Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Pediatr Transplant. 2022 Sep;26(6):e14272. doi: 10.1111/petr.14272. Epub 2022 Mar 27.
Third-dose mRNA COVID-19 vaccine is currently recommended in the United States for SOT recipients based in part on data showing diminished immune response, including Ab production, after a two-dose regimen. Data on vaccine response in adolescent and young adult SOT recipients are limited, including no data reported on third-dose responsiveness.
Results of serologic testing in a convenience sample of 28 vaccinated adolescent and young adult HT recipients at a single institution were collected from the medical record and summarized.
At a median of 98.5 days (IQR 59-150) after second dose, 17 (61%) had an Ab response. Among 12 who had serology before and after third-dose vaccination, four of seven who were negative prior to third dose became positive at a median of 34 days (IQR 31-39.5) following third dose. No myocarditis, acute rejection, graft dysfunction, graft loss, or deaths were observed.
These findings support recommendations for the routine administration of three doses of mRNA vaccines in adolescent and young adult HT recipients and show a potential subpopulation in whom the fourth dose should be contemplated.
鉴于两剂方案后免疫应答减弱，包括抗体生成减少，目前美国建议接受实体器官移植（SOT）的患者接种第三剂 mRNA COVID-19 疫苗。关于青少年和年轻成年 SOT 受者疫苗应答的数据有限，包括尚未报告关于第三剂应答的数据。
在一家机构的 28 名接受过 HT 治疗的青少年和年轻成年 SOT 受者中，对便利样本的血清学检测结果从病历中收集并进行了总结。
在第二剂后中位 98.5 天（IQR 59-150）时，有 17 名（61%）产生了抗体应答。在 12 名在第三次接种前后进行了血清学检测的患者中，在第三次接种后中位 34 天（IQR 31-39.5），7 名第三次接种前为阴性的患者中有 4 名转为阳性。未观察到心肌炎、急性排斥反应、移植物功能障碍、移植物丢失或死亡。
这些发现支持在青少年和年轻成年 HT 受者中常规接种三剂 mRNA 疫苗的建议，并表明在某些亚群中应考虑接种第四剂。
