COVID-19 mRNA Vaccine in Pregnancy and Newborn Passive Immunization: a Case Report

Kassis, Nadine El; Abdallah, Wael; Chakra, Rim Abou; Arab, Wissam; Sassine, Serge; Atallah, David

doi:10.2144/fsoa-2021-0043

Cited by 3 publications

(2 citation statements)

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“… 27 Several case reports and series to date have assessed maternal antibody response to different COVID-19 vaccines at various gestations and dynamics of placental antibody transfer after vaccination. 10 , 15 , 16 , 17 , 28 , 29 Beharier et al 14 reported efficient placental antibody transfer, with transfer ratios generally higher than 1 when the first dose of a vaccine was administered more than 14 days before delivery in a cohort of 86 pregnant persons in Israel who were vaccinated with BNT162b2 . Nir et al 23 reported a correlation between maternal serum and cord blood antibody concentrations in a study that compared 64 women who were vaccinated with the BNT162b2 vaccine with 11 parturient women who had COVID-19 during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, IgG subclass, variation in maternal antibody levels at conception; maternal comorbidities, such as HIV infection; and placental dysfunction that may be present in cases of severe fetal growth restriction or maternal preeclampsia have been described as playing a role in transfer efficiency . Several case reports and series to date have assessed maternal antibody response to different COVID-19 vaccines at various gestations and dynamics of placental antibody transfer after vaccination . Beharier et al reported efficient placental antibody transfer, with transfer ratios generally higher than 1 when the first dose of a vaccine was administered more than 14 days before delivery in a cohort of 86 pregnant persons in Israel who were vaccinated with BNT162b2 .…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Maternal and Neonatal Antibody Levels After COVID-19 Vaccination vs SARS-CoV-2 Infection

et al. 2022

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ImportancePregnant persons are at an increased risk of severe COVID-19 from SARS-CoV-2 infection, and COVID-19 vaccination is currently recommended during pregnancy.ObjectiveTo ascertain the association of vaccine type, time from vaccination, gestational age at delivery, and pregnancy complications with placental transfer of antibodies to SARS-CoV-2.Design, Setting, and ParticipantsThis cohort study was conducted in Pennsylvania Hospital in Philadelphia, Pennsylvania, and included births at the study site between August 9, 2020, and April 25, 2021. Maternal and cord blood serum samples were available for antibody level measurements for maternal-neonatal dyads.ExposuresSARS-CoV-2 infection vs COVID-19 vaccination.Main Outcomes and MeasuresIgG antibodies to the receptor-binding domain of the SARS-CoV-2 spike protein were measured by quantitative enzyme-linked immunosorbent assay. Antibody concentrations and transplacental transfer ratios were measured after SARS-CoV-2 infection or receipt of COVID-19 vaccines.ResultsA total of 585 maternal-newborn dyads (median [IQR] maternal age, 31 [26-35] years; median [IQR] gestational age, 39 [38-40] weeks) with maternal IgG antibodies to SARS-CoV-2 detected at the time of delivery were included. IgG was detected in cord blood from 557 of 585 newborns (95.2%). Among 169 vaccinated persons without SARS-CoV-2 infection, the interval from first dose of vaccine to delivery ranged from 12 to 122 days. The geometric mean IgG level among 169 vaccine recipients was significantly higher than that measured in 408 persons after infection (33.88 [95% CI, 27.64-41.53] arbitrary U/mL vs 2.80 [95% CI, 2.50-3.13] arbitrary U/mL). Geometric mean IgG levels were higher after vaccination with the mRNA-1273 (Moderna) vaccine compared with the BNT162b2 (Pfizer/BioNTech) vaccine (53.74 [95% CI, 40.49-71.33] arbitrary U/mL vs 25.45 [95% CI, 19.17-33.79] arbitrary U/mL; P &lt; .001). Placental transfer ratios were lower after vaccination compared with after infection (0.80 [95% CI, 0.68-0.93] vs 1.06 [95% CI, 0.98-1.14]; P &lt; .001) but were similar between the mRNA vaccines (mRNA-1273: 0.70 [95% CI, 0.55-0.90]; BNT162b2: 0.85 [95% CI, 0.69-1.06]; P = .25). Time from infection or vaccination to delivery was associated with transfer ratio in models that included gestational age at delivery and maternal hypertensive disorders, diabetes, and obesity. Placental antibody transfer was detectable as early as 26 weeks’ gestation. Transfer ratio that was higher than 1.0 was present for 48 of 51 (94.1%) births at 36 weeks’ gestation or later by 8 weeks after vaccination.Conclusions and RelevanceThis study found that maternal and cord blood IgG antibody levels were higher after COVID-19 vaccination compared with after SARS-CoV-2 infection, with slightly lower placental transfer ratios after vaccination than after infection. The findings suggest that time from infection or vaccination to delivery was the most important factor in transfer efficiency.

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