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Assessment of 4 Doses of SARS-CoV-2 Messenger RNA–Based Vaccine in Recipients of a Solid Organ Transplant

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

Anti–SARS-CoV-2 antibodies have been detected in up to approximately 70% of solid organ transplant recipients who were given 3 doses of the SARS-CoV-2 vaccine.1,2 In France, it has been allowed to offer a fourth dose on a case-by-case basis.3 We assessed whether a fourth dose of the SARS-CoV-2 vaccine is associated with improved anti–SARS-CoV-2 antibody concentrations in solid organ transplant recipients in France.

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Article Information

Accepted for Publication: September 28, 2021.

Published: November 24, 2021. doi:10.1001/jamanetworkopen.2021.36030

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Kamar N et al. JAMA Network Open.

Corresponding Author: Nassim Kamar, MD, PhD, Department of Nephrology and Organ Transplantation, Toulouse University Hospital, TSA 50032, 31059 Toulouse Cedex 9, France (kamar.n@chu-toulouse.fr).

Author Contributions: Dr Kamar had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Kamar, Marion, Del Bello.

Acquisition, analysis, or interpretation of data: Kamar, Abravanel, Marion, Romieu-Mourez, Couat, Izopet.

Drafting of the manuscript: Kamar.

Critical revision of the manuscript for important intellectual content: Kamar, Abravanel, Marion, Couat, Del Bello, Izopet.

Statistical analysis: Kamar, Couat.

Administrative, technical, or material support: Abravanel, Romieu-Mourez, Couat.

Supervision: Abravanel, Del Bello, Izopet.

Conflict of Interest Disclosures: Dr Kamar reported receiving speaker fees and participating in advisory boards for AbbVie, Astellas, Biotest, CSL Behring, Chiesi, Merck Sharp and Dohme, Neovii, Novartis Pharma, Sanofi, Sandoz, Shire, and Takeda and receiving personal fees from AbbVie, Astellas, Biotest, CSL Behring, Chiesi, Merck Sharp and Dohme, Neovii, Novartis Pharma, Sanofi, Sandoz, Shire, and Takeda outside the submitted work. No other disclosures were reported.

References
1.
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. 2021;385(7):661-662. doi:10.1056/NEJMc2108861 PubMedGoogle ScholarCrossref
2.
Hall  VG , Ferreira  VH , Ku  T ,  et al.  Randomized trial of a third dose of mRNA-1273 vaccine in transplant recipients.   N Engl J Med. 2021;385(13):1244-1246. doi:10.1056/NEJMc2111462 PubMedGoogle ScholarCrossref
3.
La Société Francophone de Transplantation. Renaloo. Accessed July 21, 2021. https://renaloo.com/wp-content/uploads/2021/07/20210717-mailing-SFT-4edose.pdf
4.
Dimeglio  C , Herin  F , Martin-Blondel  G , Miedougé  M , Izopet  J .  Antibody titers and protection against a SARS-CoV-2 infection.   J Infect. Published online September 20, 2021.doi:10.1016/j.jinf.2021.09.013PubMedGoogle Scholar
5.
Alejo  JL , Mitchell  J , Chiang  TP ,  et al.  Antibody response to a fourth dose of a SARS-CoV-2 vaccine in solid organ transplant recipients: a case series.   Transplantation. 2021. doi:10.1097/TP.0000000000003934 PubMedGoogle Scholar
6.
Dimeglio  C , Herin  F , Da-Silva  I ,  et al.  Heterologous ChAdOx1-S/BNT162b2 vaccination: neutralizing antibody response to SARS-CoV-2.   Clin Infect Dis. Published online August 12, 2021. doi:10.1093/cid/ciab705 PubMedGoogle Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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