Infectious Disease

Pregnant women vaccinated against COVID-19 pass antibodies on to newborns

March 26, 2021

2 min read

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Disclosure:
Edlow does not report any relevant financial information. Gray reports that he has consulted outside of the work submitted for Aetion, BillionToOne, and Illumnia. In the study you will find all relevant financial information from all other authors.

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Pregnant and breastfeeding women who received the Pfizer / BioNTech or Moderna COVID-19 vaccine had similar levels of vaccine-induced antibody titers compared to non-pregnant controls, according to new study results.

In addition, the researchers found antibodies generated by vaccines in umbilical cord blood and breast milk after the mother was vaccinated. The new results suggest that COVID-19 vaccination may provide “robust maternal and newborn immunity,” they write, in pregnant and breastfeeding women.

Reference: Gray KJ et al. At J Obstet Gynecol. 2021; doi: 10.1016 / j.ajog.2021.03.023.

“This news of excellent vaccine efficacy is very encouraging to pregnant and breastfeeding women who were not included in the initial COVID-19 vaccine studies.” Andrea Edlow, MD, MSc, A maternal-fetal medicine specialist at Massachusetts General Hospital said in a press release.

In the study, Edlow, Kathryn Gray, MD, PhD, An obstetrician at Brigham and Women’s Hospital and colleagues studied the immunogenicity and reactogenicity of COVID-19 vaccination with the Moderna and Pfizer / BioNTech vaccines in 131 pregnant (n = 84), lactating (n = 31), and non-pregnant women (n = 84) n = 16). All participants were between 18 and 45 years old, most were white, about half received the Pfizer / BioNTech vaccine, and five had previously had SARS-CoV-2 infection.

The pregnant women had a mean gestational age of 23.2 weeks when they received their first dose of vaccine. Thirteen of them were delivered during the study and ten provided cord blood at delivery. Of those with cord blood samples, nine received both COVID-19 vaccine doses.

Gray and colleagues wrote in the American Journal of Obstetrics and Gynecology that vaccine-induced antibody titers were comparable in all three cohorts, with a mean interquartile range of 5.59 (95% CI, 4.68-5.89) in pregnant women, 5.74 (95%) CI, 5.06-6.22) in breastfeeding women and 5.62 (95% CI, 4.77-5.98) in non-pregnant women.

The researchers compared the antibody titers of vaccinated women in the current study to a separate cohort of 37 pregnant women who were infected with SARS-CoV-2 during pregnancy. They found “noticeably higher antibody levels” in pregnant women who were vaccinated than in those infected with SARS-CoV-2 during pregnancy (P <0.0001).

Vaccine-generated antibodies were found in all breast milk and cord blood samples, the researchers reported. The woman’s second dose of vaccine increased the SARS-CoV-2-specific IgG in breast milk and maternal blood. The umbilical cord blood sample with the lowest IgG response was from a participant who received only one dose of COVID-19 vaccine during pregnancy, “suggesting that two doses may be essential in optimizing humoral immune transfer to the newborn,” wrote Researchers.

“Based on what is known about other vaccines, the amount of maternal IgG transferred across the placenta to the cord will likely differ depending on the vaccine trimester,” wrote Gray and colleagues. “Understanding vaccine-induced antibody transfer kinetics across all trimesters of pregnancy will be an important direction for future research. While timing of COVID-19 vaccination in mothers may not be possible at this stage of the pandemic, understanding the optimal timing for vaccination to increase the newborn’s humoral immunity remains important. “

The study also showed that mucosal IgA responses were higher with the Moderna vaccine compared to the Pfizer / BioNTech vaccine, the researchers said.

“This finding is important for everyone because SARS-CoV-2 is acquired through mucosal surfaces such as the nose, mouth and eyes,” said Gray in the press release. “But it is also of particular concern for pregnant and breastfeeding women, as IgA is a key antibody in breast milk.”

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Reproductive and Maternal Health Resource Center

Reproductive and Maternal Health Resource Center

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