"In organ-transplant recipients, the standard two-dose vaccination strategy for coronavirus disease 2019 (Covid-19) has suboptimal immunogenicity.¹ Both patients and health care providers have questioned whether a third-dose booster in transplant recipients would be safe and enhance immune response.² We performed a double-blind, randomized, controlled trial of a third dose of mRNA-1273 vaccine (Moderna) as compared with placebo."

A third dose of mRNA vaccine in transplant recipients had substantially higher immunogenicity than placebo, as determined in our analysis of both primary and secondary trial end points. This trial had short follow-up and was not powered to detect differences in clinical outcomes. We also acknowledge that the cutoff value of 100 U per milliliter for the anti-RBD antibody level is arbitrary and is not necessarily predictive of resistance to infection. A third dose was safe when risk versus benefit was considered. We note that a small subgroup of patients who received placebo did have modest increases in antibody levels (Figure 1B). This may reflect ongoing mRNA vaccine–induced B-cell stimulation, as recently described,⁵ and highlights the importance of evaluating a control group. We conclude that a third-dose booster Covid-19 vaccine should be considered, in conjunction with regulatory approval, for transplant recipients who have received two doses of mRNA-1273."

This Canadian study indicates how critical a third dose of the COVID-19 vaccine is for immunocompromised people, including transplant recipients. Therefore, PKD Foundation of Canada calls for a third dose of the COVID-19 vaccine to protect immunocompromised people. 

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