key: cord-1025871-tphnb5cu
authors: Song, Chelsey Chenxi; Christensen, Johanna; Kumar, Dhiren; Vissichelli, Nicole; Morales, Megan; Gupta, Gaurav
title: Early Experience with SARs‐CoV‐2 mRNA Vaccine Breakthrough Among Kidney Transplant Recipients
date: 2021-05-29
journal: Transpl Infect Dis
DOI: 10.1111/tid.13654
sha: 6752bf033ada0bdccfc38945cb51680c6b1f5cda
doc_id: 1025871
cord_uid: tphnb5cu

The efficacy of vaccinations among vulnerable populations such as solid organ transplant recipients on chronic immunosuppression have been suboptimal compared to the general population(1‐2). Preliminary data suggests the humoral response rate for solid organ transplant patients who have received both doses of SARs‐CoV‐2 mRNA vaccine, either mRNA‐1273 (Moderna) or BNT162b2 (Pfizer‐BioNTech), is roughly 54% (3). However, the clinical implications and real life impact of this is still unknown.

. These patients were predominately male (5/7) with a median age of 53 who received a deceased donor with a median time of 3 years from transplant.

Majority (6/7) were maintained on triple immunosuppression, with one patient taken off of anti-metabolite due to persistent BK viremia. Median time from vaccine completion to time to diagnosis was 33 days.

Interestingly, 3/7 patients had detectable Sars-CoV-2 spike IgG antibody, while 2/7 had both spike and nucleocapsid protein IgG at the time of COVID-19 diagnosis. Unfortunately, quantitative antibody levels as well as SARs-CoV-2 variant data was not available.

Our early experience suggests limited early breakthrough COVID-19 in kidney transplant recipients who completed the two-dose SARs-CoV-2 mRNA vaccine series despite a reported 54% antibody response. In patients who did experience vaccine breakthrough, the majority did not develop severe symptoms that required inpatient admission. This may reflect a need for quantitative antibody disease protection threshold measurements, as well as the importance of continued vaccine efforts among immunosuppressive patients despite the reported lower antibody response. Our results are further strengthened by a significant decline in the diagnosis of new COVID-19 cases since vaccinations started. Future studies are needed to assess newer strategies in vaccination to better protect immunosuppressed patients from preventable morbidity and mortality. 

Influenza virus vaccination in kidney transplant recipients: serum antibody response to different immunosuppressive drugs

Mycophenolate and lower graft function reduce the seroresponse of kidney transplant recipients to pandemic H1N1 vaccination

Immunogenicity of a single dose of SARS-CoV-2 messenger RNA vaccine in solid organ transplant recipients

The authors do not have any potential conflicts of interests to disclose. This article is protected by copyright. All rights reserved