Enhanced D614G and Omicron Variants Antibody Persistence in Infants at 2 Months of Age Following Maternal mRNA Booster Vaccination During Pregnancy or Postpartum-Reference-Cited by-同舟云学术

Enhanced D614G and Omicron Variants Antibody Persistence in Infants at 2 Months of Age Following Maternal mRNA Booster Vaccination During Pregnancy or Postpartum

Published:2024-08-13 Issue: Volume: Page:
ISSN:0891-3668
Container-title:Pediatric Infectious Disease Journal
language:en
Short-container-title:

Author:

Munoz Flor M.¹^ORCID,Beigi Richard²^ORCID,Posavad Christine M.³^ORCID,Kelly Clifton⁴^ORCID,Badell Martina L.⁵^ORCID,Bunge Katherine²^ORCID,Mulligan Mark J.⁶^ORCID,Parameswaran Lalitha⁶^ORCID,Richardson Barbra A.⁷^ORCID,Olsen-Chen Courtney⁸^ORCID,Novak Richard M.⁹^ORCID,Brady Rebecca C.¹⁰^ORCID,DeFranco Emily¹⁰^ORCID,Gerber Jeffrey S.¹¹^ORCID,Shriver Mallory¹²^ORCID,Suthar Mehul S.¹³^ORCID,Coler Rhea¹⁴^ORCID,Berube BryanJ.¹⁴^ORCID,Kim So Hee⁴^ORCID,Piper Jeanna M.¹⁵^ORCID,Miedema Joy¹⁶^ORCID,Pasetti Marcela¹²^ORCID,Neuzil Kathleen M.¹²^ORCID,Cardemil Cristina V.¹⁵^ORCID,

Affiliation:

1. From the Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX

2. Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women’s Hospital, Pittsburgh, PA

3. Vaccine and Infectious Disease Division, Department of Laboratory Medicine and Pathology and

4. Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA

5. Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Emory University Hospital Midtown Perinatal Center, Atlanta, GA

6. Department of Medicine, NYU Langone Vaccine Center and Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY

7. Vaccine and Infectious Disease and Public Health Sciences Divisions, Departments of Biostatistics and Global Health, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA

8. Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY

9. Division of Infectious Diseases, University of Illinois, Chicago, IL

10. Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH

11. Division of Infectious Diseases, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA

12. Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD

13. Department of Pediatrics, Department of Microbiology and Immunology, Emory Vaccine Center, Yerkes National Primate Research Center, Emory School of Medicine, Emory University, Atlanta, GA

14. Seattle Children’s Research Institute, Center for Global Infectious Disease Research, Seattle, WA

15. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD

16. FHI 360, Durham, NC; and

Abstract

Background: Following maternal COVID-19 vaccination, the persistence of antibodies in sera and breast milk for mothers and infants is not well characterized. We sought to describe the persistence of antibodies through 2 months after delivery in maternal and infant serum and breast milk following maternal COVID-19 mRNA vaccination and to examine differences by receipt of booster dose during pregnancy or postpartum. Methods: This is a prospective cohort study with enrollment from July 2021 to January 2022 at 9 US academic sites. Pregnant or postpartum participants and their infants were enrolled after COVID-19 mRNA monovalent vaccination during pregnancy (primary 2-dose series) with booster (third dose) vaccination during pregnancy or within 2 months post-partum. SARS-CoV-2–binding and functional antibody responses at delivery and 2 months after delivery in mothers and infants were measured by spike and receptor-binding domain immunoglobulin (Ig) G, pseudovirus and live neutralizing antibody (nAb) titers to ancestral and Omicron BA.1 and BA.5 strains. Breast milk spike and receptor-binding domain IgG and IgA titers were also measured. Results: A total of 237 maternal/infant dyads were included (110 primary series during pregnancy, 99 pregnancy booster and 28 postpartum booster). A pregnancy booster resulted in 2.2-4.7-fold higher IgG and nAb at delivery and 2 months for both mothers and infants compared to the primary series alone (P < 0.001 for all comparisons). While infant IgG and nAb titers decreased by 2 months of age, the proportion of infants with detectable nAb at 2 months was greater in infants of mothers boosted during pregnancy compared with primary series for all variants (D614G: 99% vs. 56%; BA.1: 56% vs. 4% and BA.5: 57% vs. 9%; P < 0.001 for all comparisons). Breast milk spike IgA and IgG were present in 64%-100% and 100% of participants, respectively, and those boosted during pregnancy or postpartum had 3.1-4.6-fold higher levels of breast milk antibodies at 2 months compared to primary series during pregnancy (P < 0.001). Conclusions: mRNA COVID-19 monovalent booster vaccination during pregnancy results in significantly higher maternal and infant serum–binding IgG and nAb titers compared to a primary 2-dose series, including against Omicron variants, through 2 months of age. Breast milk antibodies following maternal vaccination during pregnancy or postpartum may provide additional protection during early infancy.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference30 articles.

1. COVID-19-associated hospitalizations among U.S. infants aged <6 months – COVID-NET, 13 States, June 2021-August 2022.;Hamid;MMWR Morb Mortal Wkly Rep,2022

2. COVID-19 Vaccine: Interim COVID-19 immunization schedule for persons 6 months of age and older.,2023

3. Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy.;Dagan;Nat Med,2021

4. Estimation of COVID-19 mRNA vaccine effectiveness against medically attended COVID-19 in pregnancy during periods of delta and omicron variant predominance in the United States.;Schrag;JAMA Netw Open,2022

5. Vaccination against SARS-CoV-2 in pregnancy during the Omicron wave: the prospective cohort study of the Italian obstetric surveillance system.;Corsi Decenti;Clin Microbiol Infect,2023