Transplant: No or Few Antibodies after COVID Vaccination

Posted by nkdonahue @nkdonahue, Feb 27, 2021

My daughter received a kidney from her father 15 months ago. She is participating in the Johns Hopkins study of transplant patients undergoing vaccination. The study required that she be tested for antibodies just before she received her second shot. The test results showed that she had no antibodies to Covid-19. I wonder if anyone else on this list is participating in the Hopkins study and can share their experience. I know the study will be asking participants to repeat the antibody test four of five more times over the year after being fully vaccinated. Thank you

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@athenalee

Ugh, very sorry you were back in the hospital….but, happy your digestive track sounds like it’s on a better track. When I had liver disease I drank tons of CALM, tastes ok and loaded with Magnesium. Don’t think it comes with blood in it though…hopefully you won’t need that again!

Nice that you’re off Mycophenolate. I’m hoping I get there one of these days…might reduce the number of infections I get.

Be well and Happy Thanksgiving! Athena

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Thanks. B well..I send prayers to all members of the Mayo web ...

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@jackie421blfdgurl

Hey girlfriend...I was in hospital last Thursday stayed for 4 days. Was very dehydrated...all blood levels low..needed blood liquid magnesium..and lots of bags of liquid. They put me on a gluten free diet they. Think it is cellaic desiese.so I have been on gluten free. Bathroom trips stopped and feel normal .. yippee! Yes only meds I am on is tacrolimus among some others, but celecept stopped .yes ate enough rice to fill a stadium..yulk!!!! Happy Thanksgiving.....jackie

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@jackie421blfdgurl, It's always good to hear from you. You have been on a rugged journey, and maybe, this is the beginning of the end of your lousy year.
One day at a time, dear Connect friend, keep your focus toward the future.

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@rosemarya

@jackie421blfdgurl, It's always good to hear from you. You have been on a rugged journey, and maybe, this is the beginning of the end of your lousy year.
One day at a time, dear Connect friend, keep your focus toward the future.

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You always know what to say. Lousy is an understatement! I just lost my friend of 40 yrs to brain cancer. This and your message is just a big wake up call that we r not going to b here forever, at least not in this form, so b thankful for each day and b kind to others. Love u guys
Happy thanksgiving to you Rosemary and your loved ones....

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Disappointing, but not really a surprise…

Fourth Vax Dose Not the Charm for Organ Transplant Recipients

https://www.medpagetoday.com/infectiousdisease/covid19vaccine/95859
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@athenalee

Disappointing, but not really a surprise…

Fourth Vax Dose Not the Charm for Organ Transplant Recipients

https://www.medpagetoday.com/infectiousdisease/covid19vaccine/95859

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@athenalee, Thank you for the article about 4th dose for immunocompromised patients. Yes, it is disappointing to read this, but like you say, not unexpected.
I am still curious about the ages, organs, elapsed time from transplant, as well as medications involved in our immune system's response to the vaccine. And none of these were mentioned in this information.

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I am not surprised. I was at Mayo Rochester on Monday & Tuesday this week for my almost one year visit. (no rejection or antibodies to new kidney-yay!) I requested a Covid antibody test and after 3rd vaccine end of August I have zero antibodies. Was told they may make 3 plus booster the new standard, but I said if I have no response after 3, what’s the point of 4? I think we need to rely on treatment if exposed and continue cautionary measures. I also hope eventually there will be a prophylactic pill to take when we fly or have more potential exposures. That said, I am so very thankful for my cousin who donated to me and for Dr Prieto and all staff that made my transplant and bilateral nephrectomy possible. ❤️ Mayo Clinic

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@athenalee

Hey there @jackie421blfdgurl, wanted to check in and see how you are doing. Has getting off Mycophenolate helped any? Can you have turkey 🦃 with your rice yuck? I hop you’re back to walking with Booboo!

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Hey..hope your turkey day was tasty...yes I can eat anything as long as it contains gluten free. Only pills I take are prograf 6mg a day keep my fingers crossed dr. Does not add anything. Walking back with indie, that is his name I just call him a lot of precious names!!!!
Great day today sun and 54. But we know it’s coming!!!!! The winter
That is! Talk to u by Christmas......have a good day

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@rosemarya

@athenalee, Thank you for the article about 4th dose for immunocompromised patients. Yes, it is disappointing to read this, but like you say, not unexpected.
I am still curious about the ages, organs, elapsed time from transplant, as well as medications involved in our immune system's response to the vaccine. And none of these were mentioned in this information.

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I'm 2.5 year out from a liver and kidney transplant. I'm on 4mg of tac a day. I'm also on Insulin and BP meds, as well as Gabapentin for neuropathy. I had zero antibodies after 2 FULL Moderna shots, however after 4 Full shots I requested a titer test and I now do have a high level of antibodies. I'm 70 years old. I hope this information helps others. BTW I also had Carotid artery surgery and a double bypass after my transplant and I feel great.

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@rosemarya

@athenalee, Thank you for the article about 4th dose for immunocompromised patients. Yes, it is disappointing to read this, but like you say, not unexpected.
I am still curious about the ages, organs, elapsed time from transplant, as well as medications involved in our immune system's response to the vaccine. And none of these were mentioned in this information.

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To put it in context, the first part of this study notes that of the transplant recipients receiving two vaccine (Pfizer) doses, 40% developed antibodies (seropositive), thus 60% were seronegative. Participants in the study were given a third shot. One month after the transplant recipients were given the third dose of mRNA-based vaccine, 67 were documented as being Anti-SARS-CoV2 positive patients (seropositive) and 32 Anti-SARS-CoV2 negative patients (seronegative).

Among the 59 patients who had been seronegative before the third dose, 26 (44%) were seropositive at 4 weeks after the third dose.

Transplant recipients who had a low or no antibody development after the third dose were given a fourth dose in this study. Results indicated that 4 weeks after dose 4, just over 40% of those given a forth dose became seropositive, at a median antibody concentration, 19.4% had antibody concentrations greater than 14 BAU/mL, and 6.5% had antibody concentrations greater than 140 BAU/mL.

The factors limiting antibody development after both the third and fourth dose correlate to older age, Immunosuppressive level, time between transplant and vaccines, having a lower total lymphocyte count, a lower CD4-positive T- cell count, a lower CD19-positive count, and a lower estimated glomerular filtration rate before vaccination compared to responders.

So, after studying both some more, I’ve come up with the same conclusions…doom and gloom for some of us. And, rays of sunshiny protection for others. But, even with the charts and data, it’s still confusing as to which camp one is in.

The charts in the PDFs attached have the breakdown, p. 5 for the 3rd dose and p. 2 for the 4th. They don’t break down the variables for the medications, however, like the John Hopkins study.

Shared files

3rd Dose_NEJMc2108861_appendix (3rd-Dose_NEJMc2108861_appendix.pdf)

4th dose_kamar_2021_ld_210260_1637099513 (4th-dose_kamar_2021_ld_210260_1637099513.32395.pdf)

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@benlam11

I'm 2.5 year out from a liver and kidney transplant. I'm on 4mg of tac a day. I'm also on Insulin and BP meds, as well as Gabapentin for neuropathy. I had zero antibodies after 2 FULL Moderna shots, however after 4 Full shots I requested a titer test and I now do have a high level of antibodies. I'm 70 years old. I hope this information helps others. BTW I also had Carotid artery surgery and a double bypass after my transplant and I feel great.

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That’s excellent! Congratulations on your good health as well!

It probably helps your antibody development that you don’t take Mycophenolate. I’m just over one year after liver transplant, on 6 mg Tac, and 1,000 mg Mycophenolate. Mycophenolate interferes with lymphocyte production, which is one of the antibodies measured.

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