Skip to main content

ORIGINAL RESEARCH article

Front. Immunol.
Sec. Vaccines and Molecular Therapeutics
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1476294

Comparison of immune responses to SARS-CoV-2 spike after Omicron infection or Omicron BA.4/5 vaccination in kidney transplant recipients

Provisionally accepted
Inga Tometten Inga Tometten 1*Tobias Brandt Tobias Brandt 1Maike Schlotz Maike Schlotz 2Ricarda Stumpf Ricarda Stumpf 2Sinje Landmann Sinje Landmann 3Marta Kantauskaite Marta Kantauskaite 3Joshua Lamberti Joshua Lamberti 3Jonas Hillebrandt Jonas Hillebrandt 3Lisa Müller Lisa Müller 1Margarethe Kittel Margarethe Kittel 3Katrin Ivens Katrin Ivens 3Henning Gruell Henning Gruell 2Anja Voges Anja Voges 1Heiner Schaal Heiner Schaal 1Nadine Lübke Nadine Lübke 1Eva Königshausen Eva Königshausen 3Lars Christian Rump Lars Christian Rump 3Florian Klein Florian Klein 2Johannes Stegbauer Johannes Stegbauer 3Joerg Timm Joerg Timm 1
  • 1 Institute of Virology, Heinrich-Heine-University, Düsseldorf, Germany
  • 2 Institute for Virology, University Hospital of Cologne, Cologne, North Rhine-Westphalia, Germany
  • 3 Klinik für Nephrologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

The final, formatted version of the article will be published soon.

    The emergence of novel SARS-CoV-2 variants challenges immunity, particularly among immunocompromised kidney transplant recipients (KTRs). To address this, vaccines have been adjusted to circulating variants. Despite intensive vaccination efforts, SARS-CoV-2 infections surged among KTRs during the Omicron wave, enabling a direct comparison of variant-specific immunity following-vaccination against Omicron BA.4/5 or Omicron infection in KTRs.Methods: 98 SARS-CoV-2 naïve KTRs who had received four vaccine doses were studied. Before and after a 5th antigen exposure, either via the bivalent vaccine composed of ancestral SARS-CoV-2 and Omicron BA.4/5 (29 KTRs) or via natural infection with Omicron (38 BA.4/5, 31 BA.1/2), spike-specific T cells were quantified using Elispot and serum pseudovirus neutralizing activity was assessed against the ancestral Wuhan strain, BA.5 and XBB.1.5.Results: Compared to BA.4/5 vaccination, spike-specific T-cell responses and neutralization activity were higher up to six months post-Omicron infection and reached levels similar to healthy controls. Vaccinated KTRs showed modestly boosted neutralization activity against the Wuhan strain and BA.5, but not XBB.1.5. Baseline immunity correlated with immune responses three months postvaccination and post-infection, indicating a predictive value for peak immune responses. Tixagevimab/Cilgavimab treatment was associated with robust neutralization of the Wuhan strain, but ineffective against XBB.1.5.The BA.4/5 vaccine improved neutralizing activity against the BA.4/5 variant, but not against the subsequently circulating XBB.1.5 variant in KTRs. Conversely, omicron infection boosted T cells and humoral responses more effectively, showing efficacy against XBB.1.5. These findings suggest that infection-induced immunity associates with greater protection than vaccination against future variants in KTRs.

    Keywords: SARS-CoV-2, Omicron BA.4/5, Omicron XBB.1.5, Bivalent Vaccination, Kidney transplant recipients

    Received: 05 Aug 2024; Accepted: 06 Dec 2024.

    Copyright: © 2024 Tometten, Brandt, Schlotz, Stumpf, Landmann, Kantauskaite, Lamberti, Hillebrandt, Müller, Kittel, Ivens, Gruell, Voges, Schaal, Lübke, Königshausen, Rump, Klein, Stegbauer and Timm. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Inga Tometten, Institute of Virology, Heinrich-Heine-University, Düsseldorf, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.