Immunogenicity After a Heterologous BNT262b2 Versus Homologous Booster in Kidney Transplant Recipients Receiving 2 Doses of CoronaVac Vaccine: A Prospective Cohort Study.

Autor:	Medina-Pestana J; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Almeida Viana L; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Nakamura MR; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Lucena EF; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Granato CFH; Infectious Diseases Division, Universidade Federal de São Paulo, São Paulo, Brazil., Dreige YC; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Amorim LVP; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Chow CYZ; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Demarchi Foresto R; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Roberto Requião-Moura L; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Tedesco-Silva H; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil., Cristelli MP; Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2022 Oct 01; Vol. 106 (10), pp. 2076-2084. Date of Electronic Publication: 2022 Aug 05.
DOI:	10.1097/TP.0000000000004260
Abstrakt:	Background: Comparative studies of third heterologous doses following the CoronaVac vaccine against coronavirus disease 2019 (COVID-19) in kidney transplant recipients are lacking. Methods: This prospective, single-center cohort study included kidney transplant recipients without previous COVID-19. Patients received a third heterologous (BNT162b2 mRNA) or homologous dose at least 4 wk after 2 doses of the CoronaVac vaccine. Immunoglobulin G antibody response and seroprevalence for neutralizing anti-severe acute respiratory syndrome coronavirus 2 antibodies immediately before and 28 d after third doses were compared between the groups. Results: There were 307 patients in the heterologous group and 777 in the homologous group. Patients in the heterologous group were older (54 versus 50 y; P < 0.0001), with a longer time since transplant (11 versus 6 y; P < 0.0001). Immediately before the third dose, immunoglobulin G seroprevalence (36% versus 34%; P = 0.597) and antibody titers (246 versus 268 AU/mL; P = 0.279) were similar. After booster, seroconversion was higher in the heterologous group (49% versus 32%; P < 0.0001), resulting in a higher seroprevalence (67% versus 55%; P = 0.0003); however, 42% of all patients remained seronegative. Antibody titers after booster in seropositive patients were higher in the heterologous group (7771 versus 599 AU/mL; P < 0.0001). These results persisted after adjusting for confounding variables. Lastly, a similar proportion of patients became seropositive for neutralizing antibodies (98% versus 94%; P = 0.098). Conclusions: In kidney transplant recipients fully vaccinated with CoronaVac, a third dose with an mRNA vaccine produced a higher seroconversion rate and antibody titers than a third homologous dose. However, both boosters achieved equivalent seroprevalence for neutralizing antibodies. The high proportion of still seronegative patients indicates the need for alternative strategies of protection. Competing Interests: The authors declare no funding or conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu