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Vaccines
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Vaccine Efficacy and Safety in Transplant Recipients
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Vaccine Efficacy and Safety in Transplant Recipients

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Vaccine Efficacy and Safety".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 2452

Special Issue Editor

Prof. Dr. Ger Rijkers

E-Mail Website
Guest Editor
Science and Engineering Department, University College Roosevelt, 4331 CB Middelburg, The Netherlands
Interests: immunology; immunodeficiency; vaccination; pneumococcal pneumonia; SARS-CoV-2
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The immune system offers protection against bacterial, viral, and other infections. The immune system, however, may be inadequate in offering complete protection upon its first encounter with highly virulent micro-organisms such as tetanus or SARS-CoV-2. For these cases, the immune system response can be improved through vaccination with relevant antigens from these pathogens. Vaccination induces specific antibodies and effector T-cells, as well as memory B- and T-cells, which offer long-term protection. Successful vaccination does depend on an intact immune system of the host. Transplant recipients are treated with immunosuppressive drugs to prevent the rejection of the transplanted organ. As a consequence, regular vaccines, administered at regular doses and intervals, may not be as effective as in healthy individuals. Because of this immunosuppressive treatment, transplant recipients have a higher infection risk but, at the same time, can show a poorer response to vaccination. Therefore, the optimal timing and dosing of vaccination is of utmost importance.  We would like to encourage submissions to this Special Issue regarding recent advances in the optimization of the vaccination response in transplant recipients, referring to transplants in the broadest sense of the word. Adding new information on this subject may lead to a better understanding of the critical determinants of an effective immune response to vaccination and may aid in the design of optimal vaccination strategies for transplant recipients.

Prof. Dr. Ger Rijkers
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • transplant recipients
  • vaccination
  • kidney
  • heart
  • lung
  • stem cell transplants
  • safety
  • antibody response
  • efficacy

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Published Papers (3 papers)

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Research

14 pages, 493 KiB  
Article
COVID-19 Vaccine Perception in Liver Transplant Recipients: Patient-Reported Outcomes and Real-Life Experience from the Bergamo Center
by Alessandro Loglio, Elisa Farina, Francesco Ideo, Giovanni Alfieri, Tiziana Negri, Flavia Neri, Valentina Zuccaro, Stefano Fagiuoli, Stefania Camagni and Mauro Viganò
Vaccines 2025, 13(5), 455; https://doi.org/10.3390/vaccines13050455 - 24 Apr 2025
Viewed by 137
Abstract
Background: Bergamo was the most severely affected Italian province at the onset of the 2020 COVID-19 pandemic. The liver transplant (LT) patient population should be among the more sensitized to the concept of health prevention. Long-term data on both perception and outcomes of [...] Read more.
Background: Bergamo was the most severely affected Italian province at the onset of the 2020 COVID-19 pandemic. The liver transplant (LT) patient population should be among the more sensitized to the concept of health prevention. Long-term data on both perception and outcomes of SARS-CoV-2 vaccination in LT recipients since the COVID-19 vaccine became available in Italy are still lacking. Methods: From May to October 2023, a survey on actively followed LT recipients at our institution was carried on by the local patient’ advocacy (Associazione Amici del Trapianto di Fegato) to define the rate of vaccinated subjects, SARS-CoV-2 infections and self-reported COVID-19-related outcomes. Results: Out of the consecutive 753 adult LT recipients invited to the survey, 356 responded (47.3%) [71% male, 63 years old (20–85), LT performed a mean of 9 years (1–26) before vaccination] and were included in the analysis. All patients received the first vaccine dose between December 2020 and January 2022 (81.7% Cominarty®, 17.7% Spikevax®, 0.3% Vaxzevria® and 0.3% Jcovden®). In the following years, adherence to the vaccination policy decreased progressively over time: the second, third, fourth, and fifth vaccine doses were administered to 99%, 94%, 72%, and 22% of the LT population by October, 2023. In total, 43 (12%) and 93 (26%) patients reported a COVID-19 episode before and after [13 (7–21) months] the first vaccination, respectively; none of the LT recipients reported a second COVID-19 infection after the following vaccination cycles. Forty-six (13%) reported short-term post-vaccination mild adverse events but none developed either acute or chronic rejection episodes or hospitalization for COVID-19-related symptoms. A total of 64% of LT recipients resulted positive for anti-nucleocapsid serological test in 2023. Conclusions: COVID-19 vaccines are safe and effective in LT recipients, underlining once again the importance of vaccination in this special population at higher risk of complications from communicable infectious diseases. Full article
(This article belongs to the Special Issue Vaccine Efficacy and Safety in Transplant Recipients)
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15 pages, 1722 KiB  
Article
Safety and Efficacy of Influenza Vaccination in Kidney Graft Recipients in Late Period After Kidney Transplantation
by Anna Zawiasa-Bryszewska, Maja Nowicka, Monika Górska, Piotr Edyko, Krzysztof Edyko, Damian Tworek, Adam Antczak, Jacek Burzyński and Ilona Kurnatowska
Vaccines 2025, 13(2), 189; https://doi.org/10.3390/vaccines13020189 - 14 Feb 2025
Viewed by 579
Abstract
Background/Objectives: Influenza is a viral infection affecting up to 20% of the general population annually. Solid organ transplant recipients have a higher morbidity and mortality risk, as well as a greater likelihood of severe disease complications. Vaccination against the influenza virus is a [...] Read more.
Background/Objectives: Influenza is a viral infection affecting up to 20% of the general population annually. Solid organ transplant recipients have a higher morbidity and mortality risk, as well as a greater likelihood of severe disease complications. Vaccination against the influenza virus is a safe and recommended prophylaxis; however, immunosuppression and high comorbidity burdens impair the immune response. We assessed the efficacy, safety, and humoral response to influenza vaccine in a population of kidney transplant recipients (KTx). Methods: Adult KTx recipients at least 6 months post-KTx were divided into vaccinated (vKTx) and non-vaccinated (nvKTx) groups based on consent for vaccination. The vKTx group received one dose of quadrivalent split virion inactivated vaccine (Vaxigrip Tetra Sanofi Pasteur). Subjective symptoms and side effects were recorded in paper journals. Antibody levels were assessed with ELISA prior to and 3 months following vaccination. Serum creatinine and proteinuria were assessed prior to vaccination as well as 3 and 6 months after. Results: Of 450 recruited KTx recipients, 91 in the vKTx group and 36 in the nvKTx group of comparable age, KTx vintage, and graft function were included in the study. Graft function and proteinuria remained stable in both groups. The vKTx group experienced no severe adverse events. The most common complaints were general malaise (20.5%) and injection site pain (10.3%). Overall infection rates were comparable, yet the vKTx group experienced significantly fewer serious infections (11.4% vs. 32.3%, p = 0.01); the vKTx group showed a greater increase of Influenza A IgM (p = 0.05) and Influenza B IgG (p = 0.01) compared with the nvKTx group. Conclusions: Influenza vaccination prevents severe infections in KTx recipients, with good serological response and no impact on graft function or severe adverse events. Full article
(This article belongs to the Special Issue Vaccine Efficacy and Safety in Transplant Recipients)
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14 pages, 1558 KiB  
Article
Sequential Vaccination Against Streptococcus pneumoniae Appears as Immunologically Safe in Clinically Stable Kidney Transplant Recipients
by Monika Lindemann, Lukas van de Sand, Nils Mülling, Kim L. Völk, Ulrich W. Aufderhorst, Benjamin Wilde, Peter A. Horn, Andreas Kribben, Adalbert Krawczyk, Oliver Witzke and Falko M. Heinemann
Vaccines 2024, 12(11), 1244; https://doi.org/10.3390/vaccines12111244 - 31 Oct 2024
Viewed by 1197
Abstract
Background: Vaccination against Streptococcus pneumoniae is advised for transplant recipients to reduce morbidity and mortality associated with invasive pneumococcal disease. However, data on alloantibodies after sequential vaccination (with a pneumococcal conjugate vaccine followed by a polysaccharide vaccine) are still lacking. Methods: In the [...] Read more.
Background: Vaccination against Streptococcus pneumoniae is advised for transplant recipients to reduce morbidity and mortality associated with invasive pneumococcal disease. However, data on alloantibodies after sequential vaccination (with a pneumococcal conjugate vaccine followed by a polysaccharide vaccine) are still lacking. Methods: In the current study, we determined HLA class I and II and major histocompatibility class I-related chain A (MICA) antibodies in 41 clinically stable kidney transplant recipients. These antibodies were measured prior to and post sequential pneumococcal vaccination over a period of 12 months. Alloantibodies were measured by Luminex bead-based assays, and pneumococcal IgG antibodies were measured by ELISA. Results: Over a 12-month period, the sequential analysis revealed no significant change in alloantibodies. One patient developed de novo donor-specific antibodies (DSA) 1.5 months after the first vaccination, with mean fluorescence intensities of up to 2300. These DSA became undetectable in the follow-up, and the patient showed no signs of allograft rejection. Another patient experienced a biopsy-proven borderline rejection 7 months after the first vaccination but did not develop de novo DSA. Both maintained stable kidney function. As expected, the pneumococcal antibodies increased significantly after vaccination (p < 0.0001). Conclusions: Given the overall risk of alloimmune responses in transplant recipients, we would not attribute the two noticeable patient courses to vaccination. Thus, we consider sequential vaccination immunologically safe. Full article
(This article belongs to the Special Issue Vaccine Efficacy and Safety in Transplant Recipients)
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