Delayed peak antibody titers after the second dose of SARS-CoV-2 vaccine in solid organ transplant recipients: Prospective cohort study

Kohei Unagami; Mikiko Yoshikawa; Hiroto Egawa; Satoko Ohfuji; Yoichiro Natori; Rikako Oki; Tomomi Mori; Hidetoshi Hattori; Ayumi Ishiwatari; Taichi Kanzawa; Tomokazu Shimizu; Kazuya Omoto; Masashi Inui; Yuuki Masano; Takashi Ito; Daisuke Nakajima; Tetsuya Babazono; Toshio Takagi; Shinichi Nunoda; Yoshito Tomimaru; Ryoichi Imamura; Shigeru Miyagawa; Koichi Toda; Etsuro Hatano; Hiroshi Date; Miyaji Kyakuno; Shiro Takahara; Kenji Yuzawa; Naoki Tanimine; Hideki Ohdan; Hideki Ishida; Yoshio Hirota; Japan Solid Organ Transplantation COVID-19 Countermeasure Group

doi:10.1016/j.vaccine.2024.126221

Delayed peak antibody titers after the second dose of SARS-CoV-2 vaccine in solid organ transplant recipients: Prospective cohort study

Vaccine. 2024 Oct 3;42(23):126221. doi: 10.1016/j.vaccine.2024.126221. Epub 2024 Aug 24.

Authors

Kohei Unagami¹, Mikiko Yoshikawa², Hiroto Egawa³, Satoko Ohfuji⁴, Yoichiro Natori⁵, Rikako Oki⁶, Tomomi Mori⁷, Hidetoshi Hattori⁸, Ayumi Ishiwatari⁹, Taichi Kanzawa¹⁰, Tomokazu Shimizu¹¹, Kazuya Omoto¹⁰, Masashi Inui¹⁰, Yuuki Masano¹², Takashi Ito¹², Daisuke Nakajima¹³, Tetsuya Babazono⁷, Toshio Takagi¹⁴, Shinichi Nunoda¹⁵, Yoshito Tomimaru¹⁶, Ryoichi Imamura¹⁷, Shigeru Miyagawa¹⁸, Koichi Toda¹⁸, Etsuro Hatano¹², Hiroshi Date¹³, Miyaji Kyakuno¹⁹, Shiro Takahara²⁰, Kenji Yuzawa²¹, Naoki Tanimine²², Hideki Ohdan²², Hideki Ishida²³, Yoshio Hirota²⁴; Japan Solid Organ Transplantation COVID-19 Countermeasure Group

Affiliations

¹ Department of Organ Transplant Medicine, Graduate School of Medicine, Tokyo Women's Medical University, Japan; Department of Nephrology, Graduate School of Medicine, Tokyo Women's Medical University, Japan; Department of Urology, Yochomachi Clinic, Tokyo, Japan.
² Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
³ Department of Surgery, Graduate School of Medicine, Tokyo Women's Medical University, Japan. Electronic address: [email protected].
⁴ Department of Public Health, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
⁵ Division of Infectious Disease, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States.
⁶ Department of Organ Transplant Medicine, Graduate School of Medicine, Tokyo Women's Medical University, Japan; Department of Nephrology, Graduate School of Medicine, Tokyo Women's Medical University, Japan.
⁷ Department of Diabetology and Metabolism, Graduate School of Medicine, Tokyo Women's Medical University, Japan.
⁸ Department of Cardiology, Graduate School of Medicine, Tokyo Women's Medical University, Japan.
⁹ Department of Urology, Yochomachi Clinic, Tokyo, Japan.
¹⁰ Department of Urology, Graduate School of Medicine, Tokyo Women's Medical University, Japan; Department of Urology, Yochomachi Clinic, Tokyo, Japan.
¹¹ Department of Organ Transplant Medicine, Graduate School of Medicine, Tokyo Women's Medical University, Japan; Department of Urology, Graduate School of Medicine, Tokyo Women's Medical University, Japan; Department of Urology, Yochomachi Clinic, Tokyo, Japan.
¹² Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
¹³ Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
¹⁴ Department of Urology, Graduate School of Medicine, Tokyo Women's Medical University, Japan.
¹⁵ Department of Therapeutic Strategy for Severe Heart Failure, Graduate School of Medicine, Tokyo Women's Medical University, Japan.
¹⁶ Department of Gastroenterological Surgery, Osaka University, Graduate School of Medicine, Japan.
¹⁷ Department of Urology, Osaka University, Graduate School of Medicine, Japan.
¹⁸ Department of Cardiovascular Surgery, Osaka University, Graduate School of Medicine, Japan.
¹⁹ Department of Renal Transplantation, Takatsuki General Hospital, Osaka Metropolitan University, Osaka, Japan.
²⁰ Department of Renal Transplantation, Kansai Medical Clinic, Osaka Metropolitan University, Osaka, Japan.
²¹ Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Ibaraki, Japan.
²² Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
²³ Department of Organ Transplant Medicine, Graduate School of Medicine, Tokyo Women's Medical University, Japan.
²⁴ Clinical Epidemiology Research Center, Medical Co. LTA (SOUSEIKAI), Fukuoka, Japan.

PMID: 39180977
DOI: 10.1016/j.vaccine.2024.126221

Abstract

Poor post-vaccination production of antibody against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a concern among solid organ transplant (SOT) recipients. Furthermore, the timing and kinetics of antibody titers after the second vaccine dose are unknown. We conducted a multicenter prospective observational study that included 614 SOT recipients: 460 kidney, 53 heart, 50 liver, 20 lung, and 31 simultaneous pancreas-kidney (SPK). The participants received two doses of the mRNA vaccine (Pfizer BNT162b2 or Moderna mRNA-1273), as indicated. Serum samples were collected before the first and second vaccinations and at 1, 3, and 6 months after the second vaccine dose, which were then assessed for SARS-CoV-2 antibodies. The overall seropositivity rate was 43% at 1 month after administration of the second vaccine dose; it gradually increased to 68% at 3 months after second dose administration and to 70% at 6 months. In addition, recipient of kidney, lung or SPK transplants had lower antibody titers at the 3- and 6-month time points than did the other recipients. SOT recipients acquired SARS-CoV-2 S-IgG antibodies slowly, and the peak titer differed significantly from that of the general population.

Keywords: Immunosuppressive therapy; Post-vaccination antibody; Prospective cohort study; SARS-CoV-2 vaccine; Solid organ transplantation.

Publication types

Observational Study
Multicenter Study

MeSH terms

2019-nCoV Vaccine mRNA-1273 / administration & dosage
2019-nCoV Vaccine mRNA-1273 / immunology
Adult
Aged
Antibodies, Viral* / blood
BNT162 Vaccine* / administration & dosage
BNT162 Vaccine* / immunology
COVID-19 Vaccines* / administration & dosage
COVID-19 Vaccines* / immunology
COVID-19* / immunology
COVID-19* / prevention & control
Female
Humans
Immunoglobulin G / blood
Male
Middle Aged
Organ Transplantation*
Prospective Studies
SARS-CoV-2* / immunology
Transplant Recipients*
Vaccination

Substances

Antibodies, Viral
BNT162 Vaccine
COVID-19 Vaccines
2019-nCoV Vaccine mRNA-1273
Immunoglobulin G