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SARS-CoV-2 Vaccination in Transplant Recipients

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A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Innate and Adaptive Immunity in Vaccination".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 5223

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Special Issue Editors

Dr. Sam Kant

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Guest Editor

Johns Hopkins School of Medicine, Baltimore, MD, USA
Interests: SARS-CoV-2; COVID-19; vaccines; antibody response

Prof. Dr. Daniel Brennan

E-Mail Website
Guest Editor

Medical Director, Comprehensive Transplant Center, The Johns Hopkins Hospital, Baltimore, MD, USA
Interests: SARS-CoV-2; COVID-19; vaccines; antibody response

Special Issue Information

Dear Colleagues,

Recipients of solid organ transplants are at a high risk of developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated complications. The introduction of targeted vaccines has mitigated the risk of developing infection, albeit with a continued suboptimal response in comparison to the general population. This suboptimal response is mostly attributable to the use of maintenance immunosuppression to prevent organ rejection. This issue will cover the following pertinent aspects of the SARS-CoV-2 vaccine in recipients of solid organ transplantation:

Track the arc of development of the SARS-CoV-2 vaccines and their use in recipients of solid organ transplants;
Review vaccine response in transplant recipients focused on each type of solid organ transplantation;
Methods of monitoring immune response to vaccines;
Measures to reduce the risk of infection in patients with an absent/reduced response to vaccines.

Dr. Sam Kant
Prof. Dr. Daniel Brennan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

SARS-CoV-2
COVID-19
vaccines
antibody response

Published Papers (4 papers)

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Research

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7 pages, 393 KiB

Open AccessCommunication

Long-Term Assessment of Antibody Response to COVID-19 Vaccination in People with Cystic Fibrosis and Solid Organ Transplantation

by Teresa Fuchs, Dorothea Appelt and Helmut Ellemunter

Vaccines 2024, 12(1), 98; https://doi.org/10.3390/vaccines12010098 - 18 Jan 2024

Viewed by 1013

Abstract

With the worldwide spread of SARS-CoV-2 disease, people with cystic fibrosis (CF), especially solid organ transplant recipients, have quickly been identified as a risk group for severe disease. Studies have shown low antibody response to SARS-CoV-2 vaccines in recipients of solid organ transplant compared to the healthy population. Information on immune response in CF patients with solid organ transplantation is limited, especially regarding long-term efficacy. The aim of this real-world study was a long-term assessment of humoral immune response induced by three and four doses of the SARS-CoV-2 mRNA vaccine. S1RBD and IgG antibodies were measured every 12 weeks over a period of 27 months in twelve CF patients (five liver and seven lung transplantation recipients). A total of 83.3% of our patients showed a positive antibody response after three doses of the SARS-CoV-2 mRNA vaccine. A sustained immune response was observed in both groups over the observation period, with liver transplant recipients showing higher levels than lung transplant recipients. This study is among the first to show long-term data with constantly elevated or even increasing antibody levels. We conclude that this effect is most likely associated with repeated boostering in terms of infections and booster vaccinations. Full article

(This article belongs to the Special Issue SARS-CoV-2 Vaccination in Transplant Recipients)

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12 pages, 1678 KiB

Open AccessArticle

Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis

by Alexander Nikoloudis, Ines Julia Neumann, Veronika Buxhofer-Ausch, Sigrid Machherndl-Spandl, Michaela Binder, Emine Kaynak, Robert Milanov, Stefanie Nocker, Olga Stiefel, Irene Strassl, Dagmar Wipplinger, Margarete Moyses, Heidrun Kerschner, Petra Apfalter, Michael Girschikofsky, Andreas Petzer, Ansgar Weltermann and Johannes Clausen

Vaccines 2023, 11(10), 1534; https://doi.org/10.3390/vaccines11101534 - 28 Sep 2023

Cited by 3 | Viewed by 1125

Abstract

(1) Background: mRNA COVID-19 vaccines are effective but show varied efficacy in immunocompromised patients, including allogeneic hematopoietic stem cell transplant (HSCT) recipients. (2) Methods: A retrospective study on 167 HSCT recipients assessed humoral response to two mRNA vaccine doses, using the manufacturer cut-off of ≥7.1 BAU/mL, and examined factors affecting non-response. (3) Results: Twenty-two percent of HSCT recipients failed humoral response. Non-responders received the first vaccine a median of 10.2 (2.5–88.9) months post-HSCT versus 35.3 (3.0–215.0) months for responders (p < 0.001). Higher CD19 (B cell) counts favored vaccination response (adjusted odds ratio (aOR) 3.3 per 100 B-cells/microliters, p < 0.001), while ongoing mycophenolate mofetil (MMF) immunosuppression hindered it (aOR 0.04, p < 0.001). By multivariable analysis, the time from transplant to first vaccine did not remain a significant risk factor. A total of 92% of non-responders received a third mRNA dose, achieving additional 77% seroconversion. Non-converters mostly received a fourth dose, with an additional 50% success. Overall, a cumulative seroconversion rate of 93% was achieved after up to four doses. (4) Conclusion: mRNA vaccines are promising for HSCT recipients as early as 3 months post-HSCT. A majority seroconverted after four doses. MMF usage and low B cell counts are risk factors for non-response. Full article

(This article belongs to the Special Issue SARS-CoV-2 Vaccination in Transplant Recipients)

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11 pages, 235 KiB

Open AccessArticle

Disease Course, Management and Outcomes in Kidney Transplant Recipients with SARS-CoV-2 Infection during the Omicron-Variant Wave: A Single-Center Experience

by Maria Korogiannou, Kalliopi Vallianou, Efstathios Xagas, Evangelia Rokka, Ioanna Soukouli, Ioannis N. Boletis and Smaragdi Marinaki

Vaccines 2023, 11(3), 632; https://doi.org/10.3390/vaccines11030632 - 12 Mar 2023

Cited by 2 | Viewed by 1429

Abstract

Background: Since December 2019, kidney transplant recipients (KTRs) have experienced a great impact of the coronavirus disease 2019 (COVID-19) pandemic, with a higher risk of morbidity and mortality compared to the general population. Preliminary data in KTRs suggest that the Omicron variant, which has been dominant since December 2021, is more infectious than the previous ones but is associated with reduced risk of severity and low lethality rates. The purpose of our study was to assess the disease course and outcomes of the SARS-CoV-2 infection in KTRs during the Omicron-surge. Methods: This retrospective study included 451 KTRs diagnosed with SARS-CoV-2 infection between 1 December 2021 and 30 September 2022. Demographic and clinical characteristics at the time of infection, vaccination data, treatment, clinical course, and outcomes were recorded and analyzed. Results: Mean age was 51.8 ± 13.7 years with a male predominance (61.2%). The majority (76.1%) were vaccinated with at least three doses of the available mRNA vaccines, although serology revealed low anti-SARS-CoV-2 antibody titers before infection (33 [3.3–1205] AU/mL). Only 6% of the patients experienced moderate–severe disease. Accordingly, there was low prevalence of adverse outcomes, such as SARS-CoV-2-related hospitalization (11.3%) and death (0.9%). Multivariate analysis revealed that only age significantly increased the risk of SARS-CoV-2-related hospitalization. Conclusions: During the Omicron wave, the clinical course of the SARS-CoV-2 infection in KTRs has substantially changed, with lower rates of moderate and severe disease and a low prevalence of adverse outcomes. Prospective clinical trials are warranted to further elucidate the evolving pathogenesis, management, and long-term outcomes of COVID-19 in such high-risk populations. Full article

(This article belongs to the Special Issue SARS-CoV-2 Vaccination in Transplant Recipients)

Review

Jump to: Research

19 pages, 1695 KiB

Open AccessReview

Measures to Increase Immunogenicity of SARS-CoV-2 Vaccines in Solid Organ Transplant Recipients: A Narrative Review

by Bo Yu, Christina Tamargo, Daniel C. Brennan and Sam Kant

Vaccines 2023, 11(12), 1755; https://doi.org/10.3390/vaccines11121755 - 25 Nov 2023

Viewed by 1246

Abstract

Purpose of review: To review the data on the immunogenicity of COVID-19 vaccines, administered by different strategies, in solid organ transplant recipients (SOTRs). Recent findings: COVID-19 booster vaccines were given to SOTRs as a widespread practice in many transplant centers, mostly as the third and/or fourth dose in an extended vaccine series, with a significantly improved humoral response compared with the initial two-dose scheme. However, one-third of SOTRs remained unresponsive, despite these boosters. Next steps: Vaccination with standard dosing remains the most feasible strategy for attaining protection against COVID-19. Additional booster doses and temporarily holding or reducing mycophenolate mofetil/mycophenolic acid may provide immunogenicity to vaccines, according to recent studies demonstrating some efficacy with these measures. Preexposure prophylaxis with monoclonal antibodies showed benefit in immunocompromised patients but is no longer recommended by the National Institutes of Health (NIH) due to diminished efficacy against Omicron and recent variants. Screening for the presence and titers of SARS-CoV-2-specific antibodies in SOTRs is not recommended in most clinical settings. T cell-based techniques are needed to evaluate vaccine efficacy and risk of infection. As SARS-CoV-2 continues to evolve, new vaccines based on conservative protein component/complexes of the COVID virus, in addition to its spike protein, are warranted to offer prolonged protection. Full article

(This article belongs to the Special Issue SARS-CoV-2 Vaccination in Transplant Recipients)

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