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Journal Article Epublish 3 citations

PubMed: 38023564 DOI: 10.1093/ofid/ofad536

Antibody Response After the Third SARS-CoV-2 Vaccine in Solid Organ Transplant Recipients and People Living With HIV (COVERALL-2).

Open Forum Infect Dis 10(11):ofad536

Authors: Alexandra Griessbach, Frédérique Chammartin, Irene A Abela, Patrizia Amico, Marcel P Stoeckle, Anna L Eichenberger, Barbara Hasse, Dominique L Braun, Macé M Schuurmans, Thomas F Müller, Michael Tamm, Annette Audigé, Nicolas J Mueller, Andri Rauch, Huldrych F Günthard, Michael T Koller, Alexandra Trkola, Selina Epp, Alain Amstutz, Christof M Schönenberger, Ala Taji Heravi, Matthaios Papadimitriou-Olivgeris, Alessio Casutt, Oriol Manuel, Katharina Kusejko, Heiner C Bucher, Matthias Briel, Benjamin Speich

Affiliations

  • Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
  • Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
  • Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
  • Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
  • Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
  • Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
  • Nephrology Clinic, University Hospital Zurich, Zurich, Switzerland.
  • Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland.
  • Swiss Transplant Cohort Study, University Hospital Basel, Basel, Switzerland.
  • Infectious Diseases Service and Transplantation Center, Lausanne University Hospital, Lausanne, Switzerland.
  • Division of Pulmonology, Department of Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
  • Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Abstract

Background

After basic immunization with 2 mRNA SARS-CoV-2 vaccine doses, only a small proportion of patients who are severely immunocompromised generate a sufficient antibody response. Hence, we assessed the additional benefit of a third SARS-CoV-2 vaccine in patients with different levels of immunosuppression.

Methods

In this observational extension of the COVERALL trial (Corona Vaccine Trial Platform), we recruited patients from the Swiss HIV Cohort Study and the Swiss Transplant Cohort Study (ie, lung and kidney transplant recipients). We collected blood samples before and 8 weeks after the third SARS-CoV-2 vaccination with either mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech). The primary outcome was the proportion of participants showing an antibody response (Elecsys Anti-SARS-CoV-2 S test; threshold ≥100 U/mL) 8 weeks after the third SARS-CoV-2 vaccination. We also compared the proportion of patients who reached the primary outcome from basic immunization (the first and second vaccines) to the third vaccination.

Results

Nearly all participants (97.2% [95% CI, 95.9%-98.6%], 564/580) had an antibody response. This response was comparable between mRNA-1273 (96.1% [95% CI, 93.7%-98.6%], 245/255) and BNT162b2 (98.2% [95% CI, 96.7%-99.6%], 319/325). Stratification by cohort showed that 99.8% (502/503) of people living with HIV and 80.5% (62/77) of recipients of solid organ transplants achieved the primary endpoint. The proportion of patients with an antibody response in solid organ transplant recipients improved from the second vaccination (22.7%, 15/66) to the third (80.5%, 62/77).

Conclusions

People living with HIV had a high antibody response. The third vaccine increased the proportion of solid organ transplant recipients with an antibody response.  NCT04805125 (ClinicalTrials.gov).

MeSH

Antibody Formation, Sars-Cov-2, Immunization, Vaccines, Covid-19 Vaccines, Vaccination, Hiv, Transplants, Severe Acute Respiratory Syndrome-Related Coronavirus

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