Immunologic response of mRNA SARS-CoV-2 vaccination in adolescent kidney transplant recipients

Autor: Elizabeth Ingulli, Erin Phebus, Clarkson R. Crane
Rok vydání: 2021
Předmět:
Male
Nephrology
and promotion of well-being
medicine.medical_treatment
Messenger
Azathioprine
Antibodies
Viral
Immunogenicity
Vaccine
Viral
Child
Pediatric
education.field_of_study
Brief Report
Antibody titer
Immunosuppression
Urology & Nephrology
Immunogenicity
Spike Glycoprotein
Vaccination
Infectious Diseases
3.4 Vaccines
6.1 Pharmaceuticals
Spike Glycoprotein
Coronavirus
Female
Infection
Immunosuppressive Agents
Biotechnology
medicine.drug
medicine.medical_specialty
COVID-19 Vaccines
Adolescent
medicine.drug_class
Population
Antimetabolite
Antibodies
Vaccine Related
Paediatrics and Reproductive Medicine
Clinical Research
Internal medicine
medicine
Humans
RNA
Messenger
Kidney transplant
education
BNT162 Vaccine
Transplantation
SARS-CoV-2
business.industry
Prevention
Evaluation of treatments and therapeutic interventions
COVID-19
Organ Transplantation
Prevention of disease and conditions
Kidney Transplantation
Transplant Recipients
Coronavirus
Regimen
Good Health and Well Being
mRNA vaccine
Pediatrics
Perinatology and Child Health
Immunology
RNA
Immunization
business
Vaccine
Zdroj: Pediatric Nephrology (Berlin, Germany)
Pediatric nephrology (Berlin, Germany), vol 37, iss 2
ISSN: 1432-198X
0931-041X
DOI: 10.1007/s00467-021-05256-9
Popis: Background In the general population, mRNA SARS-CoV-2 vaccines are highly efficacious. Early reports suggest a diminished antibody response in immunosuppressed adult solid organ transplant (SOT) patients, but this has not been reported in pediatrics. Methods Adolescent kidney transplant recipients (KTR) at our center who received both doses of an mRNA SARS-CoV-2 vaccine had SARS-CoV-2 spike (S) protein antibody presence evaluated 4–8 weeks after their second dose of the vaccine as part of routine clinical care. Results Thirteen of 25 fully vaccinated patients (52%) had a positive spike antibody. Median age of participants was 19 years old (IQR 18–20) and the median time from transplant was 5 years (IQR 4–9 years). KTR were treated with an immunosuppression regimen including a calcineurin inhibitor, corticosteroid, and antimetabolite (9 with mycophenolate, 3 with azathioprine, and 1 without an antimetabolite due to viremia). Of those who had an antibody response, fewer had a mycophenolate-containing immunosuppressant regimen than non-responders. There was a trend toward better vaccine response and higher anti-S antibody titers at lower doses of mycophenolate. Three patients with prior COVID-19 infection all had a positive antibody response. Conclusion Our results suggest vaccine response in adolescent KRT is lower than that of the general population, but similar to that previously described in adult SOT patients and slightly better than that seen in adult KTR. This data demonstrates vaccination is safe and supports immunizing KTR who remain hesitant. Future studies should focus on better understanding of the cellular immune response to vaccination and strategies to enhance vaccine immunogenicity in pediatric SOT patients. Graphical abstract
Databáze: OpenAIRE
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