{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:55:43Z","timestamp":1788850543247,"version":"build-2803163510"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organization for Health Research and Development","doi-asserted-by":"publisher","award":["10430072010002"],"award-info":[{"award-number":["10430072010002"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002997","name":"Dutch Kidney Foundation","doi-asserted-by":"publisher","award":["22OP+060"],"award-info":[{"award-number":["22OP+060"]}],"id":[{"id":"10.13039\/501100002997","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vaccine immunogenicity is reduced in kidney transplant recipients (KTRs), especially in those using mycophenolate mofetil (MMF). Whether replacement of MMF by everolimus improves vaccine immunogenicity is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>KTRs were randomized 1:1 to continue MMF or switch to everolimus. Participants received one coronavirus disease 2019 (COVID-19) booster vaccination and two herpes zoster (HZ) vaccinations at 6, 10 and 14 weeks postrandomization. Primary outcome was the neutralizing antibody response 28 days after COVID-19 vaccination. Secondary outcomes included antibody and T-cell responses 28 days after COVID-19 and HZ vaccination, and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 110 KTRs, COVID-19 vaccination resulted in comparable Omicron XBB.1.5 neutralizing antibody titers in the everolimus versus MMF group (308 [74.4\u20131314] vs 327 [115\u2013897]; P = .83), whereas severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Spike-specific T-cell responses were slightly lower with everolimus (118 [32.1\u2013243] vs 228 [113\u2013381] spot-forming cells [SFCs]\/106 peripheral blood mononuclear cells [PBMCs]; P = .02). HZ vaccination led to higher varicella zoster virus (VZV) glycoprotein E (gE)\u2013specific immunoglobulin G titers with everolimus (2192 [888\u20134523] vs 1101 [440\u20132078] 50% endpoint titer; P = .004), while VZV gE-specific T-cell responses were similar (85.0 [27.5\u2013155] vs 115 [50.0\u2013258] SFCs\/106 PBMCs; P = .24). Besides known side effects, everolimus led to more bacterial infections (27.3% vs 11.1%; P = .03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Six weeks\u2019 replacement of MMF by everolimus in KTRs does not improve COVID-19 booster vaccine immunogenicity, whereas 10 weeks\u2019 replacement enhances humoral HZ vaccine immunogenicity. While replacing MMF by everolimus may improve vaccine responses, its timing and potential risks require careful consideration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf107","type":"journal-article","created":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T07:16:05Z","timestamp":1741418165000},"page":"e480-e490","source":"Crossref","is-referenced-by-count":6,"title":["Replacing Mycophenolate Mofetil by Everolimus in Kidney Transplant Recipients to Increase Vaccine Immunogenicity: Results of a Randomized Controlled Trial"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2792-142X","authenticated-orcid":false,"given":"A Lianne","family":"Messchendorp","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen , Groningen ,","place":["The Netherlands"]},{"name":"Department of Medical Microbiology and Infection Prevention, 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Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7135-4752","authenticated-orcid":false,"given":"Dennis A J","family":"van den Broek","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Leiden University Medical Center and Leiden Transplant Center , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5296-6104","authenticated-orcid":false,"given":"Sophie C","family":"Fr\u00f6lke","sequence":"additional","affiliation":[{"name":"Renal Transplant Unit, Amsterdam Universtiy Medical Center, University of Amsterdam , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam Institute for Infection and Immunity, Infectious Diseases , Amsterdam ,","place":["The 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