Response to two doses of a nucleoside-modified messenger ribonucleic acid (mRNA) vaccine was evaluated in a large solid-organ transplant program. mRNA COVID-19 vaccine was administered to transplant candidates and recipients who met study inclusion criteria. Qualitative anti-SARS-CoV-2 Spike Total Immunoglobulin (Ig) and IgG-specific assays, and a semi-quantitative test for anti-SARS-CoV-2 Spike protein IgG were measured in 241 (17.2%) transplant candidates and 1163 (82.8%) transplant recipients; 55.2% of whom were non-Hispanic White and 44.8% identified as another race. Transplant recipients were a median (IQR) of 3.2 (1.1, 6.8) years from transplantation. Response differed by transplant status: 96.0% versus 43.2% by the anti-SARS-CoV-2 Total Ig (candidates vs. recipients, respectively), 93.5% versus 11.6% by the anti-SARS-CoV-2 IgG assay, and 91.9% versus 30.1% by anti-spike titers after two doses of vaccine. Multivariable analysis revealed candidates had higher likelihood of response versus recipients (odds ratio [OR], 14.6; 95 %CI 2.19, 98.11; P =.02). A slightly lower response was demonstrated in older patients (OR.96; 95 %CI.94,.99; P =.002), patients taking antimetabolites (OR,.21; 95% CI.08,.51; P =.001). Vaccination prior to transplantation should be encouraged.

Original languageEnglish (US)
Article numbere14600
JournalClinical Transplantation
Issue number5
Early online dateJan 26 2022
StatePublished - May 2022


  • COVID-19 vaccines
  • antibodies
  • blood
  • chronic
  • end stage kidney disease
  • end stage liver disease
  • heart failure
  • immunology
  • organ transplantation
  • prevention and control
  • pulmonary disease
  • vaccines
  • viral
  • Humans
  • Immunoglobulin G
  • Organ Transplantation
  • Transplant Recipients
  • SARS-CoV-2
  • COVID-19/epidemiology
  • Immunity, Humoral
  • Antibodies, Viral
  • BNT162 Vaccine
  • COVID-19 Vaccines
  • Aged
  • RNA, Messenger

ASJC Scopus subject areas

  • Transplantation


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