Early humoral immune response to two doses of severe acute respiratory syndrome coronavirus 2 vaccine in a diverse group of solid organ transplant candidates and recipients.

Response to two doses of a nucleoside‐modified messenger ribonucleic acid (mRNA) vaccine was evaluated in a large solid‐organ transplant program. mRNA COVID‐19 vaccine was administered to transplant candidates and recipients who met study inclusion criteria. Qualitative anti‐SARS‐CoV‐2 Spike Total Immunoglobulin (Ig) and IgG‐specific assays, and a semi‐quantitative test for anti‐SARS‐CoV‐2 Spike protein IgG were measured in 241 (17.2%) transplant candidates and 1163 (82.8%) transplant recipients; 55.2% of whom were non‐Hispanic White and 44.8% identified as another race. Transplant recipients were a median (IQR) of 3.2 (1.1, 6.8) years from transplantation. Response differed by transplant status: 96.0% versus 43.2% by the anti‐SARS‐CoV‐2 Total Ig (candidates vs. recipients, respectively), 93.5% versus 11.6% by the anti‐SARS‐CoV‐2 IgG assay, and 91.9% versus 30.1% by anti‐spike titers after two doses of vaccine. Multivariable analysis revealed candidates had higher likelihood of response versus recipients (odds ratio [OR], 14.6; 95 %CI 2.19, 98.11; P =.02). A slightly lower response was demonstrated in older patients (OR.96; 95 %CI.94,.99; P =.002), patients taking antimetabolites (OR,.21; 95% CI.08,.51; P =.001). Vaccination prior to transplantation should be encouraged. [ABSTRACT FROM AUTHOR]