Abstract
Vaccination-induced SARS-CoV-2 neutralizing antibodies are required for herd immunity. Vaccine availability and poor vaccine response in renal transplant recipients (RTRs) remain a concern. There is no report on the efficacy of Covaxin and Covishield vaccines in RTRs. We recruited 222 live donors RTRs and analyzed the serum titer of anti-SARS-CoV-2 spike protein antibody by chemiluminescent magnetic microparticle immunoassay. Patients were categorized into three groups: group1 with SARS-CoV-2 infection and no vaccination (n = 161); group 2 with only vaccination and no SARS-CoV-2 infection (n = 41); and group 3 with both vaccination and SARS-CoV-2 infection (n = 20). Overall seroconversion rate was 193/222 (86.9%) with a median titer 1095.20 AU/mL. The median IgG titer value in group 1 was 647.0 AU/mL; group 2 was 1409.0 AU/mL; and group 3 was 1831.30 AU/mL. Covaxin associated seroconversion was observed in 16/19 (84.21%), with a median titer of 1373.90 AU/mL compared to that of Covishield 32/42 (76.19%), whose median titer was 1831.10 AU/mL. The seroconversion rate due to SARS-CoV-2 infection was 145 (90.06%), it was lowest with the vaccination-only group (70.7%), and with both vaccination and SARS-CoV-2 infection group it was highest (95%). In RTRs, SARS-CoV-2 infection and both Covaxin and Covishield vaccination effectively induce a humoral immune response against the SARS-CoV-2 spike protein; however, seroconversion rate was lower and the antibody titer was higher with vaccine than infection.
Highlights
The induction of SARS-CoV-2 neutralizing antibodies, its neutralizing activities, and duration of persistence remain disputed challenges for success of the vaccination program across the globe [1–3]
The vaccination-associated immune response is further limited in immunocompromised patients, such as those with renal transplant recipients (RTR)
These may cover a large population at a lower cost. The efficacy of these vaccines in inducing anti-SARSCoV-2 humoral response was not studied in immunocompromised RTRs, a group more vulnerable to acquiring SARS-CoV-2 infection, developing severe COVID-19, and mortality compared to that of the general population [6]
Summary
The induction of SARS-CoV-2 neutralizing antibodies, its neutralizing activities, and duration of persistence remain disputed challenges for success of the vaccination program across the globe [1–3]. The vaccination-associated immune response is further limited in immunocompromised patients, such as those with renal transplant recipients (RTR). The mRNA-based vaccination in western renal transplant patients shows a poor seroconversion rate after 28 days of the second dose of immunization [1,4,5]. Adenovirus vector-based ChAdOx1-nCOV (CovishieldTM) and inactivated whole virus-based BBV-152 (CovaxinTM) vaccines are available in India These may cover a large population at a lower cost. The efficacy of these vaccines in inducing anti-SARSCoV-2 humoral response was not studied in immunocompromised RTRs, a group more vulnerable to acquiring SARS-CoV-2 infection, developing severe COVID-19, and mortality compared to that of the general population [6]. RTRs may not achieve adequate immune response and seroconversion after vaccination, as evident from the currently available data from the most efficacious mRNA anti-SARS-CoV-2 vaccine in the general population [1,7]. The activation of viruses induces proinflammatory cytokines secretion and hamper IgG seroconversion [13]
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