Coronavirus disease 2019 vaccination is protective of clinical disease in solid organ transplant recipients

• Published in: Transplant infectious disease 2022-04, Vol.24 (2), p.e13788-n/a
• Main Authors: Aslam, Saima, Liu, Jinyuan, Sigler, Rachel, Syed, Rehan R., Tu, Xin M., Little, Susan J., De Gruttola, Victor
• Format: Article
• Language: English
• Subjects: clinical effectiveness; Confidence intervals; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Vaccines; COVID‐19 vaccine; Humans; Immunization; Immunogenicity; Medical records; mRNA; Organ Transplantation - adverse effects; Parameter estimation; SARS-CoV-2; solid organ transplant; Statistical analysis; Statistical models; Transplant Recipients; Transplantation; Transplants & implants; Vaccination; Viral diseases
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/tid.13788

Background Clinical effectiveness of coronavirus disease 2019 (COVID‐19) vaccination in solid organ transplant recipients (SOTRs) is not well documented despite multiple studies demonstrating sub‐optimal immunogenicity. Methods We reviewed medical records of eligible SOTRs at a single center to assess vaccination status and identify cases of symptomatic COVID‐19 from January 1 to August 12, 2021. We developed a Cox proportional hazards model using the date of vaccination and time since transplantation as a time‐varying covariate with age and gender as potential time‐invariant confounders. Survival curves were created using the parameters estimated from the Cox model. Results: Among 1904 SOTRs, 1362 were fully vaccinated (96% received mRNA vaccines) and 542 were either unvaccinated (n = 470) or partially vaccinated (n = 72). There were 115 cases of COVID‐19, of which 12 occurred in fully vaccinated individuals. Cox regression with the date of vaccination and time since transplantation as the time‐varying co‐variates showed that after baseline adjustment for age and sex, being fully vaccinated had a significantly lower hazard for COVID‐19, hazard ratio (HR) = 0.29 and 95% confidence interval ([CI] 0.09, 0.91). Conclusion We found that 2‐dose mRNA COVID‐19 vaccination was protective of symptomatic COVID‐19 in vaccinated versus unvaccinated SOTRs. Tweet COVID‐19 vaccination was associated with a significantly lower hazard for symptomatic COVID‐19 (HR 0.29; 95% CI 0.09, 0.91) among 1904 SOT recipients at a single center from January 1 to August 12, 2021.