Infectious Disease

Timing, type of COVID-19 vaccine impacts maternal, neonatal immunity

Source/Disclosures

Disclosures:
Atyeo reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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The type of COVID-19 vaccine and the timing of its administration can affect the immune response of pregnant women and their children, data in Nature Communications showed.

“Several studies of pregnant people receiving COVID-19 mRNA vaccines primarily in the third trimester have also demonstrated the presence of anti-SARS-CoV-2-specific antibodies capable of neutralization and immune effector functions in umbilical cord blood at delivery, and recent data from the CDC demonstrate that maternal mRNA vaccination is 61% effective in preventing newborn hospitalization from COVID-19 in the first 6 months of life,” Caroline G. Atyeo, BS, a PhD candidate at Harvard University, and colleagues wrote.

New data show that the timing of COVID-19 vaccination and the vaccine used affect the immune response in pregnant women and their children. Source: Adobe Stock

“Little is known, however, regarding how trimester-specific pregnancy immunity and different COVID-19 vaccine platforms may interact to impact maternal and neonatal protection from COVID-19,” they added.

Atyeo and colleagues evaluated the vaccine-induced immune response in 158 women who received either one dose of the Johnson & Johnson vaccine (n = 28), two doses of the Moderna vaccine (n = 61) or two doses of the Pfizer-BioNTech vaccine (n=69) during pregnancy. They examined the levels of antibodies and Fc receptor binding in the maternal serum and in the umbilical cord blood.

Results showed that the mRNA COVID-19 vaccines elicited significantly higher antibody titers and more Fc-receptor binding in women compared with the Johnson & Johnson vaccine. Specifically, the Moderna vaccine had the highest titers and functions against variants of concern compared with the Pfizer-BioNTech and the Johnson & Johnson vaccines.

According to the researchers, vaccination during the first and third trimesters increased Fc receptor binding and functional antibodies compared with vaccination during the second trimester, although the difference was not significant.

Further, recipients of the mRNA vaccines had significantly higher spike-specific antibody titers and Fc-receptor binding in their umbilical cord blood compared with Johnson & Johnson recipients, as well as higher functional antibody responses.

Of note, the antibody-dependent cellular phagocytosis (ADCP) and antibody-dependent complement deposition (ADCD) responses were significantly higher in the cord blood of women who received the Moderna vaccine vs. the Johnson & Johnson and Pfizer-BioNTech vaccines, although these responses were similar in the maternal sera between vaccines. This suggests that there was a “preferential transfer” of ADCP and ADCD antibodies in women who received the Moderna vaccine, the researchers wrote.

“Our study contributes to understanding how the maternal-neonatal dyad responds to vaccination against a de novo antigen with novel mRNA and [adenovirus vector] vaccines, which were not specifically designed to optimize maternal or neonatal protection, as pregnant individuals were excluded from initial vaccine clinical trials,” Atyeo and colleagues wrote. “… Recruitment and inclusion of pregnant individuals in vaccine studies will remain critical to constructing evidence-based vaccine strategies that maximize the benefit to both mother and newborn.”

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