Humoral and cellular immunity to SARS-CoV-2 vaccination in renal transplant versus dialysis patients: A prospective, multicenter observational study using mRNA-1273 or BNT162b2 mRNA vaccine.
BNT162b2
COVID-19
SARS-CoV-2 vaccination
clinical decision-making
dialysis patients
epidemiology
guidelines
humoral and cellular immune response
kidney transplant recipients
mRNA-1273
medical personnel
tozinameran
Journal
The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
pubmed:
29
7
2021
medline:
29
7
2021
entrez:
28
7
2021
Statut:
ppublish
Résumé
Dialysis and kidney transplant patients are vulnerable populations for COVID-19 related disease and mortality. We conducted a prospective study exploring the eight week time course of specific cellular (interferon-γ release assay and flow cytometry) or/and humoral immune responses (ELISA) to SARS-CoV-2 boost vaccination in more than 3100 participants including medical personnel, dialysis patients and kidney transplant recipients using mRNA vaccines BNT162b2 or mRNA-1273. SARS-CoV-2-vaccination induced seroconversion efficacy in dialysis patients was similar to medical personnel (> 95%), but markedly impaired in kidney transplant recipients (42%). T-cellular immunity largely mimicked humoral results. Major risk factors of seroconversion failure were immunosuppressive drug number and type (belatacept, MMF-MPA, calcineurin-inhibitors) as well as vaccine type (BNT162b2 mRNA). Seroconversion rates induced by mRNA-1273 compared to BNT162b2 vaccine were 97% to 88% ( Dialysis patients exhibit a remarkably high seroconversion rate of 95% after boost vaccination, while humoral response is impaired in the majority of transplant recipients. Immunosuppressive drug number and type as well as vaccine type (BNT162b2) are major determinants of seroconversion failure in both dialysis and transplant patients suggesting immune monitoring and adaption of vaccination protocols.
Sections du résumé
BACKGROUND
BACKGROUND
Dialysis and kidney transplant patients are vulnerable populations for COVID-19 related disease and mortality.
METHODS
METHODS
We conducted a prospective study exploring the eight week time course of specific cellular (interferon-γ release assay and flow cytometry) or/and humoral immune responses (ELISA) to SARS-CoV-2 boost vaccination in more than 3100 participants including medical personnel, dialysis patients and kidney transplant recipients using mRNA vaccines BNT162b2 or mRNA-1273.
RESULTS
RESULTS
SARS-CoV-2-vaccination induced seroconversion efficacy in dialysis patients was similar to medical personnel (> 95%), but markedly impaired in kidney transplant recipients (42%). T-cellular immunity largely mimicked humoral results. Major risk factors of seroconversion failure were immunosuppressive drug number and type (belatacept, MMF-MPA, calcineurin-inhibitors) as well as vaccine type (BNT162b2 mRNA). Seroconversion rates induced by mRNA-1273 compared to BNT162b2 vaccine were 97% to 88% (
CONCLUSION
CONCLUSIONS
Dialysis patients exhibit a remarkably high seroconversion rate of 95% after boost vaccination, while humoral response is impaired in the majority of transplant recipients. Immunosuppressive drug number and type as well as vaccine type (BNT162b2) are major determinants of seroconversion failure in both dialysis and transplant patients suggesting immune monitoring and adaption of vaccination protocols.
Identifiants
pubmed: 34318288
doi: 10.1016/j.lanepe.2021.100178
pii: S2666-7762(21)00155-1
pmc: PMC8299287
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100178Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
PA, NB, KB, IB, AB-N, SC, KE, RF-W, KF, FG, XG, CH, JH, CK, FK, AK, HK, TL, TL, HM, RM, FM, PM, AP, AP, FP, TP, HR, JS, HS, JS, HS, TS, JS, AS, TS, US, JS, TW, TT, LA, KA-R, MA have no conflict of interests. JB has a relationship with the German Ministry of Health via Hannover Medical School and receives study coordination and per-patient fees for Crit-CoV-U study (proteomic prediction of COVID-19 severity). The study has been supported by a grant from the Else-Kröner-Fresenius-Stiftung.
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