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Antibody Response to SARS-CoV-2 mRNA Vaccine Poor in Transplant Recipients

WEDNESDAY, March 24, 2021 -- Most solid organ transplant recipients do not mount an appreciable antibody response after receiving a first dose of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, according to a research letter published online March 15 in JAMA Network Open.

Brian J. Boyarsky, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues quantified the humoral response to the first dose of SARS-CoV-2 mRNA vaccines in solid organ transplant recipients. The proportion of patients who developed a positive antibody response was assessed among 436 transplant recipients.

Of the patients, 52 percent received the Pfizer-BioNTech BNT162b2 vaccine and 48 percent received the Moderna mRNA-1273 vaccine. The researchers found that antibody (anti-S1 or anti-receptor-binding domain) was detectable in 17 percent of the participants at a median of 20 days after the first dose of vaccine. The likelihood of developing an antibody response was lower among transplant recipients receiving versus not receiving anti-metabolite maintenance immunosuppression therapy (37 versus 63 percent; adjusted incidence rate ratio [IRR], 0.22). The likelihood of developing an antibody response was also lower for older transplant recipients (adjusted IRR, 0.83 per 10 years). Those who received mRNA-1273 were more likely than those receiving BNT162b2 to develop an antibody response (69 versus 31 percent; adjusted IRR, 2.15).

"These findings of poor anti-spike antibody responses in organ transplant recipients after the first dose of mRNA vaccines suggest that such patients may remain at higher early risk for COVID-19 despite vaccination," the authors write.

Two authors disclosed financial ties to the biopharmaceutical industry.

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