Humoral and Cellular Immune Responses After a 3-dose Course of mRNA-1273 COVID-19 Vaccine in Kidney Transplant Recipients: A Prospective Cohort Study
oleh: David Cucchiari, MD, PhD, Natalia Egri, MD, Diana Rodriguez-Espinosa, MD, Enrique Montagud-Marrahi, MD, Joaquim Casals-Urquiza, MD, Jimena Del Risco-Zevallos, MD, Marta Bodro, MD, PhD, Pedro Ventura-Aguiar, MD, PhD, Frederic Cofan, MD, PhD, Judit Cacho, MD, Alicia Molina-Andujar, MD, Jordi Rovira, PhD, Elisenda Banon-Maneus, PhD, Maria José Ramirez-Bajo, PhD, Anna Pérez-Olmos, RN, Marta Garcia-Pascual, RN, PhD, Mariona Pascal, MD, PhD, Anna Vilella, MD, PhD, Antoni Trilla, MD, PhD, Eduard Palou, MD, PhD, Ignacio Revuelta, MD, PhD, Manel Juan, MD, PhD, Josep M. Campistol, MD, PhD, Frederic Oppenheimer, MD, PhD, Asunción Moreno, MD, PhD, Josep M. Miró, MD, PhD, Beatriu Bayés, MD, PhD, Fritz Diekmann, MD, PhD
| Format: | Article |
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| Diterbitkan: | Wolters Kluwer 2022-11-01 |
Deskripsi
Background. In kidney transplant recipients, there is discordance between the development of cellular and humoral response after vaccination against SARS-CoV-2. We sought to determine the interplay between the 2 arms of adaptive immunity in a 3-dose course of mRNA-1273 100 μg vaccine. Methods. Humoral (IgG/IgM) and cellular (N- and S-ELISpot) responses were studied in 117 kidney and 12 kidney-pancreas transplant recipients at the following time points: before the first dose, 14 d after the second dose‚ and before and after the third dose, with a median of 203 and 232 d after the start of the vaccination cycle, respectively. Results. After the second dose, 26.7% of naive cases experienced seroconversion. Before the third dose and in the absence of COVID-19, this percentage increased to 61.9%. After the third dose, seroconversion occurred in 80.0% of patients. Naive patients who had at any time point a detectable positivity for S-ELISpot were 75.2% of the population, whereas patients who maintained S-ELISpot positivity throughout the study were 34.3%. S-ELISpot positivity at 42 d was associated with final seroconversion (odds ratio‚ 3.14; 95% confidence interval‚ 1.10-8.96; P = 0.032). Final IgG titer was significantly higher in patients with constant S-ELISpot positivity (P < 0.001). Conclusions. A substantial proportion of kidney transplant recipients developed late seroconversion after 2 doses. Cellular immunity was associated with the development of a stronger humoral response.