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COVID-19 booster dose induces robust antibody response in pregnant, lactating, and nonpregnant women.
Atyeo, Caroline; Shook, Lydia L; Nziza, Nadege; Deriso, Elizabeth A; Muir, Cordelia; Baez, Arantxa Medina; Lima, Rosiane S; Demidkin, Stepan; Brigida, Sara; De Guzman, Rose M; Burns, Madeleine D; Balazs, Alejandro B; Fasano, Alessio; Yonker, Lael M; Gray, Kathryn J; Alter, Galit; Edlow, Andrea G.
  • Atyeo C; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA; PhD Program in Virology, Division of Medical Sciences, XXX, Harvard University, Boston, MA.
  • Shook LL; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA.
  • Nziza N; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA.
  • Deriso EA; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA.
  • Muir C; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
  • Baez AM; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
  • Lima RS; Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
  • Demidkin S; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA.
  • Brigida S; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA.
  • De Guzman RM; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA.
  • Burns MD; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
  • Balazs AB; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA.
  • Fasano A; Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
  • Yonker LM; Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
  • Gray KJ; Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Alter G; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA. Electronic address: GALTER@MGH.HARVARD.EDU.
  • Edlow AG; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA. Electronic address: AEDLOW@MGH.HARVARD.EDU.
Am J Obstet Gynecol ; 2022 Jul 19.
Article in English | MEDLINE | ID: covidwho-2238845
ABSTRACT

BACKGROUND:

Although emerging data during the SARS-CoV-2 pandemic have demonstrated robust messenger RNA vaccine-induced immunogenicity across populations, including pregnant and lactating individuals, the rapid waning of vaccine-induced immunity and the emergence of variants of concern motivated the use of messenger RNA vaccine booster doses. Whether all populations, including pregnant and lactating individuals, will mount a comparable response to a booster dose is not known.

OBJECTIVE:

This study aimed to profile the humoral immune response to a COVID-19 messenger RNA booster dose in a cohort of pregnant, lactating, and nonpregnant age-matched women. STUDY

DESIGN:

This study characterized the antibody response against ancestral Spike and Omicron in a cohort of 31 pregnant, 12 lactating, and 20 nonpregnant age-matched controls who received a BNT162b2 or messenger RNA-1273 booster dose after primary COVID-19 vaccination. In addition, this study examined the vaccine-induced antibody profiles of 15 maternal-to-cord dyads at delivery.

RESULTS:

Receiving a booster dose during pregnancy resulted in increased immunoglobulin G1 levels against Omicron Spike (postprimary vaccination vs postbooster dose; P=.03). Pregnant and lactating individuals exhibited equivalent Spike-specific total immunoglobulin G1, immunoglobulin M, and immunoglobulin A levels and neutralizing titers against Omicron compared with nonpregnant women. Subtle differences in Fc receptor binding and antibody subclass profiles were observed in the immune response to a booster dose in pregnant vs nonpregnant individuals. The analysis of maternal and cord antibody profiles at delivery demonstrated equivalent total Spike-specific immunoglobulin G1 in maternal and cord blood, yet higher Spike-specific FcγR3a-binding antibodies in the cord relative to maternal blood (P=.002), consistent with the preferential transfer of highly functional immunoglobulin. Spike-specific immunoglobulin G1 levels in the cord were positively correlated with the time elapsed since receiving the booster dose (Spearman R, .574; P=.035).

CONCLUSION:

Study data suggested that receiving a booster dose during pregnancy induces a robust Spike-specific humoral immune response, including against Omicron. If boosting occurs in the third trimester of pregnancy, higher Spike-specific cord immunoglobulin G1 levels are achieved with greater time elapsed between receiving the booster and delivery. Receiving a booster dose has the potential to augment maternal and neonatal immunity.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines / Variants Language: English Year: 2022 Document Type: Article Affiliation country: J.ajog.2022.07.014

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines / Variants Language: English Year: 2022 Document Type: Article Affiliation country: J.ajog.2022.07.014