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Letter to the editor
Recommendation of a fourth SARS-CoV-2 vaccine dosage in vulnerable individuals, yes or not?
Recomendación de una cuarta dosis de vacuna frente a SARS-CoV-2 en individuos vulnerables: ¿sí o no?
Masoud Keikhaa,b,
Corresponding author
keikham971@mums.ac.ir

Corresponding author.
a Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
b Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="p0005" class="elsevierStylePara elsevierViewall">Recent studies suggested that even three doses of the Moderna SARS-CoV-2 vaccine could not be able to elicit an adequate immune response in kidney transplant recipient cases&#46;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a> Although administration of the Pfizer and AstraZeneca vaccines might able to provides a robust immune protective response against the alpha variant&#44; the effectiveness of these vaccine against delta variant was three to five less than the alpha variant even in immunocompetent individuals&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a> However&#44; the Israel&#39;s prime minister Naftali Bennett recommended the fourth dose of the COVID-19 vaccine to health-care workers and people older than 60&#8239;years on Jan 2&#44; 2022&#46; Previous reports revealed that seroconversion rate was about 50&#37; in solid organ transplant recipients even after a third dose&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> Thus&#44; establishment of long-term immune response in immune-deficient population could be helpful in significant reduction in COVID-19 mortality rate in these vulnerable subjects&#46; Till now&#44; there is doubt about effectiveness of a fourth SARS-CoV-2 vaccine dose for immune-compromised patients&#46;</p><p id="p0010" class="elsevierStylePara elsevierViewall">In recent&#44; Kamar et al&#46;&#44; investigated the effectiveness of a fourth dose of Pfizer BioNTech COVID-19 vaccine for recipients of a solid organ transplant in France&#44; they found that a fourth SARS-CoV-2 vaccine dosage was elicit a slight upgraded humoral response in participants with a weak response after 3 doses but not in patients with no response after 3 doses&#46;<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a> Alejo et al&#46; was showed that a fourth doses of SARS-CoV-2 vaccine could result increasing immune response in 50&#37; of patients with negative as well as all solid organ transplant recipients with low-positive titers after 3 doses of the Pfizer or Moderna&#46;<a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a> In addition&#44; Benotmane et al&#46;&#44; recently revealed the high portion &#40;up to 80&#37;&#41; of kidney transplant recipients have a weak immune response after three doses&#46; Meanwhile&#44; a fourth dose of the Moderna vaccine cause to significant increase of neutralizing antibodies response against the delta variant&#46;<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a> Indeed&#44; the evaluation of available documents exhibited that a four doses of SARS-CoV-2 vaccine appear to be increased both humoral and cellular-based immunity response event in immune-compromised patients with no response after 3 doses&#46; The results of Abbasi et al&#46; was confirmed the results of previous reports on the efficacy of a fourth SARS-CoV-2 mRNA-vaccine in promotion of immune-response in kidney transplant recipients who have a weak response after 3 doses&#46;<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a></p><p id="p0015" class="elsevierStylePara elsevierViewall">In summary&#44; our report indicated the effectiveness of a fourth SARS-CoV-2 vaccine dose in immune-compromised individuals with a weak antibody response after three doses&#46; In addition&#44; the fourth booster vaccine was well tolerated&#46; However&#44; there is no knowledge regarding durability of antibody levels&#46; On the other hand&#44; seroconversion rate was varied among vulnerable subject with no response after three vaccine dosage&#46; The implementation of hand hygiene&#44; face masking&#44; physical distancing&#44; as well as administration of monoclonal antibodies could be efficient prophylaxis in immune-deficient patients with no response to three doses of SARS-CoV-2 vaccine&#46;</p><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0005">Conflict of interest</span><p id="p0020" class="elsevierStylePara elsevierViewall">None to declare&#46;</p></span></span>"
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Article information
ISSN: 15769887
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos