Comparison of antibody response to SARS-CoV-2 after two doses of inactivated virus and BNT162b2 mRNA vaccines in kidney transplant

ABSTRACT Background Antibody response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after mRNA or adenoviral vector-based vaccines is weak in kidney transplant (KT) patients. However, few studies have focused on humoral response after inactivated virus-based vaccines in KT. He...

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Published in:	Clinical kidney journal Vol. 15; no. 3; pp. 527 - 533
Main Authors:	Seija, Mariana, Rammauro, Florencia, Santiago, José, Orihuela, Natalia, Zulberti, Catherine, Machado, Danilo, Recalde, Cecilia, Noboa, Javier, Frantchez, Victoria, Astesiano, Rossana, Yandián, Federico, Guerisoli, Ana, Morra, Álvaro, Cassinelli, Daniela, Coelho, Cecilia, de Aramburu, Belén, González-Severgnini, Paulina, Moreno, Romina, Pippolo, Aldana, López, Gabriela, Lemos, Mónica, Somariva, Lorena, López, Eliana, Fumero, Soledad, Orihuela, Carla, Rodríguez, Rosalía, Acuña, Gonzalo, Rabaza, Victoria, Perg, Nancy, Cordero, Rossana, Reisfeld, Cristina, Olivera, Paula, Montero, Paola, Nogueira, Cecilia, Nalerio, Catheryn, Orihuela, Sergio, Curi, Lilián, Burgstaller, Ema, Noboa, Oscar, Pritsch, Otto, Nin, Marcelo, Bianchi, Sergio
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 01-03-2022
Subjects:	Belatacept Blood Coronaviruses Enzyme-linked immunosorbent assay Ethylenediaminetetraacetic acid Health aspects Immunoglobulin G Kidneys Medical examination Medical research Medicine, Experimental Messenger RNA Original Severe acute respiratory syndrome Transplantation Vaccination Uruguay COVID-19 SARS-CoV-2 vaccine kidney transplantation
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Summary:	ABSTRACT Background Antibody response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after mRNA or adenoviral vector-based vaccines is weak in kidney transplant (KT) patients. However, few studies have focused on humoral response after inactivated virus-based vaccines in KT. Here, we compare antibody response following vaccination with inactivated virus (CoronaVac®) and BNT162b2 mRNA. Methods A national multicentre cross-sectional study was conducted. The study group was composed of patients from all KT centres in Uruguay, vaccinated between 1 and 31 May 2021 (CoronaVac®, n = 245 and BNT162b2, n = 39). The control group was constituted of 82 healthy individuals. Participants had no prior confirmed coronavirus disease 2019 (COVID-19) test. Blood samples were collected between 30 and 40 days after the second dose. Serum-specific immunoglobulin G (IgG) antibodies against the receptor-binding domain (RBD) of SARS-CoV-2 Spike protein were determined using the COVID-19 IgG QUANT ELISA Kit. Results Only 29% of KT recipients showed seroconversion (36.5% BNT162b2, 27.8% inactivated virus, P = 0.248) in comparison with 100% in healthy control with either vaccine. Antibody levels against RBD were higher with BNT162b mRNA than with inactivated virus [median (interquartile range) 173 (73–554) and 29 (11–70) binding antibody units (BAU)/mL, P < 0.034] in KT and 10 times lower than healthy control [inactivated virus: 308 (209–335) and BNT162b2: 2638 (2608–3808) BAU/mL, P < 0.034]. In multivariate analysis, variables associated with negative humoral response were age, triple immunosuppression, estimated glomerular filtration rate and time post-KT. Conclusion Seroconversion was low in KT patients after vaccination with both platforms. Antibody levels against SARS-CoV-2 were lower with inactivated virus than BNT162b mRNA. These findings support the need for strategies to improve immunogenicity in KT recipients after two doses of either vaccine. Graphical Abstract Graphical Abstract
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work.
ISSN:	2048-8505 2048-8513
DOI:	10.1093/ckj/sfab291