Infectious Disease

Study shows COVID-19 vaccines are highly immunogenic in pregnant and breastfeeding women

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Disclosure:
Barouch reports grants from Alkermes, amfAR, Bill and Melinda Gates Foundation, Cure Vac, Defense Advanced Research Projects Agency, Gilead Sciences, Henry M. Jackson Foundation, Walter Reed Army Institute of Research, Intima, Legend, Mass CPR, NIH, Ragon Institute, Sanofi, South Africa Medical Research Council, and Zentalis; Receiving personal fees from SQZ Biotech; and a patent for COVID-19 vaccines licensed to Janssen with no license fees or pre-market payments of any kind. Please refer to the study for all relevant financial information from the other authors.

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Both messenger RNA COVID-19 vaccines available in the US induce immune responses in pregnant and non-pregnant women, including breastfeeding women, researchers reported in JAMA.

Dan H. Barouch, MD, PhD, Director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in New York, and colleagues conducted an exploratory, descriptive, prospective cohort study of 103 women ages 18 to 45 who developed mRNA COVID from December to December 19 vaccine received in March, or who had COVID-19 from April 2020 to March 2021.

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Of the 103 participants, 30 were pregnant and 16 were breastfeeding. The samples became a medium of 21 days (interquartile range [IQR], 17-27 days) after the second dose in non-pregnant women, 21 days (IQR, 14-36 days) in pregnant women, and 26 days (IQR, 19-31 days) in breastfeeding women. Nine pregnant women gave birth and offered their umbilical cord blood during the trial.

Of all study participants, 56 (54%) had received the Pfizer BioNTech vaccine and the rest had received the Moderna vaccine. Five pregnant participants (17%) received their first dose in the first trimester, 15 (50%) in the second and 10 (33%) in the last trimester.

The authors reported a humoral and cellular immune response against the wild-type SARS-CoV-2 strain and the alpha and beta variants.

The results found that two doses of the vaccines produced similar levels of antibody function and T-cell responses in all participants after their second vaccination dose, and all participants developed cross-reactive immune responses against the alpha and beta variants. In addition, the researchers found that mothers transfer antibodies to the umbilical cord blood and breast milk of infants.

“Our data show that the mRNA vaccines are highly immunogenic in pregnant and breastfeeding women, and that vaccinated women can transmit antibodies to their infants through cord blood and breastfeeding,” Barouch told Healio. “These results, along with other data in the field, support the use of COVID-19 vaccines in pregnant and breastfeeding women.”

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