Response to “SARS‐CoV‐2 vaccine effectiveness trumps immunogenicity in solid organ transplant recipients”

Malinis, Maricar; Cohen, Elizabeth; Azar, Marwan M.

We recently reported a SARS-CoV-2 infection breakthrough rate of 0.65% (3/459) among fully vaccinated adult solid organ transplant recipients (SOTr) at our institution as of May 18,2021(1). The majority of fully vaccinated SOTr consisted of kidney recipients (319/459, 70%), with a minority of liver (85/459, 19%), heart (41/459, 9%), and multi-visceral transplants (11/459, 2%). Sixty-five percent was on a mycophenolate-containing regimen (Table 1) and mycophenolate with tacrolimus and prednisone was the most common regimen (33%). In response to our letter, Mossad(2) pointed out that our findings may not be generalizable to other centers whose SOTr population may be more highly immunosuppressed and/or more vulnerable to respiratory infections such as lung and multi-visceral SOTr. Furthermore, Mossad noted that SOTr with prior undocumented SARS-CoV-2 infection and thus with some level of protection from reinfection might have been included.