Head-to-Head Comparison of Response Rates to the Two mRNA SARS-CοV-2 Vaccines in a Large Cohort of Solid Organ Transplant (SOT) Recipients.

Smaragdi Marinaki,Ioannis N Boletis,Dimitrios Degiannis,Ioanna D Pavlopoulou,Efstathios Xagas,Angelos Hatzakis,Sotirios Roussos,Paraskevi Tsoutsoura,Antigoni Chaidaroglou,Stamatis Adamopoulos,Vana Sypsa

doi:10.3390/vaccines10020190

Abstract

Due to their higher risk of developing life-threatening COVID-19 disease, solid organ transplant (SOT) recipients have been prioritized in the vaccination programs of many countries. However, there is increasing evidence of reduced immunogenicity to SARS-CοV-2 vaccination. The present study investigated humoral response, safety, and effectiveness after the two mRNA vaccines in 455 SOT recipients. Overall, the antibody response rate was low, at 39.6%. Higher immunogenicity was detected among individuals vaccinated with the mRNA1273 compared to those with the BNT162b2 vaccine (47% vs. 36%, respectively, p = 0.025) as well as higher median antibody levels of 31 (7, 372) (AU/mL) vs. 11 (7, 215) AU/mL, respectively. Among the covariates assessed, vaccination with the BNT162b2 vaccine, antimetabolite- and steroid-containing immunosuppression, female gender, the type of transplanted organ and older age were factors that negatively influenced immune response. Only mild adverse effects were observed. Our findings confirm poor immunogenicity after vaccination, implicating a reevaluation of vaccination policy in SOT recipients.

Highlights

Solid organ transplant (SOT) recipients represent a high-risk group for all severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-related adverse outcomes, including mortality [1]
We included a total of 455 consecutive solid organ transplant (SOT) recipients vaccinated with either of the two authorized mRNA SARS-CoV-2 vaccines
All SOT recipients had completed vaccination with either the BNT162b2 or mRNA1273 vaccine and were thereafter invited by telephone to participate in the study

Summary

Introduction

Solid organ transplant (SOT) recipients represent a high-risk group for all severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-related adverse outcomes, including mortality [1]. The incidence of COVID-19 among kidney transplant patients is not high, but when they get infected, this is related to significant morbidity and mortality. Infection rates range from 0.27% to 1.67%, but they depend greatly on the number of tested individuals. The presence of at least one comorbidity is an almost universal finding in transplanted patients. During the first and the second wave of the pandemic, case fatality rates (CFR) at approximately 20% had been reported. Compared to the outcomes of influenza in solid organ transplant (SOT) recipients, all adverse outcomes were higher in those with COVID-19 infection: 93% vs 70% hospitalization rate and 30% vs

Methods

Results

Discussion

Conclusion