Hong Kong Society of Transplantation
COVID-19 vaccine in solid organ transplant recipients
Introduction
The novel coronavirus (COVID-19) pandemic has infected more than 200 million patients worldwide and resulted in 5 million deaths. It is caused by the SARS-CoV-2 virus. Solid organ transplant (SOT) recipients are vulnerable, and they are prone to developing complications when they are infected.
COVID-19 vaccination in solid organ transplant recipients
Vaccination is a highly effective means to prevent COVID-19 infection and reduce risk of developing complications and death. However, the immune responses to COVID-19 vaccine in immunocompromised individuals, such as SOT recipients, are diminished compared with the general population.
Should solid organ transplant recipients receive 3rd doses of COVID-19 vaccine?
At present, there are limited clinical trials on additional dose of COVID-19 vaccine for SOT recipients. Current evidences suggest that receiving third dose of vaccine is safe and reasonably well-tolerated. It offers a better protection by eliciting a more potent response and increasing antibody level against COVID-19 without an increased risk of rejection attributable to vaccine. Based on current evidence, we recommend SOT recipients to receive 3 doses of COVID-19 vaccine. The Advisory Panel on COVID-19 Vaccines recommends that a third dose of Comirnaty (BioNTech) vaccine may elicit a better immune response. The third dose should be administered at least four weeks from the second dose.
As many countries have begun rolling out the 3rd doses of COVID-19 vaccination programme, we expect more clinical information, especially regarding its use in SOT recipients, to be available in near future. We recommend all transplant recipients to consult their physician before receiving vaccination.
What precautions should transplant recipients and their family members take?
We recommend SOT recipients to continue infection control measures, including wearing surgical mask properly, maintaining personal hygiene, and adhering to social distancing measures to minimize chance of infection. We also suggest vaccination to family members of transplant recipients in order to reduce the chance of cross infection.
Shall I receive COVID-19 Vaccine together with other vaccine?
SOT recipients should receive annual influenza vaccination. We recommend maintaining minimal interval of at least 14 days between administration of COVID-19 vaccine (Comirnaty or CoronaVac) and any other vaccines including seasonal influenza vaccine.
Reference
COVID-19 Thematic Website, HKSAR Government: https://www.coronavirus.gov.hk
COVID-19 Vaccination Programme, HKSAR Government: https://www.covidvaccine.gov.hk
COVID-19 Information, American Society of Transplantation: https://www.myast.org/covid-19-information
COVID-19 Vaccine, Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/ Coronavirus disease (COVID-19) pandemic, World Health Organization: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Prepared on 10 November 2021