A Phase I/II Randomized Trial of Higher Dose mRNA-1273 Boosters in Lung Transplant Recipients

Higher-dose mRNA booster vaccines have not been well studied for transplant recipients. This study evaluated the safety, reactogenicity and immunogenicity of higher dose mRNA-1273 booster vaccines among lung transplant recipients (LTRs). This phase 1/2 open-label randomized clinical trial of higher-dose mRNA-1273 booster vaccination enrolled nineteen adult LTRs into the 50 µg (n = 8) vs. 100 µg (n = 11) groups before enrollment was terminated due to the availability of the bivalent mRNA-1273.222 vaccine. Local and systemic reactogenicity was predominantly mild or moderate in severity for both dose groups, mostly limited to pain at the injection site, fatigue and headache. Humoral and cellular immune responses were weak. Overall, 75% and 64% of the 50 µg and 100 µg groups had detectable neutralizing antibodies on Day 30 (vs. 63% and 55% on Day 1), respectively. On Day 30, 50% and 55% had detectable spike-specific CD4<sup>+</sup> IFNγ responses (vs. 29% and 36% on Day 1), and 50% and 36% had detectable CD8<sup>+</sup> IFNγ responses (vs. 29% and 45% on Day 1) for the two groups, respectively. LTRs have reactogenicity and immune responses that are attenuated compared with the non-immunocompromised population. Administration of higher doses in solid organ transplant patients may be warranted. Clinical trial NCT05280158.

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Publication Details

Journal
OBM Transplantation
Published
2024-11-20
DOI
https://doi.org/10.21926/obm.transplant.2404227
Primary Topic
Transplantation: Methods and Outcomes
Type
article
Field-Weighted Citation Impact
0.00

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article

A Phase I/II Randomized Trial of Higher Dose mRNA-1273 Boosters in Lung Transplant Recipients

D. Sayah, F. Javier Ibarrondo, Amparo L. Figueroa, John A. Belperio et al.
1 links
OBM Transplantation
Transplantation: Methods and Outcomes
article

A Phase I/II Randomized Trial of Higher Dose mRNA-1273 Boosters in Lung Transplant Recipients

D. Sayah, F. Javier Ibarrondo, Amparo L. Figueroa, John A. Belperio, Pryce Gaynor, Ariss Derhovanessian, Kate Anteyi, Terri Wrin, Christos J. Petropoulos, A. Ardehali, Maria Florian, Omer E. Beaird, Reshma Biniwale, Jacqueline M. Miller, Olawale Amubieya, Joanna Schaenman, Otto O. Yang, Jesse L. Clark, Brett Leav, Rajan Saggar, Ashrit Multani, David A. Elashoff, Michael Y. Shino, Grant A. Turner, Yolanda Lie, Allison Ramsey, Adreanne Rivera, S. Sam Weigt, Murray Kwon, Zelalem Endale
article en

Abstract

Higher-dose mRNA booster vaccines have not been well studied for transplant recipients. This study evaluated the safety, reactogenicity and immunogenicity of higher dose mRNA-1273 booster vaccines among lung transplant recipients (LTRs). This phase 1/2 open-label randomized clinical trial of higher-dose mRNA-1273 booster vaccination enrolled nineteen adult LTRs into the 50 µg (n = 8) vs. 100 µg (n = 11) groups before enrollment was terminated due to the availability of the bivalent mRNA-1273.222 vaccine. Local and systemic reactogenicity was predominantly mild or moderate in severity for both dose groups, mostly limited to pain at the injection site, fatigue and headache. Humoral and cellular immune responses were weak. Overall, 75% and 64% of the 50 µg and 100 µg groups had detectable neutralizing antibodies on Day 30 (vs. 63% and 55% on Day 1), respectively. On Day 30, 50% and 55% had detectable spike-specific CD4<sup>+</sup> IFNγ responses (vs. 29% and 36% on Day 1), and 50% and 36% had detectable CD8<sup>+</sup> IFNγ responses (vs. 29% and 45% on Day 1) for the two groups, respectively. LTRs have reactogenicity and immune responses that are attenuated compared with the non-immunocompromised population. Administration of higher doses in solid organ transplant patients may be warranted. Clinical trial NCT05280158.

OBM TransplantationVol. 08(04)
W. M. Keck Foundation, Moderna, National Institutes of Health, University of California, Los Angeles
Good health and well-being
Openalex Percentile: Top 60%
Transplantation: Methods and Outcomes
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