Active and Passive Immunization Approaches in Transplant Recipients

Abstract

Purpose of Review: The COVID-19 pandemic has greatly impacted solid organ transplant recipients (SOTr). Strategies to improve outcomes in this population include active immunization through vaccination and passive immunity through monoclonal antibodies and convalescent plasma. Unfortunately, the response to vaccination is greatly impacted by immunosuppression in SOTr, and monoclonal antibodies are no longer effective against circulating variants. Recent Findings: This review summarizes the decreased immune response to vaccination in SOTr and the clinical efficacy of vaccination. Strategies to bolster immune response to vaccination include administration of booster doses, immunomodulation, timing of vaccination, type and dose of vaccine, and use of adjuvants. In addition to active immunization, we briefly describe passive immunization strategies that have a role in SARS-CoV2 prevention. Summary: Active and passive immunization is vital in reducing poor outcomes, including hospitalization and mortality, in SOTr. Further studies on optimization of immune response to SARS-CoV2 vaccine are needed.