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Background <p>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. </p> Methods <p>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&#xa0;months after D4 of SARS-CoV-2 vaccine were evaluated in 75 KTRs. </p> Results <p>The median anti-S IgG antibody titers at 1 and 3&#xa0;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&#xa0;month and 83.1% at 3&#xa0;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.</p> Conclusion <p> 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.</p>

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Booster effect of the fourth dose of the SARS-CoV-2 mRNA vaccine in kidney transplant recipients

  • 期刊论文

  • 发表日期：

    2025年3月11日

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  • Ayaka Hayashi,
  • Mayuko Kawabe,
  • Izumi Yamamoto,
  • Yutaro Ohki,
  • Akimitsu Kobayashi,
  • Fumihiko Urabe,
  • Jun Miki,
  • Hiroki Yamada,
  • Nanae Matsuo,
  • Yudo Tanno,
  • Tetsuya Horino,
  • Ichiro Ohkido,
  • Takahiro Kimura,
  • Hiroyasu Yamamoto,
  • Takashi Yokoo

摘要

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.