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Comparison of SARS-CoV-2 Antibody Response After 2-Dose mRNA-1273 vs BNT162b2 Vaccines in Incrementally Immunosuppressed Patients

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

Both mRNA-1273 and BNT162b2 SARS-CoV-2 vaccines elicit immune responses consistent with viral neutralization in most immunocompetent persons.1,2 Immunosuppressed individuals, such as persons with rheumatic and musculoskeletal diseases (RMDs) and solid organ transplant recipients (SOTRs), have decreased immune responses to these vaccines.3,4 Thus, differential vaccine immunogenicity is clinically relevant in ways not seen in immunocompetent persons. This study compares antispike antibody titers after the 2-dose mRNA-1273 and BNT162b2 vaccines in incrementally immunosuppressed patients.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: March 27, 2022.

Published: May 16, 2022. doi:10.1001/jamanetworkopen.2022.11897

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Mitchell J et al. JAMA Network Open.

Corresponding Author: Dorry Segev, MD, PhD, Department of Surgery, Johns Hopkins University School of Medicine, 2000 E Monument St, Baltimore, MD 21205 (dorry@jhmi.edu).

Author Contributions: Drs Mitchell and Connolly had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Mitchell and Connolly contributed equally to the manuscript. Drs Segev and Massie are co–senior authors.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Mitchell, Connolly, Chiang, Alejo, Segev, Massie.

Drafting of the manuscript: Mitchell, Connolly, Chiang, Alejo, Segev.

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

Statistical analysis: Mitchell, Connolly, Chiang.

Obtained funding: Mitchell, Alejo, Werbel, Segev.

Administrative, technical, or material support: Mitchell, Connolly, Alejo.

Supervision: Alejo, Werbel, Segev, Massie.

Conflict of Interest Disclosures: Dr Mitchell reported receiving grants from the American Society of Transplant Surgeons during the conduct of the study. Dr Alejo reported receiving grants from the National Institutes of Diabetes and Digestive and Kidney Diseases during the conduct of the study. Dr Segev reported receiving honoraria from Sanofi, Novartis, Veloxis, Mallinckrodt, Jazz Pharmaceuticals, CSL Behring, Thermo Fisher Scientific, Caredx, Transmedics, Kamada, MediGO, Regeneron, AstraZeneca, Takeda, and Bridge to Life. Dr Massie reported receiving grants from National Institute of Allergy and Infectious Diseases during the conduct of the study. No other disclosures were reported.

Funding/Support: This work was supported by grant T32DK007713 from the Ben-Dov family (Dr Alejo), an American Society of Transplant Surgeons Jon Fryer Resident Scientist Scholarship (Dr Mitchell), grant K01DK101677 and from the National Institute of Diabetes and Digestive and Kidney Diseases (Dr Massie), and grant K24AI144954 (Dr Segev), U01AI138897 (Dr Werbel), and K23AI157893 (Dr Werbel) from the National Institute of Allergy and Infectious Diseases.

Role of the Funder/Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

Additional Contributions: Brian J. Boyarsky, MD, PhD, Julie J. Paik, MD, MHS, Aura T. Teles, BS, Mayan Teles, BS, Jake D. Kim, Letita Thomas, Michael T. Ou, and Jake A. Ruddy, BS, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, and Jaqueline M. Garonzik-Wang, MD, PhD, Department of Surgery, University of Wisconsin, Madison, recruited participants into the observational cohort study. They were not compensated for their work.

References
1.
Baden  LR , El Sahly  HM , Essink  B ,  et al; COVE Study Group.  Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine.   N Engl J Med. 2021;384(5):403-416. doi:10.1056/NEJMoa2035389 PubMedGoogle ScholarCrossref
2.
Polack  FP , Thomas  SJ , Kitchin  N ,  et al; C4591001 Clinical Trial Group.  Safety and efficacy of the BNT162b2 mRNA covid-19 vaccine.   N Engl J Med. 2020;383(27):2603-2615. doi:10.1056/NEJMoa2034577 PubMedGoogle ScholarCrossref
3.
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.2021.7489 PubMedGoogle ScholarCrossref
4.
Connolly  CM , Boyarsky  BJ , Ruddy  JA ,  et al.  Absence of humoral response after two-dose SARS-CoV-2 messenger RNA vaccination in patients with rheumatic and musculoskeletal diseases: a case series.   Ann Intern Med. 2021;174(9):1332-1334. doi:10.7326/M21-1451 PubMedGoogle ScholarCrossref
5.
Resman Rus  K , Korva  M , Knap  N , Avšič Županc  T , Poljak  M .  Performance of the rapid high-throughput automated electrochemiluminescence immunoassay targeting total antibodies to the SARS-CoV-2 spike protein receptor binding domain in comparison to the neutralization assay.   J Clin Virol. 2021;139:104820. doi:10.1016/j.jcv.2021.104820 PubMedGoogle ScholarCrossref
6.
Khoury  DS , Cromer  D , Reynaldi  A ,  et al.  Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection.   Nat Med. 2021;27(7):1205-1211. doi:10.1038/s41591-021-01377-8 PubMedGoogle ScholarCrossref
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