artículo
SARS-CoV-2 vaccine booster in solid organ transplant recipients previously immunised with inactivated versus mRNA vaccines: A prospective cohort study
Fecha
2022Registro en:
10.1016/j.lana.2022.100371
2667-193X
SCOPUS_ID:85138592528
Autor
Dib Marambio, Martín Javier
Le Corre Pérez, Monique Nicole
Ortiz Koh, Catalina Alejandra
García, Daniel
Ferrés, Marcela
Martínez Valdebenito, Constanza
Ruiz-Tagle, Cinthya
Ojeda Valenzuela, María José
Espinoza Sepúlveda, Manuel Antonio
Jara Contreras, Aquiles
Arab Verdugo, Juan Pablo
Rabagliati B., Ricardo
Vizcaya Altamirano, Cecilia
Ceballos, María Elena
Sarmiento Maldonado, Mauricio
Mondaca Contreras, Sebastián Patricio
Viñuela Morales, Macarena Rocío
Pastore Thomson, Antonia
Szwarcfiter Neiman, Vania
Galdames Lavín, Elizabeth Alejandra
Barrera Vásquez, Aldo Vincent
Castro Gálvez, Pablo Federico
Gálvez Arriagada, Nicolás Marcelo Salvador
Soto Ramírez, Jorge Andrés
Bueno Ramírez, Susan
Kalergis Parra, Alexis Mikes
Nervi Nattero, Bruno
Balcells Marty, María Elvira
Institución
Resumen
Solid-organ transplant (SOT) recipients have worse COVID-19 outcomes than general population and effective immunisation in these patients is essential but more difficult to reach. We aimed to determine the immunogenicity of an mRNA SARS-CoV-2 vaccine booster in SOT recipients previously immunised with either inactivated or homologous SARS-CoV-2 mRNA vaccine. Methods: Prospective cohort study of SOT recipients under medical care at Red de Salud UC-CHRISTUS, Chile, previously vaccinated with either CoronaVac or BNT162b2. All participants received a BNT162b2 vaccine booster. The primary study end point was anti-SARS-CoV-2 total IgG antibodies (TAb) seropositivity at 8-12 weeks (56-84 days) post booster. Secondary end points included neutralising antibodies (NAb) and specific T-cell responses. Findings: A total of 140 (50% kidney, 38% liver, 6% heart) SOT recipients (mean age 54 [13.6] years; 64 [46%] women) were included. Of them, 62 had homologous (three doses of BNT162b2) and 78 heterologous vaccine schedules (two doses of CoronaVac followed by BNT162b2 booster). Boosters were received at a median of 21.3 weeks after primary vaccination. The proportion achieving TAb seropositivity (82.3% vs 65.4%, P = 0.035) and NAb positivity (77.4% vs 55.1%, P = 0.007) were higher for the homologous versus the heterologous group. On the other hand, the number of IFN-γ and IL-2 secreting SARS-CoV-2-specific T-cells did not differ significantly between groups. Interpretation: This cohort study shows that homologous mRNA vaccine priming plus boosting in SOT recipients, reaches a significantly higher humoral immune response than inactivated SARS-CoV-2 vaccine priming followed by heterologous mRNA booster.