Goggin Kathryn P, Sun Elizabeth, Yun Emily, Kamel Margret, Perez Maria A, Hsiao Hui-Mien, DiMaggio Langdon S, Liverman Rochelle, Anderson Evan J, Shane Andi L, Garro Rouba, George Roshan P, Rostad Christina A
Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA.
Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
Transplant Direct. 2025 Feb 7;11(3):e1756. doi: 10.1097/TXD.0000000000001756. eCollection 2025 Mar.
There are limited data describing the immune responses to COVID-19 vaccination in pediatric kidney transplant recipients, and expanding upon this information could help inform vaccination strategies in this unique population.
We performed a prospective, observational, single-center cohort study using remnant blood samples of pediatric kidney transplant recipients from routine clinic visits to examine longitudinal serological responses after COVID-19 vaccination. We enrolled 61 pediatric kidney transplant recipients who had at least 1 sample available for analysis. Sera or plasma were analyzed for ancestral SARS-CoV-2 and Omicron (B.1.1.529; BA.1) spike IgG and nucleocapsid IgG using a Meso Scale Discovery platform.
One month after a 3-dose COVID-19 vaccination series, the IgG geometric mean titer to the SARS-CoV-2 ancestral spike was 684 binding antibody units/mL (95% confidence interval, 269-1739), but titers waned by 4-6 mo. A fourth dose of the COVID-19 vaccine boosted IgG geometric mean titer to 1606 binding antibody units/mL (95% confidence interval, 868-2972), and titers persisted through 6 mo. IgG titers against Omicron (B.1.1.529; BA.1) were overall lower than ancestral SARS-CoV-2. They were higher in participants with prior infection and were not significantly impacted by receipt of belatacept.
Additional doses of the COVID-19 vaccine bolstered durable serologic responses in pediatric kidney transplant recipients, and this study broadens our understanding of immune responses to COVID-19 vaccinations in this population.
描述儿童肾移植受者对新冠病毒疫苗免疫反应的数据有限，扩充这方面信息有助于为这一特殊人群的疫苗接种策略提供参考。
我们进行了一项前瞻性、观察性、单中心队列研究，利用儿童肾移植受者常规门诊的剩余血样，检测新冠病毒疫苗接种后的纵向血清学反应。我们纳入了61名至少有1份样本可用于分析的儿童肾移植受者。使用Meso Scale Discovery平台分析血清或血浆中的原始严重急性呼吸综合征冠状病毒2（SARS-CoV-2）和奥密克戎（B.1.1.529；BA.1）刺突蛋白IgG和核衣壳IgG。
在完成3剂新冠病毒疫苗接种系列1个月后，针对SARS-CoV-2原始刺突蛋白的IgG几何平均滴度为684结合抗体单位/毫升（95%置信区间，269-1739），但滴度在4-6个月时下降。第4剂新冠病毒疫苗将IgG几何平均滴度提高到1606结合抗体单位/毫升（95%置信区间，868-2972），且滴度持续了6个月。针对奥密克戎（B.1.1.529；BA.1）的IgG滴度总体低于原始SARS-CoV-2。在既往感染的参与者中滴度较高，且接受贝拉西普治疗对其无显著影响。
额外剂量的新冠病毒疫苗增强了儿童肾移植受者持久的血清学反应，本研究拓宽了我们对该人群对新冠病毒疫苗免疫反应的理解。
