Optimal Timing of COVID-19 Vaccination in the Peri-Transplant Period: A Single Institution Case Series

The outcomes of vaccination against Severe Acute Respiratory Syndrome Coronavirus 2 in organ transplant recipients are unclear. Recent studies have investigated outcomes for patients who are several years post transplant. There has not been much data in peri-transplant patients. This is important because patients are highly immunosuppressed during this period owing to induction immunosuppression and are thus susceptible to infection. We looked at 6 patients who were transplanted at our center after receiving their first dose of mRNA vaccines. We assessed their antibody response after 1, 2, and in two patients, 3 doses of the vaccine. Out of the two patients who received their third booster dose, one had a detectable antibody level after the third dose. We report that the overall antibody response to vaccination was weaker in transplant patients compared with the general population, with a rapid attrition of antibody response over time. There is a need for more studies that follow-up antibody levels in transplant patients over time, especially those in the peri-transplant period to help guide the vaccination plan for immunosuppressed transplant patients.