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High Immune Response Rate to the Fourth Boost of the BNT162b2 Vaccine against the Omicron Variants of Concern among Liver Transplant Recipients.

Yana DavidovVictoria IndenbaumNofar AtariLimor KlikerKeren TsarafKeren AsrafOranit Cohen-EzraMariya LikhterOrna MorRam DoolmanYael Weiss-OttolenghiTammy HodArnon AfekYitshak KreissYaniv LustigGili Regev-YochayMichal MandelboimZiv Ben-Ari
Published in: Viruses (2022)
The immune response of liver transplant (LT) recipients to a third dose of the BNT162b2 mRNA vaccine significantly waned after four months. We aimed to evaluate the immune response and breakthrough infection rates of a fourth dose against the Omicron variants among LT recipients. LT recipients who had no past or active SARS-CoV-2 infection and received three doses of the BNT162b2mRNA vaccine were included. Of the 73 LT recipients, 50 (68.5%) received a fourth dose. The fourth dose was associated with a significantly higher positive immune response than the third dose. Receptor-binding domain (RBD) IgG and Omicron BA.1 and BA.2 neutralizing antibodies were determined at a median of 132 and 29 days after the third and fourth vaccines. They were 345 binding antibody units per milliliter (BAU/mL) vs. 2118 BAU/mL ( p < 0.0001), 10 vs. 87 ( p < 0.0001), and 15 vs. 149 ( p = 0.001), respectively. Breakthrough infections were documented among nine (18%) LT recipients after the fourth dose and among seven (30.4%) patients following the third dose ( p = 0.2); 93.5% of breakthrough infections were mild. The infection rate after the fourth dose was higher among diabetic vs. nondiabetic recipients (33.3% vs. 6.9%, respectively; p = 0.02). Further studies are needed to evaluate additional factors influencing the breakthrough infection rate among LT recipients.
Keyphrases
  • immune response
  • kidney transplantation
  • end stage renal disease
  • dendritic cells
  • toll like receptor
  • chronic kidney disease
  • gene expression
  • copy number
  • peritoneal dialysis
  • coronavirus disease
  • dna binding