@article{c5f25a51590740ef8977089093eb1f6a,
title = "Heterologous Ad.26.COV2.S versus homologous BNT162b2/mRNA-1273 as a third dose in solid organ transplant recipients seronegative after two-dose mRNA vaccination",
abstract = "Heterologous vaccination (“mixing platforms”) for the third (D3) dose of SARS-CoV-2 vaccine is a potential strategy to improve antibody responses in solid organ transplant recipients (SOTRs), but data are mixed regarding potential differential immunogenicity. We assessed for differences in immunogenicity and tolerability of homologous (BNT162b2 or mRNA-1273; D3-mRNA) versus heterologous (Ad.26.COV2.S; D3-JJ) D3 among 377 SARS-CoV-2-infection na{\"i}ve SOTRs who remained seronegative after two mRNA vaccines. We measured anti-spike titers and used weighted Poisson regression to evaluate seroconversion and development of high-titers, comparing D3-JJ to D3-mRNA, at 1-, 3-, and 6 month post-D3. 1-month post-D3, seroconversion (63% vs. 52%, p =.3) and development of high-titers (29% vs. 25%, p =.7) were comparable between D3-JJ and D3-mRNA recipients. 3 month post-D3, D3-JJ recipients were 1.4-fold more likely to seroconvert (80% vs. 57%, weighted incidence-rate-ratio: wIRR = 1.101.401.77, p =.006) but not more likely to develop high-titers (27% vs. 22%, wIRR = 0.440.921.93, p =.8). 6 month post-D3, D3-JJ recipients were 1.41-fold more likely to seroconvert (88% vs. 59%, wIRR = 1.04 1.411.93, p =.029) and 2.63-fold more likely to develop high-titers (59% vs. 21%, wIRR = 1.382.635.00, p =.003). There was no differential signal in alloimmune events or reactogenicity between platforms. SOTRs without antibody response after two mRNA vaccines may derive benefit from heterologous Ad.26.COV2.S D3.",
keywords = "SARS-CoV-2, antibodies, heterologous, transplant, vaccine",
author = "Chiang, {Teresa P.Y.} and Alejo, {Jennifer L.} and Jonathan Mitchell and Kim, {Jake D.} and Abedon, {Aura T.} and Karaba, {Andrew H.} and Letitia Thomas and Levan, {Macey L.} and Garonzik-Wang, {Jacqueline M.} and Avery, {Robin K.} and Andrew Pekosz and William A Clarke and Warren, {Daniel S.} and Tobian, {Aaron A.R.} and Allan B Massie and Segev, {Dorry L.} and Werbel, {William A.}",
note = "Funding Information: This work was supported by the Ben‐Dov family, the Trokhan Patterson family, grants 5T32DK007713 (Dr. Alejo), The ASTS Fryer Resident Scientist Award (Dr. Mitchell), K01DK101677 (Dr. Massie), 5K01DK114388 (Dr. Levan), K23DK115908 (Dr. Garonzik‐Wang) from the National Institute of Diabetes and Digestive and Kidney Diseases; grant K24AI144954 (Dr. Segev) from the National Institute of Allergy and Infectious Diseases; and grants K08AI156021 (Dr. Karaba), U01AI138897, 3U01AI138897‐04S1, and K23AI157893 (Dr. Werbel). Funding Information: This work was supported by the Ben-Dov family, the Trokhan Patterson family, grants 5T32DK007713 (Dr. Alejo), The ASTS Fryer Resident Scientist Award (Dr. Mitchell), K01DK101677 (Dr. Massie), 5K01DK114388 (Dr. Levan), K23DK115908 (Dr. Garonzik-Wang) from the National Institute of Diabetes and Digestive and Kidney Diseases; grant K24AI144954 (Dr. Segev) from the National Institute of Allergy and Infectious Diseases; and grants K08AI156021 (Dr. Karaba), U01AI138897, 3U01AI138897-04S1, and K23AI157893 (Dr. Werbel). The authors thank the participants of the Johns Hopkins COVID-19 Transplant Vaccine Study, without whom this research could not be possible. They also thank the members of the study team, including Brian J. Boyarsky MD, PhD; Amy Chang, MD, Mayan Teles, BS; Laura Zeiser, MS; Alexa Jefferis, BS; Nicole Fortune Hernandez, BS; Rivka Abedon; Chunyi Xia; Kim Hall; Mary Sears; Alex Alex; Jonathan Susilo. They also thank and Ms. Yolanda Eby for project support and guidance. Publisher Copyright: {\textcopyright} 2022 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.",
year = "2022",
month = sep,
doi = "10.1111/ajt.17061",
language = "English (US)",
volume = "22",
pages = "2254--2260",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "9",
}