Safety, Reactogenicity and Patient Perceptions of COVID-19 Vaccination in Solid Organ Transplant Recipients at a Quaternary Referral Center

PURPOSE: Solid organ transplant recipients (SOTR) are at high-risk for poor health outcomes following COVID-19. Several studies have evaluated the antibody response to the vaccine amongst SOTR, yet there is a need to better understand peri-vaccination reactogenicity and patient behavior in SOTR. Our study reports the side effects, safety and the patient perceptions of the Pfizer vaccine amongst our center's SOTR. METHODS: In this single-center study, SOTR (heart, kidney, liver, lung, combined) who received the Pfizer (BNT162b2) vaccine in February-March 2021 completed an online survey about their side effects (SE) after the first and second dose of the vaccine, co-morbidities, masking behaviors, breakthrough infection, and perceptions regarding sense of protection and safety after vaccination. Descriptive and logistical regression analyses were performed. RESULTS: The survey was sent to 550 SOTR, of which 210 SOTR completed it thus far. Median age is 62 years, 154 (72%) are males and 61 (28 %) are females. 81 (39%) experienced SE after both doses. After dose one, 53% patients experienced a SE, the most common being injection site pain (79%). After dose two, 53% patients experienced a SE, including injection site pain (61%) followed by systemic SE (39%). No patient hospitalization after either dose was reported. Within a 6-month period post vaccination, only 1 patient tested positive for COVID-19 after the first dose. Increased age reduced the risk for SE for both first and second doses (0.95 (0.92-0.97, p<0.001 and 0.96 (0.94-0.99), p<0.002). SOTR without diabetes had a significant increase in injection site pain (1.92 (1.05-3.49),p=0.033). For masking behaviors, 83% plan to continue masking in healthcare settings while 10% will no longer mask in any setting. Regarding sense of worry of receiving the vaccine, 66% did not feel worried while 10% felt very worried. After vaccination, 53% felt very protected while 15% did not feel protected at all. CONCLUSION: In SOTR who received the Pfizer vaccine, 39% of patients reported side effects after both doses. Injection site pain was most common after first dose and systemic side effects were more after the second dose. The study reinforces the safety profile of the vaccine and SOTR with reactogenicity similar to other studies. Even after vaccination, majority of SOTR plan to wear masks in various settings.