SARS-CoV-2 Vaccination Efficacy & Safety in Lung Transplantation Recipients: A Single Centre Study

PURPOSE: Solid Organ Transplant recipients (SOT) are at higher risk of SARS-CoV-2 infection. Mortality rates reported between 13 to over 30% in SOT recipients. SARS‐CoV‐2 vaccination may help reduce the morbidity and mortality of COVID‐19 among SOT. There is paucity of literature of SARS-CoV-2 vaccination efficacy in lung transplantation recipients . The purpose of the study was 1) to evaluate SARS-CoV-2 vaccination efficacy & safety in lung transplantation recipients and 2) to assess the need for 3(rd) booster dose. METHODS: A retrospective study (from Jan 2021 till Oct 2021) of lung transplantation recipients receiving 2 doses of SARS-CoV-2 vaccination available in India i.e. ChAdOx1 nCoV- 19 Corona Virus Vaccine (Recombinant) or Whole-Virion Inactivated Vero Cell vaccine, was done to evaluate vaccination efficacy and safety. SARS-CoV-2 spike COVID antibodies levels were checked 4 weeks after 2(nd) dose of vaccination. Local and Systemic reactions to vaccination were noted RESULTS: 11 Bilateral lung transplantation recipients and 4 Combined Heart-Lung transplantation recipients received SARS-CoV-2 vaccination. Out of 15 recipients, 11 recipients received ChAdOx1 nCoV- 19 Corona Virus Vaccine (Recombinant) and 4 recipients received Whole-Virion Inactivated Vero Cell vaccine. 12 recipients developed mild pain at vaccination site, 2 recipients developed local tenderness and 1 recipient developed redness at vaccination site as part of local reaction . 5 recipients developed fever, 5 recipients experienced fatigue/bodypain, 2 recipients had vomiting, 2 recipients experienced headache & 1 recipient developed abdominal pain as part of systemic reactions. 8 (53.3%) out of 15 recipients developed significant SARS-CoV-2 spike antibodies level demonstrating vaccination efficacy. 7 (46.6%) recipients demonstrated lower SARS-CoV-2 antibodies titre (Less than cut off values) indicating no significant vaccination efficacy. 1 recipient developed vaccine breakthrough mild infection after 2(nd) dose. CONCLUSION: Our experience has shown that SARS-CoV-2 vaccination efficacy was demonstrated in nearly 50 % of lung transplantation recipients. The study also showed safety of SARS-CoV-2 vaccines in such immunocompromised subset. However, for those recipients with no vaccination efficacy, utility of 3(rd) booster dose and at what interval needs more research.