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Matched Versus Mixed COVID-19 Vaccinations in Korean Solid Organ Transplant Recipients: An Observational Study

 Ji-Man Kang  ;  Juhan Lee  ;  Kyu Ha Huh  ;  Dong Jin Joo  ;  Jae Geun Lee  ;  Hye Rim Kim  ;  Ha Yan Kim  ;  Myeongjee Lee  ;  Inkyung Jung  ;  Min Young Kim  ;  Sinyoung Kim  ;  Younhee Park  ;  Myoung Soo Kim 
 TRANSPLANTATION, Vol.106(9) : e392-e403, 2022-09 
Journal Title
Issue Date
Antibodies, Viral ; BNT162 Vaccine ; COVID-19 Vaccines* / administration & dosage ; COVID-19* / epidemiology ; COVID-19* / prevention & control ; ChAdOx1 nCoV-19 ; Humans ; Immunity, Humoral ; Immunogenicity, Vaccine ; Immunoglobulin G ; Organ Transplantation ; Republic of Korea ; Transplant Recipients* ; Vaccination
Background: Solid organ transplant recipients (SOTRs) are vulnerable to severe coronavirus disease 2019 (COVID-19) and exhibit poor antibody responses to COVID-19 vaccines. Herein, we compared the humoral immunogenicity of a mixed vaccine (ChAdOx1 nCoV-19 [ChAd]/BNT162b2 [BNT]) with that of conventional matched vaccines (mRNA, adenoviral vector [AdV-Vec]) in SOTRs.

Methods: Serum samples were collected at Severance Hospital (Seoul, Korea) between September and October 2021 (14 d-5 mo after COVID-19 vaccination; V2). The severe acute respiratory syndrome coronavirus 2 antispike IgG titer (BAU/mL; ELISA) and neutralization inhibition (percentage; neutralization assay) were compared between vaccination groups overall and stratified by V2 (poststudy vaccination visit) timing.

Results: Of the 464 participants, 143 (31%) received mRNA vaccines, 170 (37%) received AdV-Vec vaccines, and 151 (33%) received mixed vaccines (all ChAd/BNT). The geometric mean titer for the ChAd/BNT group was 3.2-fold higher than that of the AdV-Vec group (geometric mean ratio, 3.2; confidence interval, 1.9-5.4) but lower than that of the mRNA group (geometric mean ratio, 0.4; confidence interval, 0.2-0.7). Neutralization inhibition in the ChAd/BNT group was 32%, which was higher than that in the AdV-Vec group (21%; P < 0.001) but lower than that in the mRNA group (55%; P = 0.02). There was no difference in geometric mean titer by V2 timing (ChAd/BNT, 45 versus 31, days 14-60; mRNA, 28 versus 15, days 61-150).

Conclusions: The ChAd/BNT group showed higher humoral immunogenicity than the AdV-Vec group, with similar immunogenicity to the mRNA vaccine. Nevertheless, immunogenicity following the primary vaccination series was poor in all vaccine groups, supporting the justification for booster vaccination in SOTRs.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Ji-Man(강지만) ORCID logo https://orcid.org/0000-0002-0678-4964
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Sin Young(김신영) ORCID logo https://orcid.org/0000-0002-2609-8945
Park, Youn Hee(박윤희) ORCID logo https://orcid.org/0000-0001-8458-1495
Lee, Myeongjee(이명지)
Lee, Jae Geun(이재근) ORCID logo https://orcid.org/0000-0002-6722-0257
Lee, Ju Han(이주한)
Jung, Inkyung(정인경) ORCID logo https://orcid.org/0000-0003-3780-3213
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
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