Clinical Course, Immunogenicity, and Efficacy of BNT162b2 mRNA Vaccination Against SARS-CoV-2 Infection in Liver Transplant Recipients.

Clinical Course, Immunogenicity, and Efficacy of BNT162b2 mRNA Vaccination Against SARS-CoV-2 Infection in Liver Transplant Recipients.

Publication date: Oct 01, 2023

Immunocompromised individuals have been excluded from landmark studies of messenger RNA vaccinations for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). In such patients, the response to vaccination may be blunted and may wane more quickly compared with immunocompetent patients. We studied the factors associated with decreased antibody response to SARS-CoV-2 vaccination and risk factors for subsequent breakthrough infections in liver transplant (LT) patients undergoing coronavirus disease 2019 vaccination with at least 2 doses of messenger RNA vaccine from April 28, 2021, to April 28, 2022. All LT recipients received at least 2 doses of the BNT162b2 (Pfizer BioNTech) vaccine 21 d apart. We measured the antibody response against the SARS-CoV-2 spike protein using the Roche Elecsys immunoassay to the receptor-binding domain of the SARS-CoV-2 spike protein, and the presence of neutralizing antibodies was measured by the surrogate virus neutralization test (cPass) before first and second doses of vaccination and also between 2 and 3 mo after the second dose of vaccination. Ninety-three LT recipients who received 2 doses of BNT162b2 were included in the analysis. The mean time from LT was 110 +/- 154 mo. After 2-dose vaccination, 38. 7% of LT recipients (36/93) were vaccine nonresponders on the cPass assay compared with 20. 4% (19/93) on the Roche S assay. On multivariable analysis, increased age and increased tacrolimus trough were found to be associated with poor neutralizing antibody response (P = 0. 038 and 0. 022, respectively). The use of antimetabolite therapy in conjunction with tacrolimus approached statistical significance (odds ratio 0. 21; 95% confidence interval, 0. 180-3. 72; P = 0. 062). Breakthrough infection occurred in 18 of 88 LT recipients (20. 4%). Female gender was independently associated with breakthrough infections (P 

Concepts Keywords
Coronavirus Antibody
Immunocompromised Bnt162b2
Liver Breakthrough
Coronavirus
Cov
Doses
Infection
Liver
Messenger
Patients
Recipients
Sars
Transplant
Vaccination
Vaccine

Semantics

Type Source Name
disease MESH Clinical Course
disease VO vaccination
disease MESH SARS-CoV-2 Infection
pathway REACTOME SARS-CoV-2 Infection
disease MESH breakthrough infections
disease VO vaccine
disease VO dose
disease VO time
disease IDO assay
drug DRUGBANK Tacrolimus

Original Article

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