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Antibody Response After a Third Dose of the mRNA-1273 SARS-CoV-2 Vaccine in Kidney Transplant Recipients With Minimal Serologic Response to 2 Doses

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To identify the key insights or developments described in this article
1 Credit CME

Studies have reported low seroconversion rates (58% after the second dose) in solid organ transplant recipients who received a messenger RNA (mRNA) SARS-CoV-2 vaccine.1,2 Based on this evidence, the French National Authority for Health issued a recommendation in April 2021 to administer a third vaccine dose in immunosuppressed patients who did not respond after 2 doses. We examined the antibody responses of kidney transplant recipients who did not respond to 2 doses and received a third dose (100 μg) of the mRNA-1273 (Moderna) vaccine.

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Article Information

Corresponding Author: Sophie Caillard, MD, PhD, Department of Nephrology and Transplantation, Strasbourg University Hospital, 1 Place de l’hôpital, 67091 Strasbourg, France (sophie.caillard@chru-strasbourg.fr).

Accepted for Publication: July 9, 2021.

Published Online: July 23, 2021. doi:10.1001/jama.2021.12339

Author Contributions: Drs Benotmane and Caillard had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Benotmane, Caillard.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Benotmane, Caillard.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Benotmane, Caillard.

Administrative, technical, or material support: Gautier Vargas, Olagne, Cognard, Fafi-Kremer, Caillard.

Supervision: Caillard.

Conflict of Interest Disclosures: Dr Caillard reported receiving travel grants from Astellas, Novartis, and Sanofi and receiving lecture honoraria from Bristol Myers Squibb. Dr Benotmane reported receiving travel grants from Novartis, Sandoz, Fresenius Medical Care, and Chiesi. No other disclosures were reported.

Additional Contributions: We thank all of the physicians (Jonas Martzloff, MD, Laura Braun Parvez, MD, Francoise Heibel, MD, Bruno Moulin, MD, PhD), the clinical research team (Danielle Roy, Annie Menguy, Hugo Servais), nurses (Sandra Ludwiller, Muriel Morvan, Karima Kedjam, Lucile Steinmetz, Christelle Appenzeller), and the secretaries (Amandine Bigot and Agathe Pillon) who work in the Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France, and who were involved in the vaccination program and patient follow-up. We are grateful to Marie Josée Wendling and Aurélie Velay (Department of Virology, Strasbourg University Hospital, Strasbourg, France) for their technical support and to Marc Hazzan (Department of Nephrology and Transplantation, Lille University Hospital, Lille, France) for statistical assistance. None of these individuals received compensation for their roles in the study.

References
1.
Boyarsky  BJ , Werbel  WA , Avery  RK ,  et al.  Immunogenicity of a single dose of SARS-CoV-2 messenger RNA vaccine in solid organ transplant recipients.   JAMA. 2021;325(17):1784-1786. doi:10.1001/jama.2021.4385PubMedGoogle ScholarCrossref
2.
Boyarsky  BJ , Werbel  WA , Avery  RK ,  et al.  Antibody response to 2-dose SARS-CoV-2 mRNA vaccine series in solid organ transplant recipients.   JAMA. 2021;325(21):2204-2206. doi:10.1001/jama.2021.7489PubMedGoogle ScholarCrossref
3.
Prendecki  M , Clarke  C , Brown  J ,  et al.  Effect of previous SARS-CoV-2 infection on humoral and T-cell responses to single-dose BNT162b2 vaccine.   Lancet. 2021;397(10280):1178-1181. doi:10.1016/S0140-6736(21)00502-XPubMedGoogle ScholarCrossref
4.
Werbel  WA , Boyarsky  BJ , Ou  MT ,  et al.  Safety and immunogenicity of a third dose of SARS-CoV-2 vaccine in solid organ transplant recipients: a case series.   Ann Intern Med. Published online June 15, 2021. doi:10.7326/L21-0282PubMedGoogle Scholar
5.
Kamar  N , Abravanel  F , Marion  O , Couat  C , Izopet  J , Del Bello  A .  Three doses of an mRNA Covid-19 vaccine in solid-organ transplant recipients.   N Engl J Med. Published online June 23, 2021. doi:10.1056/NEJMc2108861PubMedGoogle Scholar
6.
Caillard  S , Chavarot  N , Bertrand  D ,  et al; French Society of Transplantation.  Occurrence of severe COVID-19 in vaccinated transplant patients.   Kidney Int. Published online May 23, 2021. doi:10.1016/j.kint.2021.05.011PubMedGoogle Scholar
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