Transplantation Direct (Jan 2022)

Risk Factors Associated With an Impaired Antibody Response in Kidney Transplant Recipients Following 2 Doses of the SARS-CoV-2 mRNA Vaccine

  • Stephanie G. Yi, MD, MPH,
  • Linda W. Moore, PhD,
  • Todd Eagar, PhD,
  • Edward A. Graviss, PhD, MPH, FIDSA,
  • Duc T. Nguyen, MD, PhD,
  • Hassan Ibrahim, MD, MS,
  • Howard J. Huang, MD,
  • Mark Hobeika, MD,
  • Robert McMillan, MD, MPH,
  • Ashish Saharia, MD,
  • Constance Mobley, MD, PhD,
  • Hemangshu Podder, MD, PhD,
  • Ashley Drews, MD,
  • R. Mark Ghobrial, MD, PhD,
  • A. Osama Gaber, MD,
  • Richard J. Knight, MD

DOI
https://doi.org/10.1097/TXD.0000000000001257
Journal volume & issue
Vol. 8, no. 1
p. e1257

Abstract

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Background. Data about vaccine efficacy in solid organ transplant patients are limited. We previously reported our initial observation of a 6.2% immunogenicity rate in kidney transplant recipients (KTRs) after administration of 1 dose of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine. We sought to report our observations of anti-SARS-CoV-2 antibody in KTRs after 2 doses of the SARS-CoV-2 mRNA vaccine. Methods. We identified 105 KTRs who received 2 doses of the Pfizer-BioNTech or Moderna mRNA-1273 vaccine per availability and had anti-SARS-CoV-2 labs obtained at least 2 wk following administration of the second dose. Antibody testing was performed using 3 clinically validated qualitative and semiquantitative assays. Results. KTRs had a 36.2% antibody response rate, whereas an age ≥68 years and a longer time from transplant were factors associated with antibody response. Conclusions. The low antibody response in KTRs may be associated with the immunosuppressive state. More data are needed to evaluate if KTRs may require higher vaccine doses or an additional booster dose to increase their ability to mount an immune response to the SARS-CoV-2 vaccine.