دورية أكاديمية
Reduced maternal immunity and vertical transfer of immunity against SARS-CoV-2 variants of concern with COVID-19 exposure or initial vaccination in pregnancy.
العنوان: | Reduced maternal immunity and vertical transfer of immunity against SARS-CoV-2 variants of concern with COVID-19 exposure or initial vaccination in pregnancy. |
---|---|
المؤلفون: | Boelig RC; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.; Department of Pharmacology, Physiology, and Cancer Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States., Chaudhury S; Center for Enabling Capabilities, Walter Reed Army Institute of Research, Silver Spring, MD, United States., Gromowski GD; Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States., Mayer S; Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States., King J; Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States., Aghai ZH; Division of Neonatology, Department of Pediatrics, Nemours, Philadelphia, PA, United States., Bergmann-Leitner E; Immunology Core, Biologics Research & Development, Walter Reed Army Institute of Research, Silver Spring, MD, United States. |
المصدر: | Frontiers in immunology [Front Immunol] 2023 Sep 11; Vol. 14, pp. 1216410. Date of Electronic Publication: 2023 Sep 11 (Print Publication: 2023). |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
اللغة: | English |
بيانات الدورية: | Publisher: Frontiers Research Foundation] Country of Publication: Switzerland NLM ID: 101560960 Publication Model: eCollection Cited Medium: Internet ISSN: 1664-3224 (Electronic) Linking ISSN: 16643224 NLM ISO Abbreviation: Front Immunol Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: [Lausanne : Frontiers Research Foundation] |
مواضيع طبية MeSH: | COVID-19*/prevention & control , Pregnancy Complications, Infectious*/prevention & control, Infant, Newborn ; Pregnancy ; Infant ; Humans ; Female ; SARS-CoV-2 ; COVID-19 Vaccines ; Retrospective Studies ; Vaccination ; Mothers |
مستخلص: | Introduction: As the SARS-CoV-2 pandemic continues to evolve, we face new variants of concern with a concurrent decline in vaccine booster uptake. We aimed to evaluate the difference in immunity gained from the original SARS-CoV-2 mRNA vaccine series in pregnancy versus SARS-CoV-2 exposure during pregnancy against recent variants of concern. Study Design: This is a retrospective analysis of previously collected samples from 192 patients who delivered between February 2021 and August 2021. Participants were categorized as 1) COVID vaccine: mRNA vaccine in pregnancy, 2) COVID-exposed, and 3) controls. The primary outcome was neutralizing capacity against wild-type, Delta, and Omicron-B1 between cohorts. Secondary outcomes include a comparison of cord-blood ID50 as well as the efficiency of vertical transfer, measured by cord-blood:maternal blood ID50 for each variant. Results: Pregnant women with COVID-19 vaccination had a greater spike in IgG titers compared to both those with COVID-19 disease exposure and controls. Both COVID exposure and vaccination resulted in immunity against Delta, but only COVID vaccination resulted in significantly greater Omicron ID-50 versus controls. The neutralizing capacity of serum from newborns was lower than that of their mothers, with COVID-vaccination demonstrating higher cord-blood ID50 vs wildtype and Delta variants compared to control or COVID-exposed, but neither COVID-exposure nor vaccination demonstrated significantly higher Omicron ID50 in cord-blood compared to controls. There was a 0.20 (0.07-0.33, p=0.004) and 0.12 (0.0-0.24, p=0.05) increase in cord-blood:maternal blood ID50 with COVID vaccination compared to COVID-19 exposure for wild-type and Delta respectively. In pair-wise comparison, vertical transfer of neutralization capacity (cord-blood:maternal blood ID50) was greatest for wild-type and progressively reduced for Delta and Omicron ID50. Conclusion: Pregnant patients with either an initial mRNA vaccination series or COVID-exposure demonstrated reduced immunity against newer variants compared to wild-type as has been reported for non-pregnant individuals; however, the COVID-vaccination series afforded greater cross-variant immunity to pregnant women, specifically against Omicron, than COVID-disease. Vertical transfer of immunity is greater in those with COVID vaccination vs COVID disease exposure but is reduced with progressive variants. Our results reinforce the importance of bivalent booster vaccination in pregnancy for both maternal and infant protection and also provide a rationale for receiving updated vaccines as they become available. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Boelig, Chaudhury, Gromowski, Mayer, King, Aghai and Bergmann-Leitner.) |
References: | MMWR Morb Mortal Wkly Rep. 2020 Nov 06;69(44):1641-1647. (PMID: 33151921) Proc Natl Acad Sci U S A. 2021 Sep 21;118(38):. (PMID: 34470866) Am J Obstet Gynecol. 2023 Jan;228(1):68.e1-68.e12. (PMID: 35868417) Am J Obstet Gynecol. 2021 Sep;225(3):303.e1-303.e17. (PMID: 33775692) JAMA. 2021 Jun 15;325(23):2370-2380. (PMID: 33983379) MMWR Morb Mortal Wkly Rep. 2021 Nov 26;70(47):1646-1648. (PMID: 34818319) Lancet. 2023 Feb 11;401(10375):447-457. (PMID: 36669520) MMWR Morb Mortal Wkly Rep. 2020 Nov 06;69(44):1635-1640. (PMID: 33151917) Ultrasound Obstet Gynecol. 2021 Feb;57(2):232-241. (PMID: 32926494) Int J Mol Med. 2005 Sep;16(3):401-7. (PMID: 16077946) Am J Obstet Gynecol. 2022 Oct;227(4):652-656. (PMID: 35640704) Front Immunol. 2020 Sep 11;11:1920. (PMID: 33013843) JAMA Netw Open. 2022 Sep 1;5(9):e2233273. (PMID: 36156146) AJOG Glob Rep. 2022 Feb;2(1):100046. (PMID: 34961853) JAMA Pediatr. 2021 Aug 1;175(8):817-826. (PMID: 33885740) N Engl J Med. 2022 Jul 14;387(2):109-119. (PMID: 35731908) |
معلومات مُعتمدة: | R21 HD107761 United States HD NICHD NIH HHS |
فهرسة مساهمة: | Keywords: COVID vaccine; COVID-19; SARS-CoV-2, pregnancy; maternal immunity; neonatal immunity; variants of concern |
المشرفين على المادة: | 0 (COVID-19 Vaccines) |
SCR Organism: | SARS-CoV-2 variants |
تواريخ الأحداث: | Date Created: 20230927 Date Completed: 20230928 Latest Revision: 20230929 |
رمز التحديث: | 20231215 |
مُعرف محوري في PubMed: | PMC10518391 |
DOI: | 10.3389/fimmu.2023.1216410 |
PMID: | 37753075 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1664-3224 |
---|---|
DOI: | 10.3389/fimmu.2023.1216410 |