Kinetics of antibody response to influenza vaccination in renal transplant recipients

Transpl Immunol. 2019 Apr;53:51-60. doi: 10.1016/j.trim.2019.01.001. Epub 2019 Jan 18.


Annual vaccination is routinely used in organ transplant recipients for immunization against seasonal influenza. However, detailed analysis of the kinetics of vaccine-induced immune responses in this population is lacking. In this study, we investigated the kinetics of vaccine strains-specific antibody responses to trivalent influenza vaccine in a group of renal transplant recipients and a control group. First, we found that the geometric mean hemagglutination inhibition titer against all 3 vaccine strains in the transplant cohort was significantly low when compared to control subjects. Next, whereas the control group sera showed significantly higher HA-specific IgG and isotype IgG1 antibodies at all four time points, a similar increase in the transplant group was delayed until day 28. Interestingly, within the transplant group, subjects receiving belatacept/MMF/prednisone-based regimen had significantly lower levels of total IgG and HA-specific IgG when compared to tacrolimus/MMF/prednisone-based regimen. Even though IgG-ASC response in both cohorts peaked at day 7 post-vaccination, the frequency of IgG-ASC was significantly low in the transplant group. Taken together, our studies show delayed kinetics and lower levels of influenza vaccine-specific antibody responses in renal transplant recipients and, more importantly, indicate the need to probe and improve current vaccination strategies in renal transplant recipients.

Keywords: Antibody; Immunosuppression; Influenza; Kidney transplant; Vaccination.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antibodies, Viral / metabolism
  • Antibody Formation
  • Cohort Studies
  • Female
  • Graft Rejection / complications
  • Graft Rejection / drug therapy
  • Graft Rejection / immunology*
  • Hemagglutinin Glycoproteins, Influenza Virus / immunology
  • Humans
  • Immunosuppression Therapy
  • Influenza A virus / immunology*
  • Influenza Vaccines / immunology*
  • Influenza, Human / complications
  • Influenza, Human / drug therapy
  • Influenza, Human / immunology*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Tacrolimus / therapeutic use
  • Transplant Recipients
  • Vaccination


  • Antibodies, Viral
  • Hemagglutinin Glycoproteins, Influenza Virus
  • Influenza Vaccines
  • hemagglutinin, human influenza A virus
  • Tacrolimus