@article{07068c81cd494a47ba14e851fd435e5c,
title = "SARS-CoV-2 messenger RNA vaccine antibody response and reactogenicity in heart and lung transplant recipients",
abstract = "Background: While several studies have observed that solid organ transplant recipients experience diminished antibody responses to SARS-CoV-2 mRNA vaccination, data specific to heart and lung transplant (HT/LT) recipients remains sparse. Methods: US adult HT and LT recipients completed their vaccine series between January 7 and April 10, 2021. Reactogencity and SARS-CoV-2 anti-spike antibody were assessed after a priming dose (D1) and booster dose (D2). Modified Poisson regression with robust variance estimator was used to evaluate associations between participant characteristics and antibody development. Results: Of 134 heart recipients, there were 38% non-responders (D1-/D2-), 48% booster responders (D1-/D2+), and 14% priming dose responders (D1+/D2+). Of 103 lung recipients, 64% were non-responders, 27% were booster responders, and 9% were priming dose responders. Lung recipients were less likely to develop antibodies (p < .001). Priming dose antibody response was associated with younger recipient age (p = .04), transplant-to-vaccination time ≥6 years (p < .01), and lack of anti-metabolite maintenance immunosuppression (p < .001). Pain at injection site was the most commonly reported reaction (85% after D1, 76% after D2). Serious reactions were rare, the most common being fatigue (2% after D1 and 3% after D2). No serious adverse events were reported. Conclusions: HT and LT recipients experienced diminished antibody response following vaccination; reactogenicity was comparable to that of the general population. LT recipients may exhibit a more impaired antibody response than HT recipients. While current recommendations are to vaccinate eligible candidates and recipients, further studies characterizing the cell-mediated immune response and clinical efficacy of these vaccines in this population are needed.",
keywords = "COVID-19, SARS-CoV-2, heart transplant, lung transplant, mRNA vaccination",
author = "Hallett, {Andrew M.} and Greenberg, {Ross S.} and Boyarsky, {Brian J.} and Shah, {Pali D.} and Ou, {Michael T.} and Teles, {Aura T.} and Krach, {Michelle R.} and L{\'o}pez, {Julia I.} and Werbel, {William A.} and Avery, {Robin K.} and Sunjae Bae and Tobian, {Aaron A.} and Massie, {Allan B.} and Higgins, {Robert S.D.} and Garonzik-Wang, {Jacqueline M.} and Segev, {Dorry L.} and Bush, {Errol L.}",
note = "Funding Information: This research was made possible with generous support of the Ben-Dov family. This work was supported by grant numbers T32DK007732 (Hallett), F32DK124941 (Boyarsky), and K23DK115908 (Garonzik‐Wang) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), K24AI144954 (Segev) from National Institute of Allergy and Infectious Diseases (NIAID), and by a grant from the Transplantation and Immunology Research Network of the American Society of Transplantation (Werbel). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government. Funding Information: This research was made possible with generous support of the Ben-Dov family. This work was supported by grant numbers T32DK007732 ( Hallett ), F32DK124941 ( Boyarsky ), and K23DK115908 ( Garonzik ‐ Wang ) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , K24AI144954 ( Segev ) from National Institute of Allergy and Infectious Diseases (NIAID) , and by a grant from the Transplantation and Immunology Research Network of the American Society of Transplantation (Werbel) . The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government. Publisher Copyright: {\textcopyright} 2021 International Society for Heart and Lung Transplantation",
year = "2021",
month = dec,
doi = "10.1016/j.healun.2021.07.026",
language = "English (US)",
volume = "40",
pages = "1579--1588",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier USA",
number = "12",
}