Third BNT162b2 mRNA SARS-CoV-2 Vaccine Dose Significantly Enhances Immunogenicity in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation

Israel Henig*, Jonathan Isenberg, Dana Yehudai-Ofir, Ronit Leiba, Shimrit Ringelstein-Harlev, Ron Ram, Batia Avni, Odelia Amit, Sigal Grisariu, Tehila Azoulay, Ilana Slouzkey, Tsila Zuckerman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

COVID-19-related mortality among hematopoietic stem cell transplantation (HSCT) recipients in the pre-vaccine era ranged between 22 and 33%. The Pfizer/BioNTech BNT162b2 vaccine demonstrated significant immunogenicity and efficacy in the healthy population; however, its long-term effects on allogeneic HSCT recipients remained unclear. Our study longitudinally evaluated humoral and cellular responses to the BNT162b2 vaccine in adult allogeneic HSCT patients. A positive response was defined as antibody titers ≥ 150 AU/mL post-second vaccination. Among 77 included patients, 51 (66.2%) responded to vaccination. Response-associated factors were female gender, recent anti-CD20 therapy, and a longer interval between transplant and vaccination. Response rates reached 83.7% in patients vaccinated >12 months post-transplant. At 6 months post-second vaccination, antibody titers dropped, but were significantly increased with the booster dose. Moreover, 43% (6/14) of non-responders to the second vaccination acquired sufficient antibody titers after booster administration, resulting in an overall response rate of 79.5% for the entire cohort. The BNT162b2 vaccine was effective in allogeneic transplant recipients. Although antibody titers decreased with time, the third vaccination led to their significant elevation, with 93% of third-dose responders maintaining titers above 150 AU/mL at 3 months post-administration.

Original languageEnglish
Article number775
JournalVaccines
Volume11
Issue number4
DOIs
StatePublished - Apr 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • allogeneic hematopoietic stem cell transplantation
  • BNT162b2
  • cellular response
  • immunogenicity
  • SARS-CoV-2
  • vaccine

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