COVID-19 vaccine response in pregnant and lactating women
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In the largest study of its kind to date, researchers have found the new mRNA COVID-19 vaccines to be highly effective in producing antibodies against the SARS-CoV-2 virus in pregnant and lactating women. They also demonstrated the vaccines confer protective immunity to newborns through breastmilk and the placenta.

The study was published by the American Journal of Obstetrics & Gynecology and was aimed to evaluate the immunogenicity and reactogenicity of COVID-19 mRNA vaccination in pregnant and lactating women compared to (1) non-pregnant controls and (2) natural COVID-19 infection in pregnancy.

131 reproductive-age vaccine recipients (84 pregnant, 31 lactating, and 16 non-pregnant) were enrolled. Titers of SARS-CoV-2 Spike and RBD IgG, IgA, and IgM were quantified in participant sera and breastmilk at baseline, second vaccine dose, 2-6 weeks post the second vaccine, and at delivery by Luminex. Umbilical cord sera titers were assessed at delivery. Titers were compared to those of pregnant women 4-12 weeks from natural infection by ELISA. A pseudovirus neutralization assay was used to quantify neutralizing antibody titers for the subset of women who delivered during the study period. Post-vaccination symptoms were assessed via questionnaire.

The result was;
--Vaccine-induced antibody titers were equivalent in pregnant and lactating compared to non-pregnant women.

--All titers were significantly higher than those induced by SARS-CoV-2 infection during pregnancy.

--Vaccine-generated antibodies were present in all umbilical cord blood and breastmilk samples. Neutralizing antibody titers were lower in the umbilical cord compared to maternal sera, although this finding did not achieve statistical significance.

--The second vaccine dose (boost dose) increased SARS-CoV-2-specific IgG, but not IgA, in maternal blood and breastmilk. No differences were noted in reactogenicity across the groups.

In particular, COVID-19 mRNA vaccines generated robust humoral immunity in pregnant and lactating women, with immunogenicity and reactogenicity similar to that observed in non-pregnant women. Vaccine-induced immune responses were significantly greater than the response to natural infection. Immune transfer to neonates occurred via placenta and breastmilk.

Source: https://doi.org/10.1016/j.ajog.2021.03.023
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