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BMC Infect Dis . Long-term immune response after SARS-CoV2 vaccination in solid organ transplant recipients

tetano

Editor, Senior Moderator
BMC Infect Dis


. 2025 Apr 25;25(1):606.
doi: 10.1186/s12879-024-10377-1. Long-term immune response after SARS-CoV2 vaccination in solid organ transplant recipients

Cecilia Bonazzetti[SUP] 1 2 [/SUP], Alice Toschi[SUP] 1 [/SUP], Dino Gibertoni[SUP] 3 [/SUP], Natascia Caroccia[SUP] 2 [/SUP], Michela Di Chiara[SUP] 2 [/SUP], Silvia Vituliano[SUP] 1 [/SUP], Federica Lanna[SUP] 4 [/SUP], Alessandro Croci[SUP] 1 [/SUP], Beatrice Tazza[SUP] 2 [/SUP], Armando Amicucci[SUP] 1 [/SUP], Maria Cristina Morelli[SUP] 5 [/SUP], Giorgia Comai[SUP] 1 6 [/SUP], Elena Salvaterra[SUP] 7 [/SUP], Luciano Potena[SUP] 8 [/SUP], Pierluigi Viale[SUP] 1 2 [/SUP], Maddalena Giannella[SUP] 9 10 11 [/SUP], Tiziana Lazzarotto[SUP] 1 4 [/SUP]



Affiliations
Abstract

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccination in solid organ transplant (SOT) recipients is associated with suboptimal antibody response (AbR) favouring breakthrough infection (BI). The role of cell-mediated immunity (CMI) remains uncertain.
Methods: Single-center prospective longitudinal cohort study of adult SOT recipients monitored for both AbR and CMI at 6 ± 2 months after booster dosage of SARS-CoV-2 vaccine. Primary end-point was BI diagnosis and CMI was the main risk factor. Relationship between CMI and BI was investigated by bivariate tests and multivariable logistic regression.
Results: CMI was performed in 139 patients. In 66 patients BI was documented before CMI, thus 73 (33 kidney, 24 liver, 14 lung, 2 heart) were analysed. The first 2 vaccine doses consisted of BNT162b2 and mRNA-1273 in 69.1% and 30.9% of cases, respectively. Whereas mRNA-1273 was used as for third dose in 91.2% of patients. At a median of 215 (IQR 181-252) days after booster dose, 40 (54.8%) patients displayed both AbR and CMI, 21 (28.8%) only AbR and 12 (16.4%) neither AbR or CMI; there were no patients showing negative AbR and positive CMI. Overall, 22 (30.1%) patients reported BI with no significant differences between those with positive vs. negative CMI (59.1% vs. 40.9%, p = 0.798), confirmed by multiple logistic regression after adjusting for age, type of vaccine and organs, high AbR and time from transplant.
Conclusion: Our data suggest that in the solid organ transplant population of our cohort, cell-mediated immunity does not appear to be a strong predictor of BI.

Keywords: Solid organ transplant; Antibody response; Cellular mediated immunity; Sars-CoV2 vaccine.

 
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