SARS-CoV-2 vaccine booster in solid organ transplant recipients previously immunised with inactivated versus mRNA vaccines: A prospective cohort study

Martín Dib, Nicole Le Corre, Catalina Ortiz, Daniel García, Marcela Ferrés, Constanza Martinez-Valdebenito, Cinthya Ruiz-Tagle, María José Ojeda, Manuel A. Espinoza, Aquiles Jara, Juan Pablo Arab, Ricardo Rabagliati, Cecilia Vizcaya, María Elena Ceballos, Mauricio Sarmiento, Sebastián Mondaca, Macarena Viñuela, Antonia Pastore, Vania Szwarcfiter, Elizabeth GaldamesAldo Barrera, Pablo Castro, Nicolás MS Gálvez, Jorge A. Soto, Susan M. Bueno, Alexis M. Kalergis, Bruno Nervi, M. Elvira Balcells

Resultado de la investigación: Contribución a una revistaArtículorevisión exhaustiva

Resumen

Background: Solid-organ transplant (SOT) recipients have worse COVID-19 outcomes than general population and effective immunisation in these patients is essential but more difficult to reach. We aimed to determine the immunogenicity of an mRNA SARS-CoV-2 vaccine booster in SOT recipients previously immunised with either inactivated or homologous SARS-CoV-2 mRNA vaccine. Methods: Prospective cohort study of SOT recipients under medical care at Red de Salud UC-CHRISTUS, Chile, previously vaccinated with either CoronaVac or BNT162b2. All participants received a BNT162b2 vaccine booster. The primary study end point was anti-SARS-CoV-2 total IgG antibodies (TAb) seropositivity at 8-12 weeks (56-84 days) post booster. Secondary end points included neutralising antibodies (NAb) and specific T-cell responses. Findings: A total of 140 (50% kidney, 38% liver, 6% heart) SOT recipients (mean age 54 [13.6] years; 64 [46%] women) were included. Of them, 62 had homologous (three doses of BNT162b2) and 78 heterologous vaccine schedules (two doses of CoronaVac followed by BNT162b2 booster). Boosters were received at a median of 21.3 weeks after primary vaccination. The proportion achieving TAb seropositivity (82.3% vs 65.4%, P = 0.035) and NAb positivity (77.4% vs 55.1%, P = 0.007) were higher for the homologous versus the heterologous group. On the other hand, the number of IFN-γ and IL-2 secreting SARS-CoV-2-specific T-cells did not differ significantly between groups. Interpretation: This cohort study shows that homologous mRNA vaccine priming plus boosting in SOT recipients, reaches a significantly higher humoral immune response than inactivated SARS-CoV-2 vaccine priming followed by heterologous mRNA booster. Funding: School of Medicine, UC-Chile and ANID. ClinicalTrials.gov

Idioma originalInglés
Número de artículo100371
PublicaciónLancet Regional Health - Americas
Volumen16
DOI
EstadoPublicada - dic. 2022
Publicado de forma externa

Áreas temáticas de ASJC Scopus

  • Políticas sanitarias
  • Medicina interna
  • Salud pública, medioambiental y laboral

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