Seroconversion rate after primary vaccination with two doses of BNT162b2 versus mRNA-1273 in solid organ transplant recipients: a systematic review and meta-analysis

Nephrol Dial Transplant. 2022 Jul 26;37(8):1566-1575. doi: 10.1093/ndt/gfac174.


Background: In the general population, the seroconversion rate after primary vaccination with two doses of an anti-severe acute respiratory syndrome coronavirus 2 messenger RNA (mRNA) vaccine reaches nearly 100%, with significantly higher antibody titers after mRNA-1273 vaccination compared to BNT162b2 vaccination. Here we performed a systematic review and meta-analysis to compare the antibody response after two-dose mRNA-1273 versus BNT162b2 vaccination in solid organ transplant (SOT) recipients.

Methods: A systematic literature review was performed using PubMed, Web of Science and the Cochrane Library and original research papers were included for a meta-analysis to calculate vaccine-specific seroconversion rates for each of the mRNA vaccines. Next, the pooled relative seroconversion rate was estimated.

Results: Eight studies that described the development of antibodies against receptor-binding domain (RBD) and/or spike protein were eligible for meta-analysis. Two of these studies also reported antibody titers. The meta-analysis revealed lower seroconversion rates in SOT recipients vaccinated with two doses of BNT162b2 {44.3% [95% confidence interval (CI) 34.1-54.7]} as compared with patients vaccinated with two doses of mRNA-1273 [58.4% (95% CI 47.2-69.2)]. The relative seroconversion rate was 0.795 (95% CI 0.732-0.864).

Conclusions: This systematic review and meta-analysis indicates that in SOT recipients, higher seroconversion rates were observed after vaccination with mRNA-1273 compared with BNT162b2.

Keywords: SARS-CoV-2/COVID-19; antibody response; mRNA vaccines; meta-analysis; solid organ transplant recipients.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • 2019-nCoV Vaccine mRNA-1273
  • Antibodies, Viral
  • BNT162 Vaccine
  • COVID-19* / prevention & control
  • Humans
  • Organ Transplantation*
  • RNA, Messenger
  • Seroconversion
  • Transplant Recipients
  • Vaccination
  • Vaccines*


  • Antibodies, Viral
  • RNA, Messenger
  • Vaccines
  • 2019-nCoV Vaccine mRNA-1273
  • BNT162 Vaccine