Measures to Increase Immunogenicity of SARS-CoV-2 Vaccines in Solid Organ Transplant Recipients: A Narrative Review

被引:1
作者
Yu, Bo [1 ]
Tamargo, Christina [2 ]
Brennan, Daniel C. [3 ,4 ]
Kant, Sam [3 ,4 ]
机构
[1] Univ Maryland, Med Ctr, Dept Med, Midtown Campus, Baltimore, MD 21201 USA
[2] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
[3] Johns Hopkins Univ, Sch Med, Dept Med, Div Nephrol, Baltimore, MD 21205 USA
[4] Johns Hopkins Univ, Sch Med, Comprehens Transplant Ctr, Baltimore, MD 21205 USA
关键词
COVID-19; SARS-CoV-2; vaccine; immunogenicity; organ transplant; kidney transplant; MESSENGER-RNA VACCINE; COVID-19; VACCINATION; HUMORAL RESPONSE; IMMUNE-RESPONSE; INFLUENZA VACCINATION; HEART; NEUTRALIZATION; INFECTION; PEOPLE; SAFETY;
D O I
10.3390/vaccines11121755
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Purpose of review: To review the data on the immunogenicity of COVID-19 vaccines, administered by different strategies, in solid organ transplant recipients (SOTRs). Recent findings: COVID-19 booster vaccines were given to SOTRs as a widespread practice in many transplant centers, mostly as the third and/or fourth dose in an extended vaccine series, with a significantly improved humoral response compared with the initial two-dose scheme. However, one-third of SOTRs remained unresponsive, despite these boosters. Next steps: Vaccination with standard dosing remains the most feasible strategy for attaining protection against COVID-19. Additional booster doses and temporarily holding or reducing mycophenolate mofetil/mycophenolic acid may provide immunogenicity to vaccines, according to recent studies demonstrating some efficacy with these measures. Preexposure prophylaxis with monoclonal antibodies showed benefit in immunocompromised patients but is no longer recommended by the National Institutes of Health (NIH) due to diminished efficacy against Omicron and recent variants. Screening for the presence and titers of SARS-CoV-2-specific antibodies in SOTRs is not recommended in most clinical settings. T cell-based techniques are needed to evaluate vaccine efficacy and risk of infection. As SARS-CoV-2 continues to evolve, new vaccines based on conservative protein component/complexes of the COVID virus, in addition to its spike protein, are warranted to offer prolonged protection.
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页数:19
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