The Benefits of Vaccination against SARS-CoV-2 during Pregnancy in Favor of the Mother/Newborn Dyad

Popescu, Daniela-Eugenia; Cîtu, Cosmin; Jura, Ana Maria Cristina; Lungu, Nicoleta; Navolan, Dan; Craina, Marius; Semenescu, Alin; Gorun, Florin; Jura, Mihai-Andrei; Belengeanu, Valerica; Boia, Marioara

doi:10.3390/vaccines10060848

Cited by 16 publications

(18 citation statements)

References 24 publications

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“…They concluded that “receiving both vaccine doses before delivery and longer latency from vaccination to delivery was associated with a higher IgG concentration in infants and stronger immunity” [ 52 ]. This result was also confirmed in other studies [ 86 , 87 ]. Prabhu et al studied 122 pregnant women, of whom 55 and 67 had received their first and second mRNA vaccine doses, respectively, before delivery.…”

Section: Covid-19 Vaccination and Transplacental Transfer Of Antibodiessupporting

confidence: 92%

Immunisation against COVID-19 in Pregnancy and of Women Planning Pregnancy

Konje

Beloushi

Ahmed

2023

Viruses

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Following reports of the first human SARS-CoV2 infection in December 2019 from Wuhan Province, China, there was such rapid spread that by March 2021, the World Health Organization (WHO) had declared a pandemic. Over 6.5 million people have died from this infection worldwide, although this is most likely an underestimate. Until vaccines became available, mortality and severe morbidity were costly in terms of life lost as well as the cost of supporting the severely and acutely ill. Vaccination changed the landscape, and following worldwide adoption, life has gradually been returning to normal. The speed of production of the vaccines was unprecedented and undoubtedly ushered in a new era in the science of fighting infections. The developed vaccines were on the already known platforms for vaccine delivery: inactivated virus, virus vector, virus-like particles (VLP) subunit, DNA and mRNA. The mRNA platform was used for the first time to deliver vaccines to humans. An understanding of these platforms and the pros and cons of each are important for clinicians who are often challenged by the recipients on the advantages and risks of these vaccines. These vaccines have so far and reassuringly been shown to be safe in reproduction (with no effect on gametes) and pregnancy (not associated with congenital malformations). However, safety remains paramount and continuing vigilance is critical, especially against rare fatal complications such as vaccine-induced thrombocytopenia and myocarditis. Finally, the waning immunity months after vaccination means repeated immunisation is likely to be ongoing, but just how often and how many such revaccinations should be recommended remains uncertain. Research into other vaccines and alternate delivery methods should continue as this infection is likely to be around for a long time.

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Section: Covid-19 Vaccination and Transplacental Transfer Of Antibodiessupporting

confidence: 92%

Immunisation against COVID-19 in Pregnancy and of Women Planning Pregnancy

Konje

Beloushi

Ahmed

2023

Viruses

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“…Publications concerning the placental transfer of vaccine-induced antibodies are very limited, and all are studies on mRNA vaccine on singleton pregnancies [ 7 , 10 , 12 , 13 ]. To the best of our knowledge, this is the first report concerning the placental transfer of passive immunization of COVID-19 from the mother to the twin fetuses.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, data on the interval of schedules to maximize the passive immunity in newborns and type of vaccines are currently very limited. Only a few studies have been published, including BNT-162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines [ 12 , 13 , 16 ] and a case report of inactivated virus antigen (CoronaVac ® ) [ 17 ]. The antibody levels were much higher in mothers who had received two doses of an mRNA vaccine than those who received only one dose [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Placental transfer antibody seems to be safe for fetuses and is expected to have a protective effect on newborns [ 9 ], though the effectiveness of such protection has not been thoroughly evaluated. To date, a very limited number of studies on COVID-19 vaccination with placental transfer have been published, and most are mRNA vaccines [ 10 , 11 , 12 , 13 ]. In low- and middle-income countries facing a vaccine shortage, especially of mRNA vaccines, and with emerging variants, the heterologous COVID-19 vaccine regimen has the potential to accelerate vaccine rollout.…”

Section: Introductionmentioning

confidence: 99%

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Placental Transfer Immunity to the Newborns in a Twin Pregnant Women Vaccinated with Heterologous CoronaVac-ChAdOx1

et al. 2023

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Pregnant women who receive the COVID-19 vaccine develop anti-SARS-CoV-2 antibodies, which can be transferred to the fetus. However, the effectiveness of placental transfer has not been evaluated in twin pregnancy, especially in cases vaccinated with heterologous CoronaVac (Sinovac)—ChAdOx1 (Oxford-AstraZeneca) regimen, which was commonly used in many countries. Case: A 34-year-old Thai woman with a twin pregnancy attended our antenatal care clinic at 21 + 2 weeks of gestation and requested COVID-19 vaccination. Her medical history and physical examination were unremarkable. She had not received COVID-19 vaccination before. Ultrasound screening for fetal anomaly revealed a dichorion diamnion twin pregnancy. Both twins showed no structural anomaly. She received the CoronaVac vaccine at 21 + 2 weeks of gestation without serious side effects and the ChAdOx1 vaccine at 24 + 2 weeks of gestation. Cesarean delivery was performed at 36 + 5 weeks of gestation, giving birth to the two healthy babies. The levels of anti-spike protein IgG levels (BAU/mL) in maternal blood just before delivery and umbilical cord blood of the two newborns were 313.349, 678.219, and 874.853, respectively. The levels of % inhibition (wild-type and delta) in the two newborns were also higher than those in the mother. In conclusion, heterologous CoronaVac-ChAdOx1-S vaccination in a twin pregnancy could effectively provide protective immunity to both twin newborns. The antibody levels in both were approximately two times higher than those in the mothers. This case report may serve as a reference in counseling couples with a twin pregnancy, while the studies on placental transfer of vaccine-derived antibodies in twin pregnancy are currently not available, especially in countries experiencing a vaccine shortage or unavailability of mRNA vaccines.

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“…Among the limited literature, three studies reported that anti-SARS-CoV-2 antibodies were not detected in infant sera of mothers vaccinated while lactating (sample sizes = 8, 5, and 21) (31, 34, 35), and one study reported that anti-SARS-CoV-2 IgG was detected in the sera of 23% (3 of 13) of breastfed infants of mothers vaccinated after delivery (36). In contrast, it is clear that transplacental transmission after maternal vaccination or infection results in detectable levels of anti-SARS-CoV-2 antibodies in infant sera (34,(37)(38)(39)(40). It is important to keep in mind that COVID-19 could manifest as an asymptomatic infection, both among infants and among lactating women.…”

Section: Discussionmentioning

confidence: 99%

Durable antibody and effector memory T cell responses in breastmilk from women with SARS-CoV-2

Narayanaswamy

Pentecost²,

Telfer³

et al. 2022

Front. Immunol.

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BackgroundGiven that only 25% of pregnant women elect to receive a COVID-19 vaccine, maternal SARS-CoV-2 infection remains an important route of conferring protective passive immunity to breastfed infants of mothers who are not vaccinated.MethodsWe enrolled 30 lactating participants between December 2020 and March 2021 who had a positive PCR-test and their first COVID-19 symptoms within the previous 21 days. Participants were asked to provide serial bilateral milk samples at 12 timepoints (~ every 3 days) over a period of 35 days. A second set of samples was collected at least four months after the beginning of the first set. Participants also were asked to provide their dried blood spots and infant stool samples. All samples were tested for receptor-binding domain (RBD)-specific immunoglobulin (Ig)A, IgG, and IgM. Milk samples were assessed for neutralizing ability against the spike protein and four SARS-CoV-2 variants: D614G, Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P.1). Permeability of the breast epithelium was assessed by measuring the sodium to potassium ions (Na:K) in milk. Using flow cytometry, memory CD4 and CD8 T cells (CD45RO+ and CCR7+/-) and mucosal-homing CD4 and CD8 T cells (CD103+) were determined in cells from milk expressed at 35 days and at least 4 months after their first milk donation.ResultsMilk antibodies from SARS-CoV-2 positive participants neutralized the spike complex. Milk from 73, 90, and 53% of participants had binding reactivities to RBD-specific IgA, IgG, and IgM, respectively. In contrast to blood spots, which showed increased levels of IgG, but not IgA or IgM, the COVID-19 response in milk was associated with a robust IgA response. Twenty-seven percent of participants had increased breast-epithelium permeability, as indicated by Na:K ≥ 0.6. The percentage of CD45RO+CCR7- effector-memory T cells in the day ≥120 milk samples was significantly higher than day 35 samples (P< 0.05).ConclusionsAntibodies in milk from participants with recent SARS-CoV-2 infection and those who recovered can neutralize the spike complex. For the first time we show that breastmilk T cells are enriched for mucosal memory T cells, further emphasizing the passive protection against SARS-CoV-2 conferred to infants via breastmilk.

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The Benefits of Vaccination against SARS-CoV-2 during Pregnancy in Favor of the Mother/Newborn Dyad

Cited by 16 publications

References 24 publications

Immunisation against COVID-19 in Pregnancy and of Women Planning Pregnancy

Immunisation against COVID-19 in Pregnancy and of Women Planning Pregnancy

Placental Transfer Immunity to the Newborns in a Twin Pregnant Women Vaccinated with Heterologous CoronaVac-ChAdOx1

Durable antibody and effector memory T cell responses in breastmilk from women with SARS-CoV-2

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