American Journal of Transplantation: Volume 21, Number 8, August 2021

On the cover: The COVID-19 pandemic has poignantly reminded the entire transplantation community, patients and physicians, about the downsides of chronic lifelong immunosuppression that are often forgotten in daily life and practice, respectively. At the outset, concerns centered on the potential for immunosuppressed compared to non immunosuppressed patients to experience heightened morbidity and mortality from SARS-CoV-2 infection. Now, more than a year and a half later, concerns have pivoted to reduced COVID vaccine immunogenicity that may translate into reduced vaccine efficacy. Multiple articles in this issue highlight the clinical and immunological impact of COVID-19 in multiple solid organ transplant cohorts (kidney, liver, heart, and lung), including children as well as the humoral and cellular responses to SARS-CoV-2 mRNA vaccines. The theme is extended by two additional articles: one that examines antibody responses to natural influenza infection versus vaccination and another that documents the lack of protective immunity against measles, mumps, and varicella among lung transplant recipients. Cover design by Megan Llewellyn, Duke University Section of Surgical Disciplines.