Why the study?
High immunosuppressive regimens in lung transplant recipients hamper the immune response to vaccination, prompting investigation of the immunogenicity of heterologous ChAdOx1 nCoV-19-BNT162b2 mRNA vaccination.
Does heterologous ChAdOx1 nCoV-19-BNT162b2 mRNA vaccination improve immunogenicity in lung transplant recipients?
Does heterologous ChAdOx1 nCoV-19-BNT162b2 mRNA vaccination improve immunogenicity in lung transplant recipients?
A heterologous booster with BNT162b2 mRNA vaccine significantly enhances the poor immunogenicity of a two-dose ChAdOx1 nCoV-19 regimen in lung transplant recipients, though overall response remains low.
May inform vaccination caution in immunosuppressed LTRs; leaves open optimal regimens for transplant recipients.
(1) Background: High immunosuppressive regimen in lung transplant recipients (LTRs) hampers the immune response to vaccination. We prospectively investigated the immunogenicity of heterologous ChAdOx1 nCoV-19-BNT162b2 mRNA vaccination in an LTR cohort. (2) Methods: Forty-nine COVID-19 naïve LTRs received a two-dose regimen ChAdOx1 nCoV-19 vaccine. A subset of 32 patients received a booster dose of BNT162b2 mRNA vaccine 18 weeks after the second dose. (3) Results: Two-doses of ChAdOx1 nCoV-19 induced poor immunogenicity with 7.2% seropositivity at day 180 and low neutralizing capacities. The BNT162b2 mRNA vaccine induced significant increases in IgG titers with means of 197.8 binding antibody units per milliliter (BAU/mL) (95% CI 0-491.4) and neutralizing antibodies, with means of 76.6 AU/mL (95% CI 0-159.6). At day 238, 32.2% of LTRs seroconverted after the booster dose. Seroneutralization capacities against Delta and Omicron variants were found in only 13 and 9 LTRs, respectively. Mycophenolate mofetil and high-dose corticosteroids were associated with a weak serological response. (4) Conclusions: The immunogenicity of a two-dose ChAdOx1 nCoV-19 vaccine regimen was very poor in LTRs, but was significantly enhanced after the booster dose in one-third of LTRs. In immunocompromised individuals, the administration of a fourth dose may be considered to increase the immune response against SARS-CoV-2.
No takes yet. Share an insight, caveat, or question.
Catry et al. (2022) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: