BNT162b2 vaccination in heart transplant recipients: Clinical experience and antibody response

BACKGROUND: Data on the safety and efficacy of SARS-CoV-2 vaccines in immunocompromised populations are sparse. METHODS: We conducted a prospective study of 77 heart transplant (HT) recipients vaccinated with two doses of BNT162b2 vaccine and monitored for adverse events following both doses, the receptorbinding domain (RBD) IgG response, and neutralizing antibodies. RESULTS: BNT162b2 vaccination was associated with a low rate of adverse events, characterized mostly by pain at the injection site. By a mean 41 days post second dose there were no clinical episodes of rejection, as suggested by a troponin leak or allograft dysfunction. At a mean 21 days following the second dose, IgG anti-RBD antibodies were detectable in 14 (18%) HT recipients. Immune sera neutralized SARS-CoV-2 pseudo-virus in 8 (57%) of those with IgG anti-RBD antibodies. Immunosuppressive regimen containing mycophenolic acid was associated with lower odds of an antibody response (OR = 0.12, p = 0.042). CONCLUSIONS: Whether a longer time-frame for observation of an antibody response is required after vaccination in immunosuppressed individuals remains unknown. J Heart Lung Transplant 2021;40:759-762 (c) 2021 International Society for Heart and Lung Transplantation. All rights reserved.

Automated summary

The study investigated the safety and efficacy of BNT162b2 vaccine in heart transplant recipients, showing a low rate of adverse events and some individuals developing antibody responses. The presence of IgG anti-RBD antibodies was associated with neutralizing SARS-CoV-2 pseudo-virus, but certain immunosuppressive regimens may impact the odds of an antibody response. Further research is needed to determine the optimal observation period for antibody response in immunocompromised individuals.