Serological Response to Three, Four and Five Doses of SARS-CoV-2 Vaccine in Kidney Transplant Recipients
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 Decembe...
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| Veröffentlicht in: | Journal of clinical medicine 2022-05, Vol.11 (9), p.2565 |
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| creator | Osmanodja, Bilgin Ronicke, Simon Budde, Klemens Jens, Annika Hammett, Charlotte Koch, Nadine Seelow, Evelyn Waiser, Johannes Zukunft, Bianca Bachmann, Friederike Choi, Mira Weber, Ulrike Eberspächer, Bettina Hofmann, Jörg Grunow, Fritz Mikhailov, Michael Liefeldt, Lutz Eckardt, Kai-Uwe Halleck, Fabian Schrezenmeier, Eva |
| description | 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. |
| doi_str_mv | 10.3390/jcm11092565 |
| format | Article |
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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.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm11092565</identifier><identifier>PMID: 35566691</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antibodies ; Clinical medicine ; Coronaviruses ; COVID-19 vaccines ; Fatalities ; Immunization ; Immunoassay ; Kidney transplants ; Laboratories ; Patients ; Population ; Proteins ; Response rates ; Serology ; Severe acute respiratory syndrome coronavirus 2 ; Variables</subject><ispartof>Journal of clinical medicine, 2022-05, Vol.11 (9), p.2565</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-c1891ed69f25743c0a9749467bf5ac48fa82229639f1e18cadf9c2d8428221cb3</citedby><cites>FETCH-LOGICAL-c409t-c1891ed69f25743c0a9749467bf5ac48fa82229639f1e18cadf9c2d8428221cb3</cites><orcidid>0000-0002-8660-0722 ; 0000-0002-3964-4685 ; 0000-0002-7929-5942 ; 0000-0002-0286-1491 ; 0000-0001-8734-9472 ; 0000-0001-8822-4268</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9105533/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9105533/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35566691$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Osmanodja, Bilgin</creatorcontrib><creatorcontrib>Ronicke, Simon</creatorcontrib><creatorcontrib>Budde, Klemens</creatorcontrib><creatorcontrib>Jens, Annika</creatorcontrib><creatorcontrib>Hammett, Charlotte</creatorcontrib><creatorcontrib>Koch, Nadine</creatorcontrib><creatorcontrib>Seelow, Evelyn</creatorcontrib><creatorcontrib>Waiser, Johannes</creatorcontrib><creatorcontrib>Zukunft, Bianca</creatorcontrib><creatorcontrib>Bachmann, Friederike</creatorcontrib><creatorcontrib>Choi, Mira</creatorcontrib><creatorcontrib>Weber, Ulrike</creatorcontrib><creatorcontrib>Eberspächer, Bettina</creatorcontrib><creatorcontrib>Hofmann, Jörg</creatorcontrib><creatorcontrib>Grunow, Fritz</creatorcontrib><creatorcontrib>Mikhailov, Michael</creatorcontrib><creatorcontrib>Liefeldt, Lutz</creatorcontrib><creatorcontrib>Eckardt, Kai-Uwe</creatorcontrib><creatorcontrib>Halleck, Fabian</creatorcontrib><creatorcontrib>Schrezenmeier, Eva</creatorcontrib><title>Serological Response to Three, Four and Five Doses of SARS-CoV-2 Vaccine in Kidney Transplant Recipients</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>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.</description><subject>Antibodies</subject><subject>Clinical medicine</subject><subject>Coronaviruses</subject><subject>COVID-19 vaccines</subject><subject>Fatalities</subject><subject>Immunization</subject><subject>Immunoassay</subject><subject>Kidney transplants</subject><subject>Laboratories</subject><subject>Patients</subject><subject>Population</subject><subject>Proteins</subject><subject>Response rates</subject><subject>Serology</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Variables</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkd1LHDEUxYNUqqhPfZdAXwp1NB-TTPJSkK2roiC4W19DNnPHzTKbjMms4H9vRCvb5uWG3B_n3pOD0DdKTjnX5Gzl1pQSzYQUO2ifkaapCFf8y9Z9Dx3lvCLlKFUz2nxFe1wIKaWm-2g5gxT7-Oid7fE95CGGDHiMeL5MACd4GjcJ29DiqX8G_DtmyDh2eHZ-P6sm8aFi-ME65wNgH_CNbwO84HmyIQ-9DWNRdH7wEMZ8iHY722c4-qgH6M_0Yj65qm7vLq8n57eVq4keK0eVptBK3THR1NwRq5ta17JZdMK6WnVWMca05LqjQJWzbacda4ux8k7dgh-gX--6w2axhtaV2cn2Zkh-bdOLidabfzvBL81jfDaaEiE4LwI_PgRSfNpAHs3aZwd98QNxkw2TslaEKlIX9Pt_6Kp8Vyj23ihOWEMbUaif75RLMecE3ecylJi3EM1WiIU-3t7_k_0bGX8FyeuWSg</recordid><startdate>20220504</startdate><enddate>20220504</enddate><creator>Osmanodja, Bilgin</creator><creator>Ronicke, Simon</creator><creator>Budde, Klemens</creator><creator>Jens, Annika</creator><creator>Hammett, Charlotte</creator><creator>Koch, Nadine</creator><creator>Seelow, Evelyn</creator><creator>Waiser, Johannes</creator><creator>Zukunft, Bianca</creator><creator>Bachmann, Friederike</creator><creator>Choi, Mira</creator><creator>Weber, Ulrike</creator><creator>Eberspächer, Bettina</creator><creator>Hofmann, Jörg</creator><creator>Grunow, Fritz</creator><creator>Mikhailov, Michael</creator><creator>Liefeldt, Lutz</creator><creator>Eckardt, Kai-Uwe</creator><creator>Halleck, Fabian</creator><creator>Schrezenmeier, Eva</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8660-0722</orcidid><orcidid>https://orcid.org/0000-0002-3964-4685</orcidid><orcidid>https://orcid.org/0000-0002-7929-5942</orcidid><orcidid>https://orcid.org/0000-0002-0286-1491</orcidid><orcidid>https://orcid.org/0000-0001-8734-9472</orcidid><orcidid>https://orcid.org/0000-0001-8822-4268</orcidid></search><sort><creationdate>20220504</creationdate><title>Serological Response to Three, Four and Five Doses of SARS-CoV-2 Vaccine in Kidney Transplant Recipients</title><author>Osmanodja, Bilgin ; 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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%). 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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central |
| subjects | Antibodies Clinical medicine Coronaviruses COVID-19 vaccines Fatalities Immunization Immunoassay Kidney transplants Laboratories Patients Population Proteins Response rates Serology Severe acute respiratory syndrome coronavirus 2 Variables |
| title | Serological Response to Three, Four and Five Doses of SARS-CoV-2 Vaccine in Kidney Transplant Recipients |
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