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Third COVID-19 vaccine dose may prompt response in transplant recipients.

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A third dose of the mRNA-1273 vaccine induces a serologic response in 49 percent of kidney transplant recipients who did not respond after receiving two doses, according to a research letter published online July 23 in the Journal of the American Medical Association.

Ilies Benotmane, M.D., from Strasbourg University Hospital in France, and colleagues examined the antibody responses of kidney transplant recipients who did not respond to two COVID-19 mRNA vaccine doses and received a third dose of the Moderna mRNA-1273 vaccine. A total of 159 kidney transplant recipients with a negative history for COVID-19 and severe acute respiratory syndrome coronavirus 2 antispike immunoglobulin (Ig)G levels <50 AU/mL on the day of the first vaccine injection and one month after the second dose were included.

The researchers found that 59.7 percent of the participants had no antibody response after two doses, while 40.3 percent of patients showed a response below the positivity limit. A third dose was given at a median of 51 days after the second dose. At a median 28 days after the third dose, 49 percent of the participants had antibody levels >50 AU/mL (median antibody titer of responders, 586 AU/mL). Compared with patients with no antibody response after the second dose, those who had a weak response were more likely to develop an antibody response after the third dose (81.3 versus 27.4 percent, respectively).

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