SARS-CoV-2 vaccine effectiveness in immunosuppressed kidney transplant recipients

Chemaitelly, H.; AlMukdad, S.; Joy, J. P.; Ayoub, H. H.; YASSINE, H. M.; Benslimane, F.; Al Khatib, H. A.; Tang, P.; Hasan, M. R.; Coyle, P.; Al Kanaani, Z.; Al Kuwari, E.; Jeremijenko, A.; Kaleeckal, A. H.; Latif, A. N.; Shaik, R. M.; Abdul Rahim, H. F.; Nasrallah, G.; Al Kuwari, M. G.; Butt, A. A.; Al Romaihi, H. E.; Al-Thani, M. H.; Alkadi, M. M.; Ali, O.; Al-Maslamani, M.; Bertollini, R.; Al Malki, H.; Almaslamani, Y.; Abu-Raddad, L. J.; Al Khal, A.

COVID-19 vaccine protection against infection in immunosuppressed solid organ transplant recipients is unknown but possibly weak with the low proportion of these patients mounting a robust humoral and cellular immune response after vaccination. Using a retrospective cohort study design with cross-over, we assessed vaccine effectiveness among 782 kidney transplant recipients registered at Hamad Medical Corporation, the national public healthcare provider in Qatar, where the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines have been used in the national immunization campaign. Vaccine effectiveness against any SARS-CoV-2 infection was estimated at 46.6% (95% CI: 0.0-73.7%) [≥]14 days after the second dose, 66.0% (95% CI: 21.3-85.3%) [≥]42 days after the second dose, and 73.9% (95% CI: 33.0-89.9%) [≥]56 days after the second dose. Vaccine effectiveness against any severe, critical, or fatal COVID-19 disease was estimated at 72.3% (95% CI: 0.0-90.9%) [≥]14 days after the second dose, 85.0% (95% CI: 35.7-96.5%) [≥]42 days after the second dose, and 83.8% (95% CI: 31.3-96.2%) [≥]56 days after the second dose. Most vaccine breakthrough infections occurred in the first few weeks after receiving the first and/or second dose. Vaccine effectiveness reached considerable levels in kidney transplant recipients, but vaccine protection mounted slowly and did not reach a high level until several weeks after the second dose.