The immunogenicity of the novel mRNA COVID-19 vaccine in immunocompromised lung transplant recipients is still unknown. We compared the antibody response after the first and second doses of the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) with the response after natural SARS-CoV-2 infection in lung transplant recipients. None of the vaccinees tested after two doses of the mRNA BNT162b2 vaccine developed anti-SARS-CoV-2 IgG, while 85% patients presented an antibody response after SARS-CoV-2 infection. The absence of antibody response to vaccination led us to investigate the cellular response in a subset of patients. We detected SARS-CoV-2 specific T-cells in 4 out of 12 tested patients. Some patients therefore might have clinical benefit from the vaccine despite an absent antibody response. These results contrast with the excellent antibody response in immunocompetent individuals observed in mRNA BNT162b2 trials and indicate an urgent need to identify the best vaccine type and scheme for immunocompromised transplanted patients.

Department of Immunology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital Prague Czech Republic

Department of Medical Microbiology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital Prague Czech Republic

Department of Pediatric Hematology and Oncology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital Prague Czech Republic

Institute of Pharmacology 1st Faculty of Medicine Charles University Prague Prague Czech Republic

Prague Lung Transplant Program 3rd Department of Surgery 1st Faculty of Medicine Charles University Prague and Motol University Hospital Prague Czech Republic

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J Heart Lung Transplant. 2021 Aug;40(8):763-766. doi: 10.1016/j.healun.2021.04.018. PubMed

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