Findings from a two-year study of nearly 2,400 solid organ transplant recipients, conducted by the Johns Hopkins Transplant Research Center (TRC) in collaboration with the Latest York University Center for Surgical and Applied Transplant Research, indicate spikes of post-vaccination SARS-CoV-2 viral infections (commonly generally known as COVID-19 breakthrough cases) remain common, yet hospitalization rates have dramatically dropped following the primary wave of the virus’ omicron subvariant.

These results mirrored what medical institutions across the country were reporting for a lot of U.S. populations, not only people who find themselves immunocompromised. It provides more evidence of the worth of vaccination against SARS-CoV-2 in high-risk individuals, specifically making breakthrough infections less severe and reducing the prospect of long-term complications.”

William Werbel, M.D., Ph.D., senior study writer, assistant professor of medication and associate director of the TRC’s epidemiology and quantitative sciences on the Johns Hopkins University School of Medicine

The research letter detailing the study was first posted online Aug. 18, 2023, in JAMA Network Open. Werbel calls it “a little bit of a capstone” to the study team’s national COVID observational research project, which has produced greater than 60 published studies since 2021, evaluating the security, immunogenicity and effectiveness of repeated vaccination in transplant recipients and other immunocompromised people.

“This time, we desired to look back through two years of knowledge to see what number of study participants reported a diagnosis of COVID-19 following vaccination, trending cases over time and by variant era to evaluate how a lot of them developed severe disease that required hospitalization,” says Werbel. “We also plotted infection trends against reported cases in the final U.S. population to grasp the connection with SARS-CoV-2 circulating locally.”

Werbel says just below a fifth of the study participants (464 of two,356, or 19.7%) reported SARS-CoV-2 infections, and of those individuals, 35 (7.5%) required hospitalization.

“The infection trends paralleled those seen in U.S. COVID-19 case counts, peaking in the primary wave of the omicron BA.1 subvariant of SARS-CoV-2 within the winter of 2021, with ongoing outstanding spikes during subsequent omicron waves,” says Werbel. “Hospitalization rates dropped by 75% within the later omicron era [subvariants BA.2 through BQ.1] versus the rates seen in the sooner subvariant waves [pre-delta, delta and BA.1].”

He explains that the decrease was likely as a result of many aspects, including growing population immunity (from vaccines and exposure to infected people), higher disease management (through the usage of therapies corresponding to antivirals), more testing and, possibly, changes within the virus itself.

“Nevertheless, we did find that certain groups -; primarily patients who had received lung transplants -; remained at higher risk for hospitalization during more contemporary subvariant eras,” says Werbel.

Werbel adds that the brand new study’s findings “can guide counseling regarding the advantages of vaccination, and supply an evidence-based framing of risk and risk behaviors for populations most vulnerable to COVID, corresponding to transplant patients.”

Next, says Werbel, the TRC will expand the present study’s methodology to analyze responses of transplant recipients to vaccines against other infectious threats, corresponding to respiratory syncytial virus (RSV), influenza and mpox (formerly generally known as monkeypox).

Moreover, he says, the team will proceed to check novel strategies to optimize SARS-CoV-2 vaccine effectiveness in transplant recipients through the National Institutes of Health-funded COVID-19 Protection After Transplant (CPAT) trials. For instance, one method is selectively reducing immunosuppressive therapy (used to stop rejection of the transplanted organ) across the time of vaccination to evaluate if this allows the immune system to properly respond.

Together with Werbel, the members of the study team are Aura Abedon from Johns Hopkins Medicine, and lead study writer Teresa Chiang, Jennifer Alejo, Allan Massie and Dorry Segev from the Latest York University Grossman School of Medicine.

The study was funded by the Ben-Dov family; the Trokhan Patterson family; grants T32DK007713 and R01DK132395 from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health; and grants U01AI138897-S04, K24AI144954 and K23AI157893 from the National Institute of Allergy and Infectious Diseases, National Institutes of Health.

Werbel reports receiving personal fees from AstraZeneca, Global Data, the Infectious Diseases Society of America COVID-19 Real Time Learning Network and Novavax. Segev reports serving as a consultant and receiving honoraria for speaking from AstraZeneca, Bridge to Life, CareDx, CSL Behring, Jazz Pharmaceuticals, Kamada Pharmaceuticals, Mallinckrodt Pharmaceuticals, MediGO, Novartis, Novavax, Regeneron Pharmaceuticals, Sanofi, Takeda/Shire, Thermo Fisher Scientific, Transmedics and Veloxis Pharmaceuticals.

Source:

Journal reference:

Chiang, T, P. (2023). Incident COVID-19 and Hospitalizations by Variant Era Amongst Vaccinated Solid Organ Transplant Recipients. JAMA Network Open. doi.org/10.1001/jamanetworkopen.2023.29736.