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Table. 2.

Table. 2.

Factors associated with symptomatic breakthrough infection after a third vaccination dose

Variables Breakthrough infection (N=64) No breakthrough infection (N=222) Univariable Multivariable*
HR 95% CI P HR 95% CI P
Age, median (IQR), yrs 50.0 (40.5–59.5) 49.0 (38.0–60.0) 1.00 0.99–1.02 0.644
Male sex, N (%) 34 (53.1) 114 (51.4) 1.07 0.62–1.88 0.802
Time since transplantation, median (IQR), yrs 4.0 (1.6–9.6) 6.1 (2.2–11.3) 0.96 0.91–1.00 0.075
Dialysis duration, median (IQR), month 8.3 (0–48.3) 14.6 (1.9–64.8) 0.99 0.99–1.00 0.089 0.99 0.99–1.00 0.066
Donor type–living donor, N (%) 48 (75.0) 137 (61.7) 1.86 1.01–3.57 0.052
Hypertension, N (%) 42 (65.6) 124 (55.9) 1.51 0.85–2.73 0.164
Steroid dose, median (IQR) 5.0 (2.5–5.0) 5.0 (2.5–5.0) 1.08 0.99–1.19 0.068 1.08 0.99–1.18 0.069
PLR 121.6 (89.5–162.0) 111.1 (86.4–146.8) 1.00 1.00–1.01 0.070
Tacrolimus trough level, ng/mL 6.0 (5.2–7.0) 5.4 (4.5–6.6) 0.91 0.35–2.40 0.171
Type of primary vaccination, N (%)
mRNA/mRNA vaccine 21 (41.2) 30 (41.7) Ref
ChAdOX1-S/ChAdOX1-S 17 (33.3) 23 (31.9) 1.01 0.48–2.02 0.988
ChAdOX1-S/BNT162b2 13 (25.5) 18 (25.0) 0.85 0.43–1.63 0.631
Janssen 0 1 (1.4) 0.00 0.988
Type of third dose vaccine, N (%)
mRNA-1273 6 (9.4) 34 (15.3) Ref
BNT162b2 58 (90.6) 188 (84.7) 1.75 0.75–4.81 0.232
Post-third dose anti-spike antibody titer <400 AU/mL, N (%) 36 (56.2) 61 (27.5) 3.39 1.92–6.07 <0.001 3.46 1.93–6.20 <0.001

*The multivariable logistic regression model included sex, age, and factors with P≤0.2 in univariable tests (i.e., time since transplantation, dialysis duration, donor type, hypertension, PLR, tacrolimus trough level, steroid dose, and post-booster anti-RBD IgG titer <400 AU/mL).

Post-booster anti-RBD IgG titer was <400 AU/mL.

Abbreviations: IQR, interquartile range; PLR, platelet:lymphocyte ratio; Ref, reference; RBD, receptor-binding domain.

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