Negative immune responses to two‐dose mRNA COVID‐19 vaccines in renal allograft recipients assessed with simple antibody and interferon gamma release assay cellular monitoring

Studies are urgently needed to characterize immunogenicity, efficacy, and safety of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) mRNA vaccines in kidney transplant (KT) recipients, excluded from major clinical trials. Complex ELISPOT and other cellular response techniques have been a...

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Bibliographic Details
Published in:	American journal of transplantation Vol. 22; no. 3; pp. 786 - 800
Main Authors:	Crespo, Marta, Barrilado‐Jackson, Antoni, Padilla, Eduardo, Eguía, Jorge, Echeverria‐Esnal, Daniel, Cao, Higini, Faura, Anna, Folgueiras, Montserrat, Solà‐Porta, Eulàlia, Pascual, Sergi, Barbosa, Francesc, Hurtado, Sara, Ribera, Laura, Río‐No, Laura, Pérez‐Sáez, María José, Redondo‐Pachón, Dolores, Pascual, Julio
Format:	Journal Article
Language:	English
Published:	United States Elsevier Limited 01-03-2022 John Wiley and Sons Inc
Subjects:	Allografts Antibodies, Viral antibody biology clinical research/practice Clinical trials Coronaviruses COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 Vaccines COVID‐19 dialysis Enzyme-linked immunosorbent assay Hemodialysis Humans Immune response (humoral) Immunity immunobiology Immunogenicity Immunoglobulin G infectious disease Infectious diseases Interferon-gamma Release Tests Kidney transplantation Kidney Transplantation - adverse effects kidney transplantation/nephrology Kidney transplants mRNA Original ORIGINAL ARTICLES Patients Peritoneal dialysis Renal Dialysis RNA, Messenger - genetics SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Spike protein T cell biology vaccine Vaccines γ-Interferon COVID-19 antibody biology dialysis vaccine infectious disease clinical research/practice kidney transplantation/nephrology T cell biology immunobiology
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Summary:	Studies are urgently needed to characterize immunogenicity, efficacy, and safety of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) mRNA vaccines in kidney transplant (KT) recipients, excluded from major clinical trials. Complex ELISPOT and other cellular response techniques have been applied, but simpler tools are needed. An easy‐to‐use real‐world monitoring of SARS‐CoV‐2 IgG antibodies against the Spike protein and QuantiFERON® SARS‐CoV‐2 IFNγ release assay (IGRA) were performed at baseline and 28 days after the second dose in KT recipients and controls (dialysis patients and healthy ones). All healthy controls and >95% dialysis controls became positive for anti‐S IgG antibodies, while only 63.3% of KT patients seroconverted with a very low antibody level. A positive IGRA was documented in 96.9% of controls, 89.3% peritoneal dialysis, 77.6% hemodialysis, 61.3% of KT patients transplanted more than 1 year ago and only 36% of those transplanted within the previous 12 months. Overall, 100% of healthy controls, 95.4% of dialysis patients and 78.8% KT recipients developed any immune response (humoral and/or cellular) against SARS‐CoV‐2. KT patients showed low rates of immune responses to mRNA Coronavirus infectious disease 2019 vaccines, especially those with recent transplantations. Simple humoral and cellular monitoring is advisable, so that repeated doses may be scheduled according to the results. Simple antibody quantification and interferon‐γ release assay demonstrates low humoral and cellular responses in kidney transplant recipients compared to to healthy controls and dialysis patients after 2 dose mRNA SARS‐CoV‐2 vaccination.
Bibliography:	Dolores Redondo‐Pachón and Julio Pascual share senior authorship. Marta Crespo and Antoni Barrilado‐Jackson share first authorship. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1600-6135 1600-6143
DOI:	10.1111/ajt.16854