This is a summary, written by members of the CITF Secretariat, of:

Groves H, Piché‐Renaud PP, Allen U. The significance and impact of SARS‐CoV‐2 variants of concern in pediatric solid organ transplantation: More unknowns than knowns. Pediatric Transplantation. 2021 Jun 16. DOI: 10.1111/petr.14071

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

In this short perspective in Pediatric Transplantation, CITF-funded researcher Dr. Upton Allen and colleagues present the latest evidence regarding the impact of variants of concern (VOCs) in children with solid organ transplants. They suggest that given the prolonged viral shedding observed more broadly in people with compromised immune statuses, there may be a greater chance that new VOCs develop. They argue that VOC-specific vaccines may need to be explored for this population, meaning continued protective measures are required in the meantime.

Key Points:

  • A compromised immune status (as is the case in children with solid organ transplants) leading to prolonged viral shedding may enhance viral replication and therefore the generation of mutations. This would contribute to the potential emergence of new SARS-CoV-2 variants.
  • Given vaccine effectiveness concerns in this population, VOC-specific vaccines may need to be explored.
  • Given concerns regarding the lower vaccine effectiveness in this population, it is likely that continued strict protective measures will remain necessary, especially in areas where community spread of SARS-CoV-2 remains high.
  • The remaining unknowns include the following:
    • The potential impact of VOCs on disease severity; and
    • The potential impact of re-infection by VOCs.
  • The inclusion of both children and solid organ transplant recipients in vaccine trials is urgently needed.

For more on this topic, please read the news release regarding a CITF-funded study looking at COVID-19 vaccine efficacy and safety in transplant patients (Prospective Evaluation of COVID-19 Vaccine in Transplant Recipients (PREVenT-COVID) led by Dr. Deepali Kumar. A summary of Dr. Kumar’s latest publication on this topic can also be found here.