Fourth Vax Dose Not the Charm for Organ Transplant Recipients

Strong organ transplant recipients exhibited suboptimal immune responses to Pfizer’s COVID-19 mRNA vaccine, even after 4 doses, a small French research discovered.

All 37 sufferers examined had low neutralizing antibody titers and mobile responses, and people with no detectable immune response after the third dose didn’t seem to mount one after the fourth dose, reported Nassim Kamar, MD, PhD, of Toulouse College Hospital in France, and colleagues in JAMA Network Open.

In August, CDC really useful that solid organ transplant recipients receive an additional dose of Pfizer or Moderna vaccine, and in October they added that “reasonably or severely immunocompromised” individuals may receive a fourth dose of any approved COVID vaccine a minimum of 6 months after their third dose.

Kamar’s group famous that prior analysis confirmed neutralizing antibodies have been detected in 70% of strong organ transplant recipients after a 3rd dose.

They examined 37 strong organ transplant recipients from July to August of this yr. Of those, 31 had no response after the third dose of vaccine and 5 had a “weak” response. The primary two doses of Pfizer vaccine got a month aside, the third a imply of 57 days later, and the booster a imply of 65 days later.

Imply age of sufferers was 60, and 54% have been males. Anti-SARS-CoV-2 antibodies have been detected in 5 sufferers previous to the fourth dose, and in 18 sufferers a month later.

Of the 31 sufferers who have been seronegative after the third dose, 13 turned seropositive Four weeks after the fourth dose. Not surprisingly, antibody concentrations have been considerably larger amongst sufferers with a detectable response versus no response previous to the fourth dose, however neutralizing antibody titers a month after the fourth dose “didn’t differ between responders and non-responders to [three] doses,” the authors wrote.

A month after the fourth dose, 32 of 37 sufferers had antibody concentrations lower than 140 BAU/mL, which Kamar’s group outlined as “a threshold offering 12.4% safety amongst healthcare employees,” and all 37 sufferers had neutralizing antibody titers lower than 64 IU/mL.

Among the many examined sufferers, there have been no severe hostile occasions or acute rejection. 4 sufferers skilled fatigue and myalgia, one had gastrointestinal signs, and one kidney transplant recipient had “a recurrence of IgA nephropathy.”