Table 1.
Humoral response to two doses of SARS-CoV-2 vaccine in solid organ transplant recipients
| Organ transplanted, number of patients | Type of vaccine | % Seropositive humoral response | Associations with seronegative response | Associations with seropositive response | Adverse Events (AE) | Time from second dose of vaccine | |
|---|---|---|---|---|---|---|---|
| Bertrand et al. [35] | Kidney, 45 | BNT162b2 (Pfizer-BioNTech) | 17.8% |
Duration of kidney transplantation and a cyclosporin-based immunosuppressive regimen |
1 month | ||
| Boyarsky et al. [77] |
Total = 436 Kidney, 219 Liver, 78 Heart, 66 Lung, 50 |
• BNT162b2 (Pfizer-BioNTech) • mRNA-1273 (Moderna) |
17.4% 18.7% 47.4% 18.2% 10% |
Regimen includes anti-metabolite (OR = 0.22 (0.1–0.3)) Age (OR = 0.83 (0.7–0.9)) |
mRNA-1273 (OR = 2.1 (1.3–3.5)) compared to BNT162b2 | 20 days post first dose | |
| Boyarsky et al. [78••] |
Total = 658 Kidney, 322 Liver, 129 Heart, 97 Lung, 71 Pancreas, 5 |
• BNT162b2 (Pfizer-BioNTech) • mRNA-1273 (Moderna) |
54% 48% 80% 57% 39% 20% |
Younger age Type of vaccine (BNT162b2 > BNT162b2) More years since transplantation Organ transplanted Maintenance includes anti-metabolite |
28–31 days | ||
| Bruminhent et al. [79] | Kidney, 35 | Inactivated whole-virus SARS-CoV-2 vaccine | 9% |
Low-dose mycophenolic acid Cyclosporine-based regimen |
No serious AE | 2 weeks | |
| Crespo et al. [80] | Kidney, 90 | mRNA-1273 (Moderna) | 63% | > 6 months after transplantation (OR 0.29 (0.08–1.0)) | No serious AE | 28 days | |
| Cucchiari et al. [39•] | Kidney, 117 | mRNA-1273 (Moderna) | 30% | Combination Tacrolimus + mTOR inhibitors (OR 0.3 (0.09–0.8)) | No serious AE | 2 weeks | |
| Grupper et al. [74] | Kidney, 136 | BNT162b2 (Pfizer-BioNTech) | 37.5% |
Older age (1.7 (1.2–2.7)) High-dose corticosteroids in the last 12 months (1.3 (1.09–1.8)), Maintenance with triple immunosuppression (1.4 (1.06–2.1)) Regimen that includes mycophenolate (1.5 (1.3–2.3)) |
No serious AE | 14–21 days | |
| Grupper et al. [63••] | Kidney, 128 | BNT162b2 (Pfizer-BioNTech) | 52% |
Vaccination post-transplantation (22.4 (3.6–36)) Age (1.04 (1.01–1.1)) Time on dialysis ((1.02 (1.01–1.04)) |
Higher lymphocyte count ((0.52(0.3–0.9)) | No serious AE | 95 days after second dose |
| Guarino et al. [81] | Liver, 365 | BNT162b2 (Pfizer-BioNTech) | 75% |
Older age (> 65 years) Higher BMI Shorter time from transplantation Immunosuppressive regimens (anti-metabolite, mTORS, 2 < Immunosuppressive medications) |
No serious AE | 4 weeks | |
| Hallett et al. [82] |
Heart, 134 Lung, 103 |
• BNT162b2 (Pfizer-BioNTech) • mRNA-1273 (Moderna |
62% 36% |
Heart vs. lung transplant (1.55 (1.2–2.0)) Anti-metabolite maintenance immunosuppression (0.7 (0.5–0.8)) Younger age ((0.61 (0.4–0.9)) > 6 years out from transplantation (1.22 (1.1–1.3)) |
No serious AE | 28 days | |
| Itzhaki Ben Zadok et al. [83] | Heart, 37 | BNT162b2 (Pfizer-BioNTech) | 49% |
Older age Treatment with anti-metabolite-based protocols |
No serious AE | 35–40 days post first dose | |
| Marion et al. [84•] |
Total = 367 Kidney, 271 Liver, 58 Thoracic organs, 33 |
• BNT162b2 (Pfizer-BioNTech) • mRNA-1273 (Moderna) |
34% 33% 50% 12% |
Most mild 1 acute cellular rejection in kidney recipient |
28 days | ||
| Masset et al. [85•] | Kidney, 456 | BNT162b2 (Pfizer-BioNTech) | 50% |
Anti-metabolite drugs (5.7 (3.0–11.5)) or steroids (3.6 (2.1–6.6)) Age (1.03 ( 1.01–1.06)) Impaired allograft function (0.98 (0.96–0.99)) Transplant < 4 years (2.9 (1.70–5.1)) |
1 month | ||
| Mazzola et al. [86] |
Total = 133 Kidney, 59 Liver, 58 Heart, 26 |
BNT162b2 (Pfizer-BioNTech) |
28.% 16.6% 37.5% 34.8% |
Transplantation < 2 years (2.8 (1.06–7.7)) Diabetes (3.4 (1.3–8.5)) Kidney transplantation (4.0 (1.5–10.2)) |
No serious AE | 28 days | |
| Peled et al. [87] | Heart, 77 | BNT162b2 (Pfizer-BioNTech) | 18% | Mycophenolate use (0.12 (0.01–0.8)) | No serious AE | 28 days | |
| Prendecki et al. [88••] | Kidney, 920 |
• ChAdOx1 (Oxford University–AstraZeneca) • BNT162b2 (Pfizer-BioNTech) |
Pfizer 66% Astra zeneca 44% |
< 1 year after transplant (0·2 0.15–0·5)) Diabetes (0·6 (0·4–0·9)) |
Vaccination with BNT162b2 (2.4 (1.7–3.4)) Tacrolimus monotherapy (5.2 (3.6–7.6)) |
31 days | |
| Rabinowich et al. [89] | Liver, 80 | BNT162b2 (Pfizer-BioNTech) | 47% |
Age (1.3 (1.1–1.9)) Lower eGFR (0.8 (0.4–0.9)) High-dose prednisone in the past 12 months (1.8 (1.5–4.6)) Triple therapy immunosuppression (1.7 (1.2–2.5)) Low-dose steroids (1.5 (0.9–4.1)) MMF (1.8 (1.1–3.5)) |
No serious AE | 10–20 days | |
| Rashidi-Alavijeh et al. [90] | Liver, 43 | BNT162b2 (Pfizer-BioNTech) | 79% | MMF treatment | 15 days | ||
| Rozen-Zvi et al. [91] | Kidney, 308 | BNT162b2 (Pfizer-BioNTech) | 36% |
eGFR (1.02 (1.01–1.04)) Lower mycophenolic acid dose (2.3 (1.8–3.1)) Younger age (1.03 (1.01–1.05)) Lower calcineurin inhibitor blood level (1.9 (1.1–3.4)) |
No serious AE | 2–4 weeks | |
| Sattler et al. [34•] | Kidney, 39 | BNT162b2 (Pfizer-BioNTech) | 8.3% | No significant associations | No serious AE | 24 days | |
| Shostak et al. [92] | Lung, 168 | BNT162b2 (Pfizer-BioNTech) | 18% |
Age (0.9 (0.92–0.98)) Use of antimetabolites (0.2 (0.08–0.8)) Use of mTOR (0.1 (0.02–0.99)) |
No serious AE | 14–21 days | |
| Strauss et al. [93] | Liver, 161 |
• BNT162b2 (Pfizer-BioNTech) • mRNA-1273 (Moderna) |
81% | Antimetabolites (0.6 (0.5–0.8)) | mRNA-1273 (1.25 (1.09–1.4)) | 30 days | |
| Stumpf et al. [36•] | Kidney, 368 |
• BNT162b2 (Pfizer-BioNTech) • mRNA-1273 (Moderna) |
42% |
Age (1.02 (1.008–1.04)) Time since transplantation (0.9 (0.91–0.98)) Number of immunosuppressive drugs (2.0 (1.3–3.1)) mRNA-1273 v (0.35 (0.2–0.6)) compared to BNT162b2 |
Most mild, 1.6% hospitalization due to side effects |
8 weeks post first dose | |
| Thuluvath et al. [94] | Liver, 62 |
• Johnson & Johnson • BNT162b2 (Pfizer-BioNTech) • mRNA-1273 (Moderna) |
39% |
Use of 2–3 immunosuppressive medications (14.4 (5–40.7)) Vaccination with a single dose of Johnson & Johnson Vaccine (0.02 (0.01–0.1) compared to Moderna 0.06 (0.02–0.24 compared to Pfizer) |
No serious AE | 28 days |