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SARS-CoV-2 vaccine booster in solid organ transplant recipients previously immunised with inactivated versus mRNA vaccines: A prospective cohort study.


ABSTRACT:

Background

Solid-organ transplant (SOT) recipients have worse COVID-19 outcomes than general population and effective immunisation in these patients is essential but more difficult to reach. We aimed to determine the immunogenicity of an mRNA SARS-CoV-2 vaccine booster in SOT recipients previously immunised with either inactivated or homologous SARS-CoV-2 mRNA vaccine.

Methods

Prospective cohort study of SOT recipients under medical care at Red de Salud UC-CHRISTUS, Chile, previously vaccinated with either CoronaVac or BNT162b2. All participants received a BNT162b2 vaccine booster. The primary study end point was anti-SARS-CoV-2 total IgG antibodies (TAb) seropositivity at 8-12 weeks (56-84 days) post booster. Secondary end points included neutralising antibodies (NAb) and specific T-cell responses.

Findings

A total of 140 (50% kidney, 38% liver, 6% heart) SOT recipients (mean age 54 [13.6] years; 64 [46%] women) were included. Of them, 62 had homologous (three doses of BNT162b2) and 78 heterologous vaccine schedules (two doses of CoronaVac followed by BNT162b2 booster). Boosters were received at a median of 21.3 weeks after primary vaccination. The proportion achieving TAb seropositivity (82.3% vs 65.4%, P = 0.035) and NAb positivity (77.4% vs 55.1%, P = 0.007) were higher for the homologous versus the heterologous group. On the other hand, the number of IFN-γ and IL-2 secreting SARS-CoV-2-specific T-cells did not differ significantly between groups.

Interpretation

This cohort study shows that homologous mRNA vaccine priming plus boosting in SOT recipients, reaches a significantly higher humoral immune response than inactivated SARS-CoV-2 vaccine priming followed by heterologous mRNA booster.

Funding

School of Medicine, UC-Chile and ANID.ClinicalTrials.gov ID: NCT05124509.

SUBMITTER: Dib M 

PROVIDER: S-EPMC9503242 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

SARS-CoV-2 vaccine booster in solid organ transplant recipients previously immunised with inactivated versus mRNA vaccines: A prospective cohort study.

Dib Martín M   Le Corre Nicole N   Ortiz Catalina C   García Daniel D   Ferrés Marcela M   Martinez-Valdebenito Constanza C   Ruiz-Tagle Cinthya C   Ojeda María José MJ   Espinoza Manuel A MA   Jara Aquiles A   Arab Juan Pablo JP   Rabagliati Ricardo R   Vizcaya Cecilia C   Ceballos María Elena ME   Sarmiento Mauricio M   Mondaca Sebastián S   Viñuela Macarena M   Pastore Antonia A   Szwarcfiter Vania V   Galdames Elizabeth E   Barrera Aldo A   Castro Pablo P   Gálvez Nicolás Ms NM   Soto Jorge A JA   Bueno Susan M SM   Kalergis Alexis M AM   Nervi Bruno B   Balcells M Elvira ME  

Lancet regional health. Americas 20220923


<h4>Background</h4>Solid-organ transplant (SOT) recipients have worse COVID-19 outcomes than general population and effective immunisation in these patients is essential but more difficult to reach. We aimed to determine the immunogenicity of an mRNA SARS-CoV-2 vaccine booster in SOT recipients previously immunised with either inactivated or homologous SARS-CoV-2 mRNA vaccine.<h4>Methods</h4>Prospective cohort study of SOT recipients under medical care at Red de Salud UC-CHRISTUS, Chile, previou  ...[more]

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