Support for Prioritizing Kidney Transplant Patients for COVID Boosters

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May 03, 2022

By Reuters Staff NEW YORK (Reuters Health) - Among kidney-transplant recipients, two doses of an mRNA SARS-CoV-2 vaccine will lower the risk for infection, although perhaps not as much compared with the general population, according to a study from the Czech Republic.

Kidney-transplant recipients are considered particularly vulnerable to SARS-CoV-2 and the real-world protection provided by SARS-CoV-2 mRNA vaccines remains uncertain.

To investigate, Dr. Ondrej Viklicky and colleagues with the Institute for Clinical and Experimental Medicine in Prague compared the rate of SARS-CoV-2 infection in 2,101 kidney-transplant patients who did and did not receive mRNA vaccination between February and May of 2021, when the Alpha variant was predominant in the Czech Republic.

Infection with SARS-CoV-2 was reported in 33 vaccinated and 79 unvaccinated patients. The incidence rate was lower in the vaccinated than unvaccinated group (0.47 vs. 1.37 per 1,000 person-days), with an unadjusted incidence-rate ratio of 0.35 (95% CI, 0.23 to 0.51) and a multivariable-adjusted IRR for transplant recipients of 0.54 (95% CI, 0.32 to 0.88).

Writing in Annals of Internal Medicine, the researchers say "the association between two doses of mRNA SARS-CoV-2 vaccines and lowered risk for infection shown in our study provides much needed real-world evidence."

"However, despite the effectiveness in kidney transplant recipients, there were still breakthrough infections, and indirect comparisons suggest lower effectiveness compared with the general population," they point out.

"Thus, we believe that the current recommendations for additional booster doses based on laboratory immune-monitoring studies are also supported by our clinical report. Kidney transplant recipients should continue to be prioritized for booster doses in vaccination programs," they advise.

Primary funding for the study was provided by The Ministry of Health of the Czech Republic.

SOURCE: Annals of Internal Medicine, online May 2, 2022.