A third dose of the BNT162b2 mRNA vaccine sufficiently improves the neutralizing activity against SARS-CoV-2 variants in liver transplant recipients

Takahiro Tomiyama; Rigel Suzuki; Noboru Harada; Tomokazu Tamura; Katsuya Toshida; Yukiko- Kosai-Fujimoto; Takahiro Tomino; Shohei Yoshiya; Yoshihiro Nagao; Kazuki Takeishi; Shinji Itoh; Nobuhiro Kobayashi; Hayato Ito; Sachiyo Yoshio; Tatsuya Kanto; Tomoharu Yoshizumi; Takasuke Fukuhara

doi:10.3389/fcimb.2023.1197349

A third dose of the BNT162b2 mRNA vaccine sufficiently improves the neutralizing activity against SARS-CoV-2 variants in liver transplant recipients

Front Cell Infect Microbiol. 2023 May 16:13:1197349. doi: 10.3389/fcimb.2023.1197349. eCollection 2023.

Authors

Takahiro Tomiyama¹, Rigel Suzuki², Noboru Harada¹, Tomokazu Tamura², Katsuya Toshida¹, Yukiko- Kosai-Fujimoto¹, Takahiro Tomino¹, Shohei Yoshiya¹, Yoshihiro Nagao¹, Kazuki Takeishi¹, Shinji Itoh¹, Nobuhiro Kobayashi², Hayato Ito², Sachiyo Yoshio³, Tatsuya Kanto³, Tomoharu Yoshizumi¹, Takasuke Fukuhara²

Affiliations

¹ Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
² Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
³ Department of Liver Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan.

Abstract

Introduction: We examined the neutralizing antibody production efficiency of the second and third severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine doses (2^nd- and 3^rd-dose) and neutralizing activity on mutant strains, including, the Ancestral, Beta and Omicron strains using green fluorescent protein-carrying recombinant SARS-CoV-2, in living-donor liver transplantation (LDLT) recipients.

Methods: The patients who were administered vaccines other than Pfizer- BioNTechBNT162b2 and who had coronavirus disease 2019 in this study period were excluded. We enrolled 154 LDLT recipients and 50 healthy controls.

Result: The median time were 21 days (between 1^st and 2^nd vaccination) and 244 days (between 2^nd and 3^rd vaccination). The median neutralizing antibody titer after 2^nd-dose was lower in LDLT recipients than in controls (0.46 vs 1.00, P<0.0001). All controls had SARS-CoV-2 neutralizing antibodies, whereas 39 LDLT recipients (25.3%) had no neutralizing antibodies after 2^nd-dose; age at vaccination, presence of ascites, multiple immunosuppressive treatments, and mycophenolate mofetil treatment were significant risk factors for nonresponder. The neutralizing activities of recipient sera were approximately 3-fold and 5-fold lower than those of control sera against the Ancestral and Beta strains, respectively. The median antibody titer after 3^rd-dose was not significantly different between recipients and controls (1.02 vs 1.22, p=0.0758); only 5% recipients was non-responder. The neutralizing activity after third dose to Omicron strains were enhanced and had no significant difference between two groups.

Conclusion: Only the 2nd-dose was not sufficiently effective in recipients; however, 3rd-dose had sufficient neutralizing activity against the mutant strain and was as effective as that in healthy controls.

Keywords: SARS-CoV-2; anti-SARS-CoV-2 vaccination; immunosuppressive treatment; liver transplantation; mutant strains.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Neutralizing
Antibodies, Viral
BNT162 Vaccine
COVID-19* / prevention & control
Humans
Liver Transplantation*
Living Donors
SARS-CoV-2 / genetics
Vaccination

Substances

BNT162 Vaccine
Antibodies, Neutralizing
Antibodies, Viral

Supplementary concepts

SARS-CoV-2 variants