SARS-CoV-2 Vaccination Rates and Uptake of Tixagevimab-Cilgavimab Among a Cohort of Pediatric Solid Organ Transplant Recipients

Clin Transplant. 2024 Jul;38(7):e15407. doi: 10.1111/ctr.15407.

Abstract

Introduction: There is a lack of data regarding SARS-CoV-2 vaccination rates and tixagevimab-cilgavimab (TC) uptake among pediatric solid organ transplant recipients. The purpose of our study was to assess these rates.

Materials and methods: We reviewed vaccination records of pediatric recipients of heart, kidney, and liver transplants at Mayo Clinic, Rochester, MN, who received a transplant between January 2011 and December 2021. All SARS-CoV-2 vaccines and doses of TC received on or before September 1, 2022, the date of approval of the bivalent SARS-CoV2 vaccine, were included. We also assessed whether patients had been seen by an infectious diseases physician (ID) in the preceding 6 months.

Results: Our study included 110 patients: 47 kidney, 36 heart, and 27 liver transplant recipients. All vaccine doses recorded were monovalent SARS-CoV-2 vaccines. Sixty-eight (61.8%) patients received at least one vaccine. This varied by age group, with f of ≥12 years olds, 40.9% of 5-11 year olds and 14.3% of under 5 year olds (p = 0.001). Seven patients (6.4%) were up-to-date (UTD) for age. There was no difference in UTD status by organ type (p = 0.335). Patients who saw ID were significantly more likely to be UTD (13.2% versus 2.8%; p = 0.047). Among those eligible, 14 (18.2%) received TC, with rates not different based on transplanted organ type (p = 0.158) or whether they saw ID (p = 0.273).

Conclusions: Despite the availability of vaccines, nearly 40% of pediatric solid organ transplant recipients remained unvaccinated against SARS-CoV-2 at time of the bivalent vaccine release. Less than a fifth of eligible patients received TC. Strategies to increase uptake of SARS-CoV-2 vaccines as well as adjunctive agents among this vulnerable group should be further explored.

Keywords: SARS‐CoV‐2 vaccine; monoclonal antibodies; organ transplant; pediatric solid organ transplant; pediatrics; tixagevimab‐cilgavimab; vaccine uptake.

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • COVID-19 Vaccines* / immunology
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Organ Transplantation*
  • Retrospective Studies
  • SARS-CoV-2* / immunology
  • Transplant Recipients* / statistics & numerical data
  • Vaccination / statistics & numerical data

Substances

  • COVID-19 Vaccines
  • Antibodies, Monoclonal, Humanized