香港移植學會

器官受贈者2019冠狀病毒病疫苗

 

 

簡介

2019冠狀病毒病(COVID-19)全球大流行感染人數已超越兩億,並造成近五百萬人死亡。2019冠狀病毒病是由一種名為嚴重急性呼吸綜合症冠狀病毒2的新型冠狀病毒引起的疾病。器官受贈人士屬於較高感染風險人士,比一般人更容易受到感染和出現併發症。

 

器官受贈者接受2019冠狀病毒病疫苗

接種疫苗能有效預防2019冠狀病毒病感染和減低其併發症及死亡率。但器官受贈者對接種疫苗產生的保護作用及持續時間可能會比一般人低。

 

器官受贈者應否接受第三劑2019冠狀病毒病疫苗

根據現有器官受贈者接受者第三劑COVID-19疫苗的臨床試驗數據資料顯示,接受第三劑疫苗是安全的。第三劑疫苗亦能有效提高病毒抗體量及增強保護力。因此我們建議所有器官受贈者接種第三劑疫苗。本港疫苗專家委員會建議接種第三劑復必泰疫苗以帶來更強保護。而第二及第三劑疫苗接種時間應相隔至少四星期。

 

現時有多個國家正推行第三劑2019冠狀病毒病疫苗接種計劃,我們預計屆時將會有更多臨床資訊提供(尤其在器官受贈者使用上的資料)。我們建議所有器官受贈者在接種疫苗前先向醫生查詢。

 

器官受贈者和家人的注意事項

我們建議所有器官受贈者繼續實行感染控制措施,包括正確佩戴外科手術口罩,保持個人衛生及遵從社交距離措施,以減低感染機會。我們亦建議器官受贈者的家人接種疫苗,以減低交叉傳染的機會。

 

器官受贈者可以接種其他疫苗嗎?

器官受贈者應每年接種流感疫苗。我們建議接種新冠疫苗(復必泰或克爾來福)和其他疫苗(包括季節性流感疫苗)之間距應維持最少14日。

 

 

參考資料

香港特區政府2019冠狀病毒病專題網站: https://www.coronavirus.gov.hk

香港特區政府2019冠狀病毒病疫苗接種計劃網站: https://www.covidvaccine.gov.hk

美國移植學會2019冠狀病毒病資訊: https://www.myast.org/covid-19-information

美國疾病管制與預防中心2019冠狀病毒病疫苗資訊: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/
世界衛生組織2019冠狀病毒病專題網站: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

 

於2021年11月10日撰寫

 

 


 

 

Hong Kong Society of Transplantation

COVID-19 vaccine in solid organ transplant recipients

 

 

Introduction

The novel coronavirus (COVID-19) pandemic has infected more than 200 million patients worldwide and resulted in 5 million deaths. It is caused by the SARS-CoV-2 virus. Solid organ transplant (SOT) recipients are vulnerable, and they are prone to developing complications when they are infected.

 

COVID-19 vaccination in solid organ transplant recipients

Vaccination is a highly effective means to prevent COVID-19 infection and reduce risk of developing complications and death. However, the immune responses to COVID-19 vaccine in immunocompromised individuals, such as SOT recipients, are diminished compared with the general population.

 

Should solid organ transplant recipients receive 3rd doses of COVID-19 vaccine?

At present, there are limited clinical trials on additional dose of COVID-19 vaccine for SOT recipients. Current evidences suggest that receiving third dose of vaccine is safe and reasonably well-tolerated. It offers a better protection by eliciting a more potent response and increasing antibody level against COVID-19 without an increased risk of rejection attributable to vaccine. Based on current evidence, we recommend SOT recipients to receive 3 doses of COVID-19 vaccine. The Advisory Panel on COVID-19 Vaccines recommends that a third dose of Comirnaty (BioNTech) vaccine may elicit a better immune response. The third dose should be administered at least four weeks from the second dose.

 

As many countries have begun rolling out the 3rd doses of COVID-19 vaccination programme, we expect more clinical information, especially regarding its use in SOT recipients, to be available in near future. We recommend all transplant recipients to consult their physician before receiving vaccination.

 

What precautions should transplant recipients and their family members take?

We recommend SOT recipients to continue infection control measures, including wearing surgical mask properly, maintaining personal hygiene, and adhering to social distancing measures to minimize chance of infection. We also suggest vaccination to family members of transplant recipients in order to reduce the chance of cross infection.

 

Shall I receive COVID-19 Vaccine together with other vaccine?

SOT recipients should receive annual influenza vaccination. We recommend maintaining minimal interval of at least 14 days between administration of COVID-19 vaccine (Comirnaty  or CoronaVac) and any other vaccines including seasonal influenza vaccine.

 

 

Reference

COVID-19 Thematic Website, HKSAR Government: https://www.coronavirus.gov.hk

COVID-19 Vaccination Programme, HKSAR Government: https://www.covidvaccine.gov.hk

COVID-19 Information, American Society of Transplantation: https://www.myast.org/covid-19-information

COVID-19 Vaccine, Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/
Coronavirus disease (COVID-19) pandemic, World Health Organization: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

 

 

Prepared on 10 November 2021