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02-12-2022 | SARS-CoV-2 | Original Article

Humoral and cellular immune response to SARS-CoV-2 mRNA BNT162b2 vaccine in pediatric kidney transplant recipients compared with dialysis patients and healthy children

Authors: Ruveyda Gulmez, Dogukan Ozbey, Ayse Agbas, Bagdagul Aksu, Nurdan Yildiz, Diana Uckardes, Seha Saygili, Esra Karabag Yilmaz, Zeynep Yuruk Yildirim, Mehmet Tasdemir, Ayca Kiykim, Haluk Cokugras, Nur Canpolat, Ahmet Nayir, Bekir Kocazeybek, Salim Caliskan

Published in: Pediatric Nephrology | Issue 7/2023

Abstract

Background

Compared with the general population, the immune response to COVID-19 mRNA vaccines is lower in adult kidney transplant recipients (KTRs). However, data is limited for pediatric KTRs. In this study, we aimed to assess humoral and cellular immune responses to the COVID-19 mRNA vaccine in pediatric KTRs.

Methods

This multicenter, prospective, case–control study included 63 KTRs (37 male, aged 12–21 years), 19 dialysis patients, and 19 controls. Humoral (anti-SARS-CoV2 IgG, neutralizing Ab (nAb)) and cellular (interferon-gamma release assay (IGRA)) immune responses were assessed at least one month after two doses of BNT162b2 mRNA vaccine.

Results

Among COVID-19 naïve KTRs (n = 46), 76.1% tested positive for anti-SARS-CoV-2 IgG, 54.3% for nAb, and 63% for IGRA. Serum levels of anti-SARS-CoV-2 IgG and nAb activity were significantly lower in KTRs compared to dialysis and control groups (p < 0.05 for all). Seropositivity in KTRs was independently associated with shorter transplant duration (p = 0.005), and higher eGFR (p = 0.007). IGRA titer was significantly lower than dialysis patients (p = 0.009). Twenty (43.4%) KTRs were positive for all immune parameters. Only four of 11 seronegative KTRs were IGRA-positive. COVID-19 recovered KTRs had significantly higher anti-SARS-CoV-2 IgG and nAb activity levels than COVID-19 naïve KTRs (p = 0.018 and p = 0.007, respectively).

Conclusions

The humoral and cellular immune responses to SARS-CoV-2 mRNA BNT162b2 vaccine are lower in pediatric KTRs compared to dialysis patients. Further prospective studies are required to demonstrate the clinical efficacy of the mRNA vaccine in KTRs.

This prospective study was registered in ClinicalTrials.gov (NCT05465863, registered retrospectively at 20.07.2022).

Graphical abstract

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Title: Humoral and cellular immune response to SARS-CoV-2 mRNA BNT162b2 vaccine in pediatric kidney transplant recipients compared with dialysis patients and healthy children
Authors: Ruveyda Gulmez
Dogukan Ozbey
Ayse Agbas
Bagdagul Aksu
Nurdan Yildiz
Diana Uckardes
Seha Saygili
Esra Karabag Yilmaz
Zeynep Yuruk Yildirim
Mehmet Tasdemir
Ayca Kiykim
Haluk Cokugras
Nur Canpolat
Ahmet Nayir
Bekir Kocazeybek
Salim Caliskan
Publication date: 02-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: SARS-CoV-2
COVID-19
Published in: Pediatric Nephrology / Issue 7/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-022-05813-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Humoral and cellular immune response to SARS-CoV-2 mRNA BNT162b2 vaccine in pediatric kidney transplant recipients compared with dialysis patients and healthy children

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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