Serologic Responses to COVID-19 Vaccination in Pediatric Kidney Transplant Recipients

Serologic Responses to COVID-19 Vaccination in Pediatric Kidney Transplant Recipients

Background. There are limited data describing the immune responses to COVID-19 vaccination in pediatric kidney transplant recipients, and expanding upon this information could help inform vaccination strategies in this unique population. Methods. We performed a prospective, observational, single-cen...

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Main Authors: Kathryn P. Goggin, MD, Elizabeth Sun, BS, Emily Yun, BS, Margret Kamel, PhD, MSPH, Maria A. Perez, BS, Hui-Mien Hsiao, MS, Langdon S. DiMaggio, MD, Rochelle Liverman, PharmD, Evan J. Anderson, MD, Andi L. Shane, MD, MPH, Rouba Garro, MD, Roshan P. George, MD, Christina A. Rostad, MD
Format: Article
Language:English
Published: Wolters Kluwer 2025-03-01
Series:Transplantation Direct
Online Access:http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001756
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Summary:Background. There are limited data describing the immune responses to COVID-19 vaccination in pediatric kidney transplant recipients, and expanding upon this information could help inform vaccination strategies in this unique population. Methods. We performed a prospective, observational, single-center cohort study using remnant blood samples of pediatric kidney transplant recipients from routine clinic visits to examine longitudinal serological responses after COVID-19 vaccination. We enrolled 61 pediatric kidney transplant recipients who had at least 1 sample available for analysis. Sera or plasma were analyzed for ancestral SARS-CoV-2 and Omicron (B.1.1.529; BA.1) spike IgG and nucleocapsid IgG using a Meso Scale Discovery platform. Results. One month after a 3-dose COVID-19 vaccination series, the IgG geometric mean titer to the SARS-CoV-2 ancestral spike was 684 binding antibody units/mL (95% confidence interval, 269-1739), but titers waned by 4–6 mo. A fourth dose of the COVID-19 vaccine boosted IgG geometric mean titer to 1606 binding antibody units/mL (95% confidence interval, 868-2972), and titers persisted through 6 mo. IgG titers against Omicron (B.1.1.529; BA.1) were overall lower than ancestral SARS-CoV-2. They were higher in participants with prior infection and were not significantly impacted by receipt of belatacept. Conclusions. Additional doses of the COVID-19 vaccine bolstered durable serologic responses in pediatric kidney transplant recipients, and this study broadens our understanding of immune responses to COVID-19 vaccinations in this population.
ISSN:2373-8731

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