Serological Response to Three, Four and Five Doses of SARS-CoV-2 Vaccine in Kidney Transplant Recipients

Autor: Bilgin Osmanodja, Simon Ronicke, Klemens Budde, Annika Jens, Charlotte Hammett, Nadine Koch, Evelyn Seelow, Johannes Waiser, Bianca Zukunft, Friederike Bachmann, Mira Choi, Ulrike Weber, Bettina Eberspächer, Jörg Hofmann, Fritz Grunow, Michael Mikhailov, Lutz Liefeldt, Kai-Uwe Eckardt, Fabian Halleck, Eva Schrezenmeier
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Clinical Medicine, Vol 11, Iss 9, p 2565 (2022)
Druh dokumentu: article
ISSN: 2077-0383
DOI: 10.3390/jcm11092565
Popis: Mortality from COVID-19 among kidney transplant recipients (KTR) is high, and their response to three vaccinations against SARS-CoV-2 is strongly impaired. We retrospectively analyzed the serological response of up to five doses of the SARS-CoV-2 vaccine in KTR from 27 December 2020 until 31 December 2021. Particularly, the influence of the different dose adjustment regimens for mycophenolic acid (MPA) on serological response to fourth vaccination was analyzed. In total, 4277 vaccinations against SARS-CoV-2 in 1478 patients were analyzed. Serological response was 19.5% after 1203 basic immunizations, and increased to 29.4%, 55.6%, and 57.5% in response to 603 third, 250 fourth, and 40 fifth vaccinations, resulting in a cumulative response rate of 88.7%. In patients with calcineurin inhibitor and MPA maintenance immunosuppression, pausing MPA and adding 5 mg prednisolone equivalent before the fourth vaccination increased the serological response rate to 75% in comparison to the no dose adjustment (52%) or dose reduction (46%). Belatacept-treated patients had a response rate of 8.7% (4/46) after three vaccinations and 12.5% (3/25) after four vaccinations. Except for belatacept-treated patients, repeated SARS-CoV-2 vaccination of up to five times effectively induces serological response in kidney transplant recipients. It can be enhanced by pausing MPA at the time of vaccination.
Databáze: Directory of Open Access Journals
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