Antibody response after a third dose of the mRNA-1273 SARS-CoV-2 vaccine in kidney transplant recipients with minimal serologic response to 2 doses

JAMABenotmane I, Gautier G, Perrin P, et al. | September 23, 2021


Kidney transplant recipients who did not respond to 2 doses and received a third dose (100 μg) of the mRNA-1273 (Moderna) vaccine were investigated for the development of antibody responses.

  • Researchers identified 159 kidney transplant recipients who exhibited SARS-CoV-2 antispike IgG levels less than 50 arbitrary units (AU) per milliliter after 1 month of the second dose.

  • No antibody response was detected in 95 patients (59.7%) after 2 doses (titers < 6.8 AU/mL), and a response below the positivity limit was observed in 64 patients (40.3%) (titers, 6.8-49.9 AU/mL).

  • A third dose of mRNA-1273 vaccine was injected after a median of 51 days (IQR, 48-59 days) following the second dose.

  • 49% of kidney transplant recipients who did not respond after 2 doses showed a serologic response after the third dose.

  • In this large group of kidney transplant recipients, the findings are in accordance with other studies of solid organ transplant recipients.

  • However, anti–SARS-CoV-2 antibodies did not develop after the third dose in 51% of the patients, especially in those receiving triple immunosuppression.

  • Some vaccinated transplant recipients showed the occurrence of severe COVID-19 suggesting the possible lack of immunity.

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