Humoral antibody response following mRNA vaccines against SARS-CoV-2 in solid organ transplant recipients; a status after a fifth and bivalent vaccine dose.

Autor:	Christophorou E; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark., Nilsson AC; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Clinical Immunology, Odense University Hospital, Odense, Denmark., Petersen I; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark., Lindvig SO; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Davidsen JR; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; South Danish Center for Interstitial Lung Diseases (SCILS), Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark., Abazi R; Department of Gastroenterology, Odense University Hospital, Odense, Denmark., Poulsen MK; Department of Cardiology, Odense University Hospital, Odense, Denmark., Pedersen RM; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark., Justesen US; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark., Johansen NE; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark., Bistrup C; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Nephrology, Odense University Hospital, Odense, Denmark., Madsen LW; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.; Unit for Infectious Diseases, Department of Medicine, Lillebaelt Hospital, Kolding, Denmark., Johansen IS; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.
Jazyk:	angličtina
Zdroj:	Frontiers in immunology [Front Immunol] 2023 Nov 27; Vol. 14, pp. 1270814. Date of Electronic Publication: 2023 Nov 27 (Print Publication: 2023).
DOI:	10.3389/fimmu.2023.1270814
Abstrakt:	Background: In solid organ transplant (SOT) recipients, the humoral response following COVID-19 vaccination is reduced, as a result of their immunosuppressed treatment. In this study, we investigated antibody concentrations after booster vaccinations until the fifth dose, the latter by monovalent or bivalent BA1 or BA4/5 vaccines. In addition, we evaluated the efficacy of vaccination by recording breakthrough infections, hospitalizations, and deaths. Method: This prospective cohort study included 438 SOT recipients (>18 years) vaccinated with mRNA vaccines against COVID-19 from January 2021 until March 2023. Blood samples were drawn before and after each vaccination and tested for SARS-CoV-2 spike RBD IgG antibodies with the lowest and highest cut-off at 7.1 and 5,680 BAU/mL, respectively. Vaccine information, breakthrough infections, and hospitalizations were collected from the medical records. Results: Most participants received BNT162b2 and 61.4% received five vaccine doses. The response proportion in SOT recipients increased from 86.7% after the fourth dose to 93.0% following the fifth dose. Antibody concentration decreased with 142.7 BAU/mL between the third and fourth dose (median 132 days, Quartile 1: 123, Quartile 3: 148) and 234.3 BAU/mL between the fourth and fifth (median 250 days, Quartile 1: 241, Quartile 3: 262) dose among those without breakthrough infection (p=0.34). When comparing the Omicron BA.1 or Omicron BA.4/BA.5 adapted vaccines, no significant differences in antibody concentration were found, but 20.0% of SOT recipients receiving a monovalent fifth vaccine dose had a breakthrough infection compared to 4.0% and 7.9% among those who received BA.1 and BA.4/BA.5 adapted vaccines, respectively (p=0.04). Since January 2021, 240 (54.8%) participants had a breakthrough infection, and 22 were hospitalized, but no deaths were observed. Conclusions: The fifth COVID-19 vaccine dose raised antibody response to 93.0% of the study population. Additional booster doses, as well as bivalent vaccines, led to higher levels of antibody concentration in SOT recipients. We found a lower incidence of breakthrough infections among SOT recipients after receiving a bivalent vaccine as a fifth dose compared to those receiving a monovalent dose. Antibody concentrations did not wane when the time between doses was prolonged from four to eight months. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Christophorou, Nilsson, Petersen, Lindvig, Davidsen, Abazi, Poulsen, Pedersen, Justesen, Johansen, Bistrup, Madsen and Johansen.)
Databáze:	MEDLINE
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