Third COVID-19 shot could improve immunity for some organ recipients

Embargoed until: Publicly released: 2021-06-15 07:00

International

Steven Cornfield

While those with organ transplants may not get the same immunity from two doses of a COVID-19 vaccine, international researchers believe a third dose could help in some circumstances. The researchers tested the antibody levels of 30 patients after two doses of mRNA vaccines (Pfizer or Moderna) and then gave them a third dose. Half the participants received Johnson/Janssen for their third dose and half received mRNA vaccines. Before the third dose, 24 had no antibodies and six had low antibodies. 12 participants had high antibodies after the third dose, two had low antibodies and 16 still had no antibodies.

Media release

From: American College of Physicians

A third dose of COVID-19 vaccine increased antibody levels in organ transplant recipients with a suboptimal response following standard 2-dose vaccination

Study is the first to report on response to a third vaccine dose

A case series published in Annals of Internal Medicine found that a third dose of vaccine increased antibody levels in organ transplant recipients who had suboptimal response to standard vaccination. These findings suggest that clinical trials are warranted to determine whether booster doses should be incorporated into clinical practice for transplant patients, just as they have been for hepatitis B and influenza vaccinations. This is the first study to report on response to a third vaccine dose.

The antibody response after 2 doses of an mRNA vaccine against the SARS-CoV-2 virus is excellent in the general population, yet the antibody responses in transplant recipients may be markedly attenuated. In addition, reports of COVID-19 breakthrough infections in vaccinated transplant recipients have prompted interest in administering additional doses of vaccine.

Researchers from Johns Hopkins University School of Medicine studied 30 organ transplant recipients who received a third dose of COVID-19 vaccine to describe antibody responses and vaccine reactions after the booster. They found that a third of the patients who had negative antibody levels and all patients who had low levels of antibody before the booster increased their antibody levels after the third dose of vaccine. Self-reported reactions to the booster were relatively minor, including injection site reactions, fever, chills, headache, myalgia, and diarrhea. The authors could not say for sure whether one case of mild rejection was related to the vaccine, but conclude that the benefits of vaccination likely outweigh the cons. Also, this study was examined only antibody levels and future studies are needed to show if those antibody levels were associated with lower infection rates in those who received a third vaccine dose.

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Journal/
conference: Annals of Internal Medicine

Research:Paper

Organisation/s: Johns Hopkins University School of Medicine, USA

Funder: This work was supported by the Ben-Dov family, grant number F32DK124941 (Boyarsky) and K23DK115908 (Garonzik‐Wang) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), K24AI144954 (Segev) from National Institute of Allergy and Infectious Diseases (NIAID), and by grant gSAN-201C0WW from the Transplantation and Immunology Research Network of the American Society of Transplantation (Werbel). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government.

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