed a detectable anti-spike response. Moreover, the cellular and the humoral responses were well correlated. Patients with no humoral response were also without a detectable cellular response. Those belatacept-treated patients who developed an anti-SARS-CoV-2 humoral response were younger, had been transplanted for longer, and had a higher lymphocyte count and a better glomerular filtration rate than those with no response. Finally, patients on tacrolimus plus belatacept produced a lower immune response. Conclusions: Belatacept-treated SOT recipients have a reduced immune response to anti-SARS-CoV-2 mRNA vaccination. The vaccine should be given quite separately from the belatacept infusion to improve immunogenicity. Studies to assess whether switching to another immunosuppressive regimen can improve the post-vaccination immune response would be useful

Humoral and Cellular Immune Responses of Solid Organ Transplant Patients on Belatacept to Three Doses of mRNA-Based Anti-SARS-CoV-2 Vaccine

Background: Two doses of anti-SARS-CoV-2 mRNA-based vaccines are poorly immunogenic in solid organ transplant recipients (SOT). Methods: In total, 68 belatacept-treated SOT recipients followed at the Toulouse University Hospital were investigated. They were given three injections of the BNT162b2 mRNA COVID-19 vaccine. Their humoral response was assessed by determining anti-spike antibodies and neutralizing antibodies. The T-cell responses were assessed using an enzyme-linked immunospot assay that measured the interferon-γ produced by specific SARS-CoV-2 T-cells in a subgroup of 17 patients. Results: Only 23.5% of these patients developed a detectable anti-spike response. Moreover, the cellular and the humoral responses were well correlated. Patients with no humoral response were also without a detectable cellular response. Those belatacept-treated patients who developed an Anti-SARS-CoV-2 humoral response were younger, had been transplanted for longer, and had a higher lymphocyte count and a better glomerular filtration rate than those with no response. Finally, patients on tacrolimus plus belatacept produced a lower immune response. Conclusions: Belatacept-treated SOT recipients have a reduced immune response to anti-SARS-CoV-2 mRNA vaccination. The vaccine should be given quite separately from the belatacept infusion to improve immunogenicity. Studies to assess whether switching to another immunosuppressive regimen can improve the post-vaccination immune response would be useful

Poor Anti-SARS-CoV-2 Humoral and T-cell Responses After 2 Injections of mRNA Vaccine in Kidney Transplant Recipients Treated With Belatacept

International audienceData about coronavirus disease 2019 (COVID-19) vaccine in the general population provided an excellent profile of immunogenicity strong antibody response following the second dose of mRNA-1273 or BNT162b2 vaccines, associated with a potent T-cell immune response