Disclosures: Qin reports no relevant financial disclosures.
October 15, 2021
2 min read

Pediatric transplant patients respond to COVID-19 vaccine better than adult counterparts

Disclosures: Qin reports no relevant financial disclosures.
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After two doses of a COVID-19 vaccine, pediatric transplant patients responded with positive and protective antibody levels with results indicating a “more robust” immune response than that found in adult transplant patients.

In an observational cohort study, Caroline X. Qin, of the department of surgery at Johns Hopkins University of Medicine, and colleagues analyzed the response in 57 pediatric transplant patients (median age, 14 years; 40% boys; 74% white; 44% experienced liver transplants; median 10 years since transplant) to determine their antibody levels after receiving two doses of the BNT162b2 (Pfizer-BioNTech) mRNA COVID-19 vaccine.

Researchers took samples before vaccination, 2 weeks after the first vaccine dose (post-V1) and 1 month after the second vaccine dose (post-V2). Researchers processed the samples using the Roche Elecsys anti-SARS-CoV-2 S enzyme immunoassay for antibodies against the spike protein reception-binding domain. Forty-five patients were included in the final analysis.

Antibody titers were found in 56.8% of patients with post-V1 titers and in 73.3% with post-V2 titers. Of those with both serologies available, 16.7% had negative titers after both vaccine doses, 33.3% had a negative titer that became positive and 46.7% had positive titers.

Researchers noted that patients who received a transplant within 3 years of their vaccine (P = .010), those who had multiple immunosuppressive agents (P = .031) or had antimetabolite immunosuppression (P = .020) were more likely to experience a negative post-V2 response.

After receiving both doses of the vaccine, no patients developed allergic reactions or organ rejection. Researchers noted limitations of the study include a small convenience sample.

“Compared to adult [solid organ transplant recipients] SOTRs with reported seroconversation rates ranging from 5% to 58.8%, these findings suggest that pediatric SOTRs may be able to mount more robust immune responses to SARS-CoV-2 vaccination,” researchers wrote.

“Our preliminary findings suggest the possibility that the standard two-dose regimen for mRNA vaccines is safe in pediatric transplant recipients,” Qin said in a Johns Hopkins press release. “Further research is needed to show if two doses provide clinical protection and if not, the role that a third dose may play in boosting the immune systems of those unable to respond after two.”