Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients

John McAteer; Divya D Kalluri; Rivka R Abedon; Caroline X Qin; Scott R Auerbach; Olga Charnaya; Lara A Danziger-Isakov; Noelle H Ebel; Amy G Feldman; Evelyn K Hsu; Saeed Mohammad; Emily R Perito; Ashley M Thomas; Teresa P Y Chiang; Jacqueline M Garonzik-Wang; Dorry L Segev; William A Werbel; Douglas B Mogul

doi:10.1111/petr.14671

Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients

Pediatr Transplant. 2024 Feb;28(1):e14671. doi: 10.1111/petr.14671.

Authors

John McAteer^{1

2}, Divya D Kalluri³, Rivka R Abedon³, Caroline X Qin³, Scott R Auerbach⁴, Olga Charnaya², Lara A Danziger-Isakov⁵, Noelle H Ebel⁶, Amy G Feldman⁷, Evelyn K Hsu⁸, Saeed Mohammad⁹, Emily R Perito¹⁰, Ashley M Thomas¹¹, Teresa P Y Chiang¹², Jacqueline M Garonzik-Wang¹³, Dorry L Segev¹², William A Werbel³, Douglas B Mogul¹¹

Affiliations

¹ Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins Children's Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
² Division of Nephrology, Department of Pediatrics, Johns Hopkins Children's Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
³ Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
⁴ Division of Cardiology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
⁵ Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
⁶ Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine, Palo Alto, California, USA.
⁷ Section of Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.
⁸ Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA.
⁹ Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, USA.
¹⁰ Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Francisco Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA.
¹¹ Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins Children's Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹² Department of Surgery, NYU Grossman School of Medicine, New York City, New York, USA.
¹³ Division of Transplant Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin, USA.

PMID: 38317335
PMCID: PMC11056938 (available on 2024-08-01)
DOI: 10.1111/petr.14671

Abstract

Background: Adolescent solid organ transplant recipients (aSOTRs) who received three doses of the COVID-19 mRNA vaccine experience high seroconversion rates and antibody persistence for up to 3 months. Long-term antibody durability beyond this timeframe following three doses of the SARS-CoV-2 mRNA vaccine remains unknown. We describe antibody responses 6 months following the third vaccine dose (D3) of the BNT162b2 mRNA vaccination among aSOTRs.

Methods: Participants in a multi-center, observational cohort who received the third dose of the vaccine were analyzed for antibodies to the SARS-CoV-2 spike protein receptor-binding domain (Roche Elecsys anti-SARS-CoV-2-S positive: ≥0.8, maximum: >2500 U/mL). Samples were collected at 1-, 3-, and 6-months post-D3. Participants were surveyed at each timepoint and at 12-months post-D3.

Results: All 34 participants had positive anti-RBD antibody titers 6 months post-D3. Variations in titers occurred between 3 and 6 months post-D3, with 8/28 (29%) having decreased antibody levels at 6 months compared to 3 months and 2/28 (7%) reporting increased titers at 6 months. The remaining 18/28 (64%) had unchanged antibody titers compared to 3-month post-D3 levels. A total of 4/34 (12%) reported breakthrough infection within 6 months and 3/32 (9%) reported infection after 6-12 months following the third dose of the SARS-CoV-2 mRNA vaccine.

Conclusions: The results suggest that antibody durability persists up to 6 months following three doses of the SARS-CoV-2 mRNA in aSOTRs. Demography and transplant characteristics did not differ for those who experienced antibody weaning. Breakthrough infections did occur, reflecting immune-evasive nature of novel variants such as Omicron.

Keywords: COVID-19; SARS-CoV-2; adolescent solid organ transplant recipients; antibody; durability; mRNA vaccination; pediatric.

Publication types

Multicenter Study
Observational Study

MeSH terms

Adolescent
Antibodies
Antibodies, Viral
BNT162 Vaccine
COVID-19 Vaccines
COVID-19* / prevention & control
Cohort Studies
Humans
Organ Transplantation*
RNA, Messenger
SARS-CoV-2
Spike Glycoprotein, Coronavirus*
Transplant Recipients
Vaccination
mRNA Vaccines

Substances

Antibodies
Antibodies, Viral
BNT162 Vaccine
COVID-19 Vaccines
mRNA Vaccines
RNA, Messenger
Spike Glycoprotein, Coronavirus
spike protein, SARS-CoV-2

Abstract

Publication types

MeSH terms

Substances

Grants and funding