Risk Factors Associated With an Impaired Antibody Response in Kidney Transplant Recipients Following 2 Doses of the SARS-CoV-2 mRNA Vaccine

Stephanie G Yi; Linda W Moore; Todd Eagar; Edward A Graviss; Duc T Nguyen; Hassan Ibrahim; Howard J Huang; Mark Hobeika; Robert McMillan; Ashish Saharia; Constance Mobley; Hemangshu Podder; Ashley Drews; R Mark Ghobrial; A Osama Gaber; Richard J Knight

doi:10.1097/TXD.0000000000001257

Risk Factors Associated With an Impaired Antibody Response in Kidney Transplant Recipients Following 2 Doses of the SARS-CoV-2 mRNA Vaccine

Transplant Direct. 2021 Dec 13;8(1):e1257. doi: 10.1097/TXD.0000000000001257. eCollection 2022 Jan.

Authors

Stephanie G Yi^{1

2}, Linda W Moore¹, Todd Eagar³, Edward A Graviss^{1

3}, Duc T Nguyen³, Hassan Ibrahim^{2

4}, Howard J Huang^{2

5}, Mark Hobeika^{1

2}, Robert McMillan^{1

2}, Ashish Saharia^{1

2}, Constance Mobley^{1

2}, Hemangshu Podder^{1

2}, Ashley Drews⁶, R Mark Ghobrial^{1

2}, A Osama Gaber^{1

2}, Richard J Knight^{1

2}

Affiliations

¹ Department of Surgery, Houston Methodist Hospital, Houston, TX.
² J.C. Walter Jr Center for Transplantation, Houston Methodist Hospital, Houston, TX.
³ Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX.
⁴ Division of Nephrology, Department of Internal Medicine, Houston Methodist Hospital, Houston, TX.
⁵ Division of Pulmonology, Department of Internal Medicine, Houston Methodist Hospital, Houston, TX.
⁶ Division of Infectious Disease, Department of Internal Medicine, Houston Methodist Hospital, Houston, TX.

Abstract

Background: Data about vaccine efficacy in solid organ transplant patients are limited. We previously reported our initial observation of a 6.2% immunogenicity rate in kidney transplant recipients (KTRs) after administration of 1 dose of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine. We sought to report our observations of anti-SARS-CoV-2 antibody in KTRs after 2 doses of the SARS-CoV-2 mRNA vaccine.

Methods: We identified 105 KTRs who received 2 doses of the Pfizer-BioNTech or Moderna mRNA-1273 vaccine per availability and had anti-SARS-CoV-2 labs obtained at least 2 wk following administration of the second dose. Antibody testing was performed using 3 clinically validated qualitative and semiquantitative assays.

Results: KTRs had a 36.2% antibody response rate, whereas an age ≥68 years and a longer time from transplant were factors associated with antibody response.

Conclusions: The low antibody response in KTRs may be associated with the immunosuppressive state. More data are needed to evaluate if KTRs may require higher vaccine doses or an additional booster dose to increase their ability to mount an immune response to the SARS-CoV-2 vaccine.