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Published on: November 10, 2023
Immunity After Vaccination Against SARS-CoV-2 in Lung Transplant?
Gema María Siesto López1, Rodrigo Alonso Moralejo2, María Piñeiro Roncal3
1Pneumology Department, Universitary Hospital of Salamanca. P. San Vicente, Salamanca, Spain.
Background:
SARS-CoV2 infection causes high morbidity and mortality in lung transplant (LT) recipients. Vaccination with messenger RNA vaccines has been shown to play a key role in controlling the severity of infection in the general population. The aim of our study is to analyze whether vaccination with 2 doses of SARS-Cov2 provides immunity in LT recipients.
Methods:
Retrospective descriptive and analytical study of LT recipients vaccinated with 2 doses of SARS-CoV2. We analyzed the vaccine received, if they had COVID-19, antibody levels (antispike and antinucleoprotein), anticalcineurin levels, infections in the last year, and presence of neoplasias.
Results:
The most commonly administered vaccine was from Moderna, with 27% of patients showing immunity with a median antibody levels of 4.81 binding antibody units/mL, far from the values considered protective (> 34 binding antibody units/mL). Thirteen patients were infected with SARS-CoV2, 7 post vaccination (5 of them were antispike-positive). No relationship was demonstrated between generation of immunity and age and level of immunosuppression.
Conclusions:
Vaccination against SARS-CoV2 in LT recipients generates limited and ineffective immunity with only 2 doses.
Insights
Messenger RNA (mRNA) vaccines offer limited protection against SARS-CoV-2 in lung transplant recipients. Two doses of the vaccine generated insufficient antibody levels for effective immunity in this vulnerable patient group.
Area of Science:
- Immunology
- Transplantation Medicine
- Infectious Diseases
Background:
- Lung transplant (LT) recipients face severe outcomes from SARS-CoV-2 infection.
- Messenger RNA (mRNA) vaccines are crucial for managing COVID-19 in the general population.
Purpose of the Study:
- To evaluate the immunogenicity of a two-dose SARS-CoV-2 mRNA vaccination in lung transplant recipients.
Main Methods:
- Retrospective analysis of LT recipients who received two doses of SARS-CoV-2 vaccine.
- Assessment of vaccine type, COVID-19 incidence, antibody levels (anti-spike, anti-nucleoprotein), and immunosuppression.
- Analysis included anticalcineurin levels, prior infections, and neoplasia presence.
Main Results:
- Moderna vaccine was most common; only 27% achieved immunity with median antibody levels (4.81 BAU/mL) below protective thresholds (>34 BAU/mL).
- Thirteen LT recipients contracted SARS-CoV-2, with 7 post-vaccination cases (5 anti-spike positive).
- No correlation found between immunity generation, age, or immunosuppression levels.
Conclusions:
- Two-dose SARS-CoV-2 vaccination in lung transplant recipients induces limited and inadequate immunity.
- Further strategies are needed to enhance vaccine effectiveness in this high-risk population.
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