BNT162b2 COVID-19 mRNA vaccine elicits a rapid and synchronized antibody response in blood and milk of breastfeeding women

Mr, Friedman; Kigel, Aya; Bahar, Yeal; Yogev, Yariv; Dror, Yael; Lubetzky, Ronit; Many, Ariel; Wine, Yariv

doi:10.1101/2021.03.06.21252603

Cited by 32 publications

(36 citation statements)

References 18 publications

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“…Other groups have also found SARS-CoV-2 spike and RBD-specific IgG [11][12][13][14] in human milk after vaccination in addition to IgA. Here, we showed that SARS-CoV-2 spike and RBD-specific IgG are found at significantly higher levels in T4 compared to T1.…”

Section: Discussionsupporting

confidence: 58%

“…This is similar to the kinetics found in Baird et al and Friedman et al, and could either be a function of time after the initial antigenic stimulation of dose one, or an immunological need for dose two. 11,12 As the humoral immunological response in lactating individuals has been recently shown 18 to be more dependent on the booster dose of vaccination compared to non-lactating individuals, the latter is highly probable. Thus, whether significant amounts of antigen-specific antibodies can be elicited after administering one-dose regime vaccines, requires confirmation.…”

Section: Discussionmentioning

confidence: 99%

“…9 However, such measures may disrupt mother-child bonding and may result in premature cessation of breastfeeding. 10 There is emerging evidence that SARS-CoV-2 specific antibodies are detectable in human milk post vaccination; [11][12][13][14] however, the amount of immunoglobulin G (IgG) and immunoglobulin A (IgA) have not been clearly quantified. It is also unknown whether vaccine components such as mRNA are transferred in human milk; preliminary studies purportedly detect no vaccine mRNA in human milk.…”

Section: Introductionmentioning

confidence: 99%

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BNT162b2 vaccination induces SARS-CoV-2 specific antibody secretion into human milk with minimal transfer of vaccine mRNA

Low

et al. 2021

Preprint

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Importance: To examine the impact of SARS-CoV-2 vaccination of lactating mothers on human milk Objective: (1) To quantify SARS-CoV-2-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) in human milk of lactating mothers who received the BNT162b2 vaccine, with reference to a cohort convalescent from antenatal COVID-19, and healthy lactating mothers. (2) To detect and quantify vaccine mRNA in human milk after BNT162b2 vaccination. Design: Gestational Immunity For Transfer 2 (GIFT-2) is a prospective cohort study of lactating mothers who were due to receive two doses of BNT162b2 vaccine, recruited between 5th February 2021 and 9th February 2021. Setting: Lactating healthcare workers living in Singapore Participants: Convenience sample of ten lactating healthcare workers. Human milk samples were collected at four time points: pre-vaccination, 1 to 3 days after dose one, 7 to 10 days after dose one, and 3 to 7 days after dose two of the BNT162b2 vaccine. Exposure: Two doses of the BNT162b2 vaccine 21 days apart. Main Outcome and Measure: (i) SARS-CoV-2-specific IgA and IgG in human milk of lactating mothers who received BNT162b2 vaccine, (ii) Detection and quantification of vaccine mRNA in human milk after BNT162b2 vaccination. Results: Ten lactating healthcare workers aged 32.5 years (range 29 to 42) were recruited, with 40 human milk samples collected and analysed. SARS-CoV-2-specific IgA was predominant in human milk of lactating mothers who received BNT162b2 vaccine. The sharpest rise in antibody production was 3 to 7 days after dose two of the BNT162b2 vaccine, with medians of 1110 picomolar of anti-SARS-CoV-2 spike and 374 picomolar of anti-Receptor Binding Domain IgA. Vaccine mRNA was detected only on rare occasions, at a maximum concentration of 2 ng/mL. Infants had no reported adverse events, up to 28 days after ingestion of post-vaccination human milk. Conclusions and Relevance: In this cohort of ten lactating mothers following BNT162b2 vaccination, nine (90%) produced SARS-CoV-2 IgA, and ten (100%) produced IgG in human milk with minimal amounts of vaccine mRNA. Lactating individuals should continue breastfeeding in an uninterrupted manner after receiving mRNA vaccination for SARS-CoV-2.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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BNT162b2 vaccination induces SARS-CoV-2 specific antibody secretion into human milk with minimal transfer of vaccine mRNA

Low

et al. 2021

Preprint

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“…Recent studies have shown that milk produced by infected mothers is a source of anti-SARS-CoV-2 antibodies 6 , and two reports have demonstrated the existence of anti-SARS-CoV-2 antibodies in women vaccinated with Moderna® and Pfizer-BioNTech® mRNA vaccines 7,8 . If this exerts a protective effect for breastfed infants remains to be established.…”

Section: Introductionmentioning

confidence: 99%

Quantification of specific antibodies against SARS-CoV-2 in breast milk of lactating women vaccinated with an mRNA vaccine

Esteve-Palau

González-Cuevas

Guerrero

et al. 2021

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INTRODUCTION The recent approval of vaccines against COVID–19 has generated great concern among breastfeeding women, since these patients were excluded from vaccination clinical trials. The present study aimed to analyze the levels of specific SARS–CoV–2 antibodies in breast milk of mRNA–vaccinated women across time and their correlation with serum antibody levels. METHODS Prospective study including lactating women aged over 18 who were vaccinated against SARS–CoV–2 with the Pfizer–BioNTech® COVID–19 vaccine (BNT162b2). Paired serum and breast milk samples were simultaneously taken from each participant at three timepoints after receiving the vaccine: 2 weeks after 1st dose, 2 weeks after 2nd dose and 4 weeks after 2nd dose (Timepoints 1, 2 and 3, respectively). Levels of IgG antibodies against the spike protein (S1 subunit) were determined for each sample (Architect, Abbott®). RESULTS We collected and analyzed 52 serum and 52 milk samples from the first 18 study participants. Median (interquartile range) IgG(S1) levels for serum – milk pairs at each timepoint were 410 (208-606) – 1.7 (0-2.9) AU/ml at Timepoint 1, 11505 (8933 – 21184) – 52.2 (34.1–113) at Timepoint 2 and 8311 (5578–17419) – 41.7 (24.8–75.3) at Timepoint 3. Pearson′s correlation coefficient between breast milk and serum IgG(S1) levels was 0.71. No major adverse reactions were observed in mothers or infants. CONCLUSIONS Breast milk from women vaccinated with mRNA–based Pfizer–BioNTech® vaccine contains specific anti–SARS–CoV–2 IgG(S1) antibodies, with levels increasing considerably after second dose. IgG(S1) levels in breast milk are positively correlated with corresponding serum levels.

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“…In addition, COVID-19 appears to be less prevalent and, generally, less severe in infants (8,9), and there is evidence that breastmilk from mothers with a history of COVID-19 infection contains speci c IgA with an activity against SARS-CoV-2 (9-13). Furthermore, prospective cohort studies have found that anti-SARS-CoV-2 IgA and IgG generated by anti-COVID-19 mRNAbased vaccines administered to lactating and pregnant mothers are transferred to their babies via breastmilk (14,15) and umbilical cord blood (16, 17), while COVID-19 mRNA does not (18,19). Moreover, evidence suggests that vaccine-induced immune responses are even greater than natural infection-induced immunity (17), due to an IgG-dominant response (20).…”

Section: Introductionmentioning

confidence: 99%

Breastfeeding Media Coverage and Beliefs During the COVID-19 Pandemic in Mexico: Implications for Breastfeeding Equity.

Vilar‐Compte

Gaitán-Rossi

Rhodes

et al. 2021

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Background: Breastfeeding offers short- and long- term health benefits to mothers and children and constitutes a priority for public health. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are presumably contained in breastmilk of mothers with history of COVID-19 infection or vaccination. Direct breastfeeding is the preferred infant feeding option during the pandemic, but conflicting practices have been adopted, which could widen existing disparities in breastfeeding. This study aims to describe how was information about breastfeeding communicated in Mexican media during the pandemic and assess Mexican adults’ beliefs regarding breastfeeding among mothers infected with COVID-19.Methods: A retrospective content analysis of media coverage on breastfeeding in Mexico between March 1 and September 24, 2020, excluding advertisements, was done. For the content analysis, both a sentiment analysis and an analysis based on strengths, weaknesses, opportunities and threats for breastfeeding promotion were performed. Also, we incorporated a descriptive analysis from the July 2020 wave of the ENCOVID-19 survey, which included questions on beliefs about breastfeeding. This information was stratified by gender, age, and socioeconomic status.Results: 1014 publications on breastfeeding were identified in internet, newspapers, TV, and magazines. Most information was published during World Breastfeeding Week, celebrated in August. Based on the sentiment analysis, 57.2% of all information was classified as positive, and based on the SWOT analysis, most information was classified either as strengths or opportunities for breastfeeding promotion. However, the ENCOVID-19 data showed that 67.3% of people living in households with children under 3 years of age believe that mothers with COVID-19 should not breastfeed, and 19.8% stated that they simply didn’t know. These beliefs showed differences both by gender and by socioeconomic status.Conclusions: While the Mexican government endorsed the recommendations on breastfeeding during the COVID-19 pandemic, communication of those messages was sporadic, inconstant and unequal across types of media. Moreover, there were also negative messages for breastfeeding circulating on the media. There continues to be a widespread notion that mothers with COVID-19 should not breastfeed and, due to differences on beliefs by socioeconomic status, health inequities could be exacerbated.

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BNT162b2 COVID-19 mRNA vaccine elicits a rapid and synchronized antibody response in blood and milk of breastfeeding women

Cited by 32 publications

References 18 publications

BNT162b2 vaccination induces SARS-CoV-2 specific antibody secretion into human milk with minimal transfer of vaccine mRNA

BNT162b2 vaccination induces SARS-CoV-2 specific antibody secretion into human milk with minimal transfer of vaccine mRNA

Quantification of specific antibodies against SARS-CoV-2 in breast milk of lactating women vaccinated with an mRNA vaccine

Breastfeeding Media Coverage and Beliefs During the COVID-19 Pandemic in Mexico: Implications for Breastfeeding Equity.

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