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Recommendations for vaccination in case of lung transplantation

Dear expert team,
I have a question about recommendations for Corona vaccination in case of transplantation. Transplanted patients are treated with immunosuppressive drugs, in oder to avoid organ rejection. After vaccination, there should be a reaction of the immune system, however I think this could only be a slight reaction. Until now, the physicians were not able to explain, why a patient should be vaccinated if the effectiveness is only very small. What is even more dramatic in my example is, that the patient is threaten not to be treated if he refuses the vaccination. This is how it happened. In general, we are not against vaccinations, however it has to be taken into account, if this is the best in case of a grade 4 kidney failure. Healthy people are free to decide, even if they have only advantages in case of vaccination. Could you please help me further in this situation?
Dear questioner,
we resume from your question, that you want to know something about recommendations of COVID-19 vaccinations for transplanted patients. It is recommended for patients after lung-tx to have a COVID-19 vaccination, also the booster immunization. It is expected that about 50% of patients develop antibodies. Furthermore there is a cellular immunity after vaccination und protection against a severe infection and death. There is data from Great Britian, that two times vaccinated transplanted patients have nearly half of the mortalitiy rate of transplanted patiens who are not vaccinated (
However it is true, that in some immunosuppressed patients even after the 3rd COVID-19 vaccination, antibodies and T-cell activation could not be measured. Therefore it could make sense, to choose another vaccination preparation in case of another vaccination. Furthermore is makes sense to sensitize the patients to get tested regularly in order to be able to react quickly in case of infection.
I hope to have answered your question,
Yours sincerely,
Christina Smaczny