Antibody Response to a Fourth Messenger RNA COVID-19 Vaccine Dose in Kidney Transplant Recipients: A Case Series

• DOI: 10.7326/l21-0598
• Publication Date: 2022-01-10T22:00:28Z
• Authors: Sophie Caillard; Olivier Thaunat; Ilies Benotmane; Christophe Masset; Gilles Blancho
• Keywords: Nephrology

LettersMarch 2022Antibody Response to a Fourth Messenger RNA COVID-19 Vaccine Dose in Kidney Transplant Recipients: A Case SeriesFREESophie Caillard, MD, PhD, Olivier Thaunat, Ilies Benotmane, Christophe Masset, Gilles Blancho, PhDSophie PhDDepartment of Nephrology and Transplantation, University Hospitals Strasbourg, INSERM Unit 1109, France, Transplantation Clinical Immunology, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 1111, MDDepartment MDInstitut Urologie Néphrologie, Centre Hospitalier Universitaire Nantes, Recherche en et Immunologie, UMR 1064, INSERM, Nantes Université, PhDInstitut FranceAuthor, Article, Disclosure Informationhttps://doi.org/10.7326/L21-0598 SectionsAboutVisual AbstractPDF ToolsAdd favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: transplant recipients receiving immunosuppressive drugs have impaired immune responses messenger (mRNA) vaccines (1). Consequently, despite standard vaccination with mRNA vaccines, many these patients remain at high risk for severe disease during the ongoing pandemic. The U.S. Food Drug Administration has authorized immunocompromised people receive third dose vaccine after 2-dose regimen further boost protection, French health authorities approved on 11 April 2021. Subsequent studies found that approximately 50% who did not respond second seroconverted dose, which produced an overall seroconversion rate about 65% (2, 3). Antispike IgG titers above 143 binding antibody units (BAU) per milliliter correlate presence neutralizing antibodies (the most widely accepted marker protection) against wild-type virus Alpha, Beta, Gamma variants, but neutralization Delta variant requires higher antispike (4). Therefore, low may insufficiently protected. In June 2021, offering fourth solid organ transplants had weak response dose.Objective: To investigate whether mRNA-based anti–SARS-CoV-2 would increase kidney showed serologic 3 doses.Case Report: (BNT162b2 [Pfizer], n = 34; mRNA-1273 [Moderna], 58) was given 92 from independent university hospitals (Strasbourg, Nantes) less than BAU/mL month dose. All measurements 2 6 weeks later (median, 29 days [interquartile range, 26 34 days]). Table shows characteristics patients.Table. Characteristics Recipients Who Received Against SARS-CoV-2, According Their Levels Antibody Spike ProteinThere were no safety concerns After median days, levels increased 16.4 (interquartile 5.9 62.3 BAU/mL) 145 27.6 243 (Figure) reached threshold BAU/mL. Patients this longer interval between their frequently treated steroids (Table). percentage 48% BNT162b2 52% vaccine, received 150 vs. 122 BAU/mL). Only patient subsequently diagnosed mild COVID-19, he level 28 his dose.Figure. measured 2–6 wk doses recipients.Titers are expressed BAU calibration World Health Organization standard. dotted line indicates units; D3 dose; D4 Download figure PowerPoint Discussion: Our study produces satisfactory some adequately previous doses, it supports use patients. We shown unpublished uninfected vaccinated. Assuming difference can be attributed antigen infection vaccination, those results also support additional, repeated do vaccination. Prophylactic infusion monoclonal offered additional (5). For example, our experience, only 10% (<1 able reach It been interesting examine T-cell immunity patients, assays time-consuming, makes challenging implement them routine practice. Finally, we recognize does invariably provide protection disease, is why encourage longitudinal sufficient duration follow-up evaluate like doses.References1. Boyarsky BJ, Werbel WA, Avery RK, al. SARS-CoV-2 series recipients. JAMA. 2021;325:2204-2206. [PMID: 33950155] doi:10.1001/jama.2021.7489 CrossrefMedlineGoogle Scholar2. Benotmane I, Gautier G, Perrin P, minimal doses. 34297036] doi:10.1001/jama.2021.12339 Scholar3. Kamar N, Abravanel F, Marion O, Three Covid-19 solid-organ [Letter]. N Engl J Med. 2021;385:661-662. 34161700] doi:10.1056/NEJMc2108861 Scholar4. Planas D, Veyer Baidaliuk A, Reduced sensitivity neutralization. Nature. 2021;596:276-280. 34237773] doi:10.1038/s41586-021-03777-9 Scholar5. O’Brien MP, Forleo-Neto E, Musser al; Phase Prevention Trial Team. Subcutaneous REGEN-COV combination prevent Covid-19. 2021;385:1184-1195. 34347950] doi:10.1056/NEJMoa2109682 Scholar Comments0 CommentsSign Submit Comment Rujittika Mungmunpuntipantip; Viroj WiwanitkitPrivate Academic Contulant, Bangkok Thailand; Honorary professor, Dr DY Patil Pune, India12 January 2022 Correspondence “Antibody Recipients” Dear Editor, share ideas publication “. Series. [1].” Caillard concluded “a agree might useful. However, as Cailard already noted, there factors considered. background status different subjects generally based [2]. Whether will useful recipient still issue studied. or directly tell us utility As cannot imply protection. Additionally, evaluation titer rule out possibility post silent infection. long-term give data. If utility, should start assessment specific laboratory investigation both B-cell function performed. Conflict interest: None References S, Thaunat Masset C, Blancho G.Antibody Ann Intern Jan 11. doi: 10.7326/L21-0598. Online ahead print. Duni Markopoulos GS, Mallioras Pappas H, Koutlas V, Tzalavra Baxevanos Priska Gartzonika K, Mitsis M, Dounousi E. Humoral Immune Is Associated With Circulating CD19+ B Lymphocytes Naive CD45RA Memory CD45RO CD4+ T Helper Cells Ratio Hemodialysis Recipients. Front Immunol. 2021 Dec 3;12:760249. Christine Weart MDRetired internist ( NY Presbyterian Hospital)24 4th This done by Dr. Dorry Segev Johns Hopkins each successive Covid developed antibodies. I am early drug rare leukemia zero #1&2 (Pfizer), so opted full (Moderna) next yielding then got maximal Moderna. Eternally grateful researchers! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8612849/ Author, InformationAffiliations: Department FranceDepartment FranceInstitut FranceDisclosures: Disclosures viewed www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L21-0598.Corresponding Author: Sophie Hôpitaux Universitaires 1, place l’Hôpital, 67091 France; e-mail, Sophie.[email protected]fr.This article published Annals.org 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySARS-CoV-2 Omicron variant: recent progress future perspectivesQuantifying excess deaths among COVID‐19 eraInferior humoral sustained cellular omicron concern hemodialysis immunized compared 4 dosesCOVID-19 Vaccination Lung RecipientsSerological Three, Four Five Doses RecipientsEvaluation Cellular Responses Common Variable Immunodeficiency Phenotype Patient Receiving B-Cell Depletion TherapyImmune Third Among Recipients—A Prospective StudyShould clinically assessing covid people?Seroresponse Maintenance DialysisInfection elicits recipientsAntibody Solid Organ An Update March 2022Volume 175, Issue 3Page: 455-456KeywordsAntibodiesBooster dosesCOVID-19NephrologyRenal transplantationSolid transplantationTransplantationVaccines ePublished: Published: Copyright & PermissionsCopyright © American College Physicians. Rights Reserved.PDF downloadLoading ...