Immunogenicity and Predictive Factors Associated with Poor Response after Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination in Lung Transplant Patients

• Published in: Vaccines (Basel) Vol. 12; no. 7; p. 822
• Main Authors: Lee, Se Ju, Woo, Ala, Lee, Jung Ah, Lee, Yongseop, Kim, Ha Eun, Lee, Jin Gu, Kim, Song Yee, Park, Moo Suk, Jeong, Su Jin
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.07.2024
• Subjects: Anemia; Antibodies; Blood levels; Confidence intervals; Coronaviruses; COVID-19; COVID-19 vaccines; Evaluation; Hemoglobin; Immunization; Immunogenicity; Lung diseases; Lung transplantation; Lung transplants; Lungs; Neutralization; Organ transplant recipients; Patients; Population studies; Regression analysis; Respiratory diseases; Serology; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Transplantation; Vaccination; Viral diseases; South Korea
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines12070822

Lung transplant patients are more likely to develop severe coronavirus disease 2019 (COVID-19) compared with the general population and should be vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, previous studies have reported reduced vaccination immunogenicity in lung transplantation patients. We aimed to investigate the serological response and associated factors after SARS-CoV-2 vaccination in this population. Lung transplant patients without a history of contracting coronavirus disease who had received a second or higher dose of SARS-CoV-2 vaccination were enrolled. The anti-SARS-Cov-2 spike and neutralizing antibody levels were measured in blood samples. Firth’s logistic regression analysis was performed to assess the factors associated with non-response after vaccination. Forty-six lung transplant patients were enrolled, of which sixteen (34.8%) showed a serological response to vaccination. All patients who received anti-SARS-CoV-2 vaccination before transplantation (n = 5) exhibited a serological response. No significant difference was observed in anti-SARS-CoV-2 S antibody or neutralization titers based on the number and timing of vaccination. Firth’s logistic regression showed an association between lower hemoglobin levels (odds ratio, 0.59; confidence interval, 0.35–0.92; p = 0.017) and non-response to SARS-CoV-2 vaccination. Lung transplant patients showed poor serologic responses after SARS-CoV-2 vaccination in this pilot study; anemia may be associated with this poor response.