Clinical and experimental nephrology · 2025
Booster effect of the fourth dose of the SARS-CoV-2 mRNA vaccine in kidney transplant recipients.
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Hayashi Ayaka, Kawabe Mayuko, Yamamoto Izumi, Ohki Yutaro, Kobayashi Akimitsu, Urabe Fumihiko, Miki Jun, Yamada Hiroki, Matsuo Nanae, Tanno Yudo, Horino Tetsuya, Ohkido Ichiro, Kimura Takahiro, Yamamoto Hiroyasu, Yokoo Takashi
Аннотация
BACKGROUND: Solid organ transplant recipients taking immunosuppressive drugs are at greater risk of severe COVID-19 than the general population. In particular, kidney transplant recipients (KTRs) are known to have lower seropositivity after basal doses of SARS-CoV-2 vaccines, and the strategy of administering booster doses in these immunocompromised individuals has been promoted worldwide.
METHODS: This study evaluated the effect of a fourth dose (D4) of SARS-CoV-2 vaccine in Japanese KTRs. Anti-spike (anti-S) IgG antibody titers at 1 and 3 months after D4 of SARS-CoV-2 vaccine were evaluated in 75 KTRs.
RESULTS: The median anti-S IgG antibody titers at 1 and 3 months after D4 were 4728.1 (interquartile range [IQR]: 643.2-13,953.1) AU/mL and 3778 (IQR: 642-9436.6) AU/mL, respectively. The seropositivity rate after D4 was 85.1% at 1 month and 83.1% at 3 months, and the seroconversion rate was 28.6% (4 of 14 KTRs seronegative after the third dose). Factors associated with poor humoral responses were shorter time post-transplant to infection, a higher mycophenolate mofetil dose, a lower lymphocyte count, and a lower estimated glomerular filtration rate.
CONCLUSION: This study demonstrates some efficacy of D4 of SARS-CoV-2 vaccine in KTRs who are seronegative after three doses and encourages consideration of further booster doses of the SARS-CoV-2 vaccine.
METHODS: This study evaluated the effect of a fourth dose (D4) of SARS-CoV-2 vaccine in Japanese KTRs. Anti-spike (anti-S) IgG antibody titers at 1 and 3 months after D4 of SARS-CoV-2 vaccine were evaluated in 75 KTRs.
RESULTS: The median anti-S IgG antibody titers at 1 and 3 months after D4 were 4728.1 (interquartile range [IQR]: 643.2-13,953.1) AU/mL and 3778 (IQR: 642-9436.6) AU/mL, respectively. The seropositivity rate after D4 was 85.1% at 1 month and 83.1% at 3 months, and the seroconversion rate was 28.6% (4 of 14 KTRs seronegative after the third dose). Factors associated with poor humoral responses were shorter time post-transplant to infection, a higher mycophenolate mofetil dose, a lower lymphocyte count, and a lower estimated glomerular filtration rate.
CONCLUSION: This study demonstrates some efficacy of D4 of SARS-CoV-2 vaccine in KTRs who are seronegative after three doses and encourages consideration of further booster doses of the SARS-CoV-2 vaccine.