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Serologic Responses to COVID-19 Vaccination in Pediatric Kidney Transplant Recipients
Kathryn P Goggin1,2, Elizabeth Sun3, Emily Yun3
1Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA.
Insights
COVID-19 vaccination in pediatric kidney transplant recipients elicits antibody responses that wane over time but can be boosted with additional doses. Booster shots improve durable serologic responses in this vulnerable population.
Area of Science:
- Immunology
- Pediatric Nephrology
- Vaccinology
Background:
- Limited data exist on COVID-19 vaccine immune responses in pediatric kidney transplant recipients.
- Understanding these responses is crucial for optimizing vaccination strategies in this population.
Purpose of the Study:
- To investigate longitudinal serological responses to COVID-19 vaccination in pediatric kidney transplant recipients.
- To assess antibody titers against ancestral and Omicron SARS-CoV-2 variants.
Main Methods:
- Prospective, observational, single-center cohort study.
- Analysis of remnant blood samples from 61 pediatric kidney transplant recipients.
- Measurement of spike IgG and nucleocapsid IgG for ancestral and Omicron SARS-CoV-2 using Meso Scale Discovery.
Main Results:
- Three vaccine doses yielded an initial IgG titer to ancestral SARS-CoV-2, which waned by 4-6 months.
- A fourth dose significantly boosted IgG titers, with sustained responses for 6 months.
- Omicron-specific IgG titers were lower than ancestral, higher in previously infected individuals, and unaffected by belatacept.
Conclusions:
- Additional COVID-19 vaccine doses enhance durable serologic responses in pediatric kidney transplant recipients.
- This study expands knowledge of vaccine-induced immune responses in this specific patient group.
Background:
There are limited data describing the immune responses to COVID-19 vaccination in pediatric kidney transplant recipients, and expanding upon this information could help inform vaccination strategies in this unique population.
Methods:
We performed a prospective, observational, single-center cohort study using remnant blood samples of pediatric kidney transplant recipients from routine clinic visits to examine longitudinal serological responses after COVID-19 vaccination. We enrolled 61 pediatric kidney transplant recipients who had at least 1 sample available for analysis. Sera or plasma were analyzed for ancestral SARS-CoV-2 and Omicron (B.1.1.529; BA.1) spike IgG and nucleocapsid IgG using a Meso Scale Discovery platform.
Results:
One month after a 3-dose COVID-19 vaccination series, the IgG geometric mean titer to the SARS-CoV-2 ancestral spike was 684 binding antibody units/mL (95% confidence interval, 269-1739), but titers waned by 4-6 mo. A fourth dose of the COVID-19 vaccine boosted IgG geometric mean titer to 1606 binding antibody units/mL (95% confidence interval, 868-2972), and titers persisted through 6 mo. IgG titers against Omicron (B.1.1.529; BA.1) were overall lower than ancestral SARS-CoV-2. They were higher in participants with prior infection and were not significantly impacted by receipt of belatacept.
Conclusions:
Additional doses of the COVID-19 vaccine bolstered durable serologic responses in pediatric kidney transplant recipients, and this study broadens our understanding of immune responses to COVID-19 vaccinations in this population.
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