Just 18% of transplant patients develop antibody responses to shots

Just 18% of people who have had kidney transplants develop antibody responses to COVID-19 vaccines due to immunosuppressant medication – compared to 90% of those on dialysis

  • A new study looked at 55 patients, including 45 kidney transplant recipients and 10 patients undergoing chronic hemodialysis
  • After two doses of Pfizer’s vaccine, 88.9% of dialysis patients developed antibodies against the virus compared to 17.8% of transplant recipients
  • For T-cell responses, a type of white blood cell, they were evident in 100% of patients on dialysis but only 57.8% of transplant patients
  • Researchers believe the low rates in organ recipients are due to immune system suppressing drugs transplant patients are on 

Kidney patients on dialysis had better antibody responses to COVID-19 vaccines than transplant patients, a new study suggests.

Researchers found that patients whose kidneys were failing were nearly five times more likely to develop antibodies than those who just received a new organ.

What’s more, half as many organ recipients generated T-cells, which are a type of white blood cell that binds to and kills viruses, compared to those on dialysis.

The team, from Rouen University Hospital, in France says the findings suggest that more research needs to be done on different vaccination strategies for transplant patients so that they receive the most protection possible against COVID-19. 

A new study from France found that after two doses of Pfizer’s vaccine 88.9% of dialysis patients developed antibodies against the virus compared to 17.8% of kidney transplant recipients. Pictured: Janice Brown hooked up to a dialysis machine in COVID-19 unit isolation room at Desert Valley Medical Group in Victorville, California, April 2020

Recent studies have suggested that people who have received organ transplants have less protection than the general population.

A Johns Hopkins study from March 2021 found that just 17 percent of transplant recipients produced acceptable antibody levels after just one dose of a two-dose COVID-19 vaccine.

A follow-up in May found that, after the second shot, this number increased to only 54 percent.

The reason for this low level of protection is because people who receive transplants are on life-long immunosuppressants to prevent their body from rejecting the donor organ.

These drugs likely interfere with the body’s ability to generate immune system cells that protect against COVID-19. 

For the new study, published in the Journal of the American Society of Nephrology, the team looked at 55 patients in total: 45 kidney transplant recipients and 10 patients undergoing chronic hemodialysis.

All of the patients received two doses of the Pfizer-BioNTech COVID-19 vaccine, which are given 21 days apart. 

After the second dose, 88.9 percent of patients on dialysis developed neutralizing antibodies against the virus – in line with figures seen in the general population.

Comparatively, responses were seen in 17.8 percent of transplant recipients, representing 4.9-fold decrease.

Additionally, when researchers looked at T-cell response, they found that it was evident in 100 percent of patients on dialysis but only 57.8 percent of transplant patients. 

The team says the findings may be used to develop specific vaccination strategies for kidney transplant recipients.

‘The vaccine seems efficient in individuals undergoing dialysis, indicating that vaccination should be highly recommended in these patients,’ said study author Dr Dominique Bertrand in a statement.

‘By contrast, the low antibody response observed in kidney transplant recipients is worrying.

‘However, antibodies are not the full spectrum of protection induced by the vaccine. T cell immunity is probably also very important.’ 

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