Table. Summary of Factors Associated With Immunogenicity After 2 Doses of mRNA Vaccines.
| Risk factor | Positive humoral immune response, pOR (95% CI) | Pooled difference in positive humoral immune response, mean (SE) | Studies, No. | Certainty of evidence (GRADE) | Comments |
|---|---|---|---|---|---|
| Host characteristics | |||||
| Age | NA | –3.94 (1.1) | 10 | Very low | None |
| Male | 1.16 (1.01-1.33) | NA | 26 | Low | pOR of male sex lost significance after removing 1 of several studies from analysis |
| BMI | NA | 0.15 (0.23) | 9 | Very low | None |
| Lymphocyte count | NA | 0.16 (0.13) | 4 | Very low | None |
| Transplant characteristics | |||||
| Time from transplant, y | NA | 2.12 (0.71) | 9 | Low | None |
| Deceased donor status | 0.66 (0.53-0.83) | NA | 10 | Moderate | None |
| Maintenance IS | |||||
| Antimetabolites | 0.21 (0.14-0.29) | NA | 25 | Low | pOR of mTOR inhibitors lost significance after removing 1 of several studies from analysis; it also lost significance after accounting for publication bias. |
| Calcineurin inhibitors | 0.92 (0.65-1.30) | NA | 17 | Low | None |
| mTOR inhibitors | 1.46 (1.02-2.08) | NA | 21 | Very low | None |
| Augmented IS in 12 mo | |||||
| Antithymocyte globulin | 0.32 (0.15-0.71) | NA | 5 | Very low | pORs of rituximab exposure lost significance after removing Haskin et al47 study from the analysis |
| Rituximab | 0.21 (0.07-0.61) | NA | 5 | Moderate | None |
Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); IS, immunosuppression; mTOR, mammalian (mechanistic) target of rapamycin; NA, not applicable; pORs, pooled odds ratios.