Imperial College London
Alternate

Dr Peter Kelleher

Faculty of Medicine, Department of Infectious Disease

Reader in Immunology
 
 
 
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Contact

 

+44 (0)20 3315 8251p.kelleher

 
 
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Location

 

J.2.10Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Thomson:2022:10.1016/j.eclinm.2022.101642,
author = {Thomson, T and Prendecki, M and Gleeson, S and Martin, P and Spensley, K and De, Aguiar RC and Sandhu, B and Seneschall, C and Gan, J and Clarke, CL and Lewis, S and Pickard, G and Thomas, D and McAdoo, SP and Lightstone, L and Cox, A and Kelleher, P and Willicombe, M},
doi = {10.1016/j.eclinm.2022.101642},
journal = {eClinicalMedicine},
pages = {1--9},
title = {Immune responses following 3rd and 4th doses of heterologous and homologous COVID-19 vaccines in kidney transplant recipients},
url = {http://dx.doi.org/10.1016/j.eclinm.2022.101642},
volume = {53},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundSolid organ transplant recipients have attenuated immune responses to SARS-CoV-2 vaccines. In this study, we report on immune responses to 3rd- (V3) and 4th- (V4) doses of heterologous and homologous vaccines in a kidney transplant population.MethodsWe undertook a single centre cohort study of 724 kidney transplant recipients prospectively screened for serological responses following 3 primary doses of a SARS-CoV2 vaccine. 322 patients were sampled post-V4 for anti-spike (anti-S), with 69 undergoing assessment of SARS-CoV-2 T-cell responses. All vaccine doses were received post-transplant, only mRNA vaccines were used for V3 and V4 dosing. All participants had serological testing performed post-V2 and at least once prior to their first dose of vaccine.Findings586/724 (80.9%) patients were infection-naïve post-V3; 141/2586 (24.1%) remained seronegative at 31 (21-51) days post-V3. Timing of vaccination in relation to transplantation, OR: 0.28 (0.15-0.54), p=0.0001; immunosuppression burden, OR: 0.22 (0.13-0.37), p<0.0001, and a diagnosis of diabetes, OR: 0.49 (0.32-0.75), p=0.001, remained independent risk factors for non-seroconversion. Seropositive patients post-V3 had greater anti-S if primed with BNT162b2 compared with ChAdOx1, p=0.001.Post-V4, 45/239 (18.8%) infection-naïve patients remained seronegative. De novo seroconversion post-V4 occurred in 15/60 (25.0%) patients. There was no difference in anti-S post-V4 by vaccine combination, p=0.50. T-cell responses were poor, with only 11/54 (20.4%) infection-naive patients having detectable T-cell responses post-V4, with no difference seen by vaccine type.InterpretationA significant proportion of transplant recipients remain seronegative following 3- and 4- doses of SARS-CoV-2 vaccines, with poor T-cell responses, and are likely to have inadequate protection against infection. As such alternative strategies are required to provide protection to this vulnerable group.FundingMW/PK received study
AU  - Thomson,T
AU  - Prendecki,M
AU  - Gleeson,S
AU  - Martin,P
AU  - Spensley,K
AU  - De,Aguiar RC
AU  - Sandhu,B
AU  - Seneschall,C
AU  - Gan,J
AU  - Clarke,CL
AU  - Lewis,S
AU  - Pickard,G
AU  - Thomas,D
AU  - McAdoo,SP
AU  - Lightstone,L
AU  - Cox,A
AU  - Kelleher,P
AU  - Willicombe,M
DO  - 10.1016/j.eclinm.2022.101642
EP  - 9
PY  - 2022///
SN  - 2589-5370
SP  - 1
TI  - Immune responses following 3rd and 4th doses of heterologous and homologous COVID-19 vaccines in kidney transplant recipients
T2  - eClinicalMedicine
UR  - http://dx.doi.org/10.1016/j.eclinm.2022.101642
UR  - https://www.sciencedirect.com/science/article/pii/S2589537022003728?via%3Dihub
UR  - http://hdl.handle.net/10044/1/99695
VL  - 53
ER  -
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