SARS-CoV-2 immunoglobulin G antibody levels in infants following messenger RNA COVID-19 vaccination during pregnancy

Kugelman, Nir; Nahshon, Chen; Shaked‐Mishan, Pninit; Lavie, Ofer; Stein, Nili; Kedar, Reuven; Waisman, Dan

doi:10.1016/j.ajog.2022.07.016

Cited by 5 publications

(10 citation statements)

References 5 publications

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“…Our results are in accordance with previous studies that presented a positive correlation between maternal and neonatal antibody titers 7 . We showed that vaccination in the third trimester with either a second or third dose leads to higher maternal and umbilical cord IgG levels at the time of delivery compared with vaccination in the second trimester.…”

Section: Discussionsupporting

confidence: 94%

“…Additional studies have shown an effective transplacental transfer of antibodies after COVID-19 vaccination [6][7][8] . Nir et al 8 suggested a positive correlation between maternal serum and cord blood antibody concentrations following the second vaccine.…”

mentioning

confidence: 99%

“…However, the optimal timing for the vaccination is debatable. Kugelman et al 7 suggested that the favorable timing of COVID-19 vaccination during pregnancy for optimal neonatal immunity is during the second trimester, while Rottenstreich et al 6 suggested that early compared with late third-trimester maternal SARS-CoV-2 immunization enhanced transplacental antibody transfer and increased neonatal neutralizing antibody levels.…”

mentioning

confidence: 99%

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Maternal and Cord Anti-SARS-CoV-2-Spike IgG following COVID-19 Vaccination versus Infection during Pregnancy: A Prospective Study, Israel October 2021–March 2022

Abu Shqara,

Frank Wolf,

Mikhail Mustafa

et al. 2023

Am J Perinatol

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Objectives: Defining how pregnant women respond to SARS-CoV-2 infection and vaccination is critical to optimize vaccination strategies that protect mother and infant at the epidemic. This study aimed to compare Anti-SARS-CoV-2-spike IgG of vaccinated vs. infected women and to determine the optimal timing of maternal vaccination during pregnancy at the time of epidemic. Study design: We collected maternal/cord blood at delivery (October 2021-March 2022) and measured Anti-SARS-CoV-2-spike-IgG geometric mean concentrations (IgG-GMC), using a quantitative immunoassay. We compared groups according to timing and number of doses and correlated maternal and fetal IgG levels. We described the proportion of women with IgG-levels above the 150 AU/ml positivity threshold according to the timing of infection/vaccination and performed a sub-analysis for maternal IgG-GMC levels pre and during the Omicron wave. Results: We included 238 vaccinated women, 125 who received two doses and 113 three; and 48 unvaccinated infected women. All groups infected/vaccinated in the second or third-trimester had an IgG-GMC above the positivity threshold. Third-trimester vaccination (second/third dose) resulted in higher maternal and cord-blood IgG-GMC compared to the second-trimester (maternal-IgG:10232 vs. 4325 AU/mL,p<0.001; cord-IgG:12113 vs. 8112 AU/mL,p<0.001). Compared with infected-only women, a higher proportion of vaccinated-women with >two doses and their newborns had IgG-levels above the positivity threshold at all time points. In vaccinated-women, there were higher maternal IgG-GMC levels during the Omicron wave than pre-Omicron. Conclusions: At the time of epidemic, receiving an additional COVID-19 vaccine dose in the third-trimester resulted in a higher IgG-GMC compared to the second-trimester. Relatively higher levels of maternal and cord IgG-GMC were achieved following vaccination than infection. Women infected during or before the first-trimester might benefit from an additional third-trimester dose to prevent peripartum infection and to passively immunize their newborn. The higher levels of maternal IgG-GMC in the Omicron period are suggestive of hybrid immunity.

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Section: Discussionsupporting

confidence: 94%

mentioning

confidence: 99%

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confidence: 99%

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Maternal and Cord Anti-SARS-CoV-2-Spike IgG following COVID-19 Vaccination versus Infection during Pregnancy: A Prospective Study, Israel October 2021–March 2022

Abu Shqara,

Frank Wolf,

Mikhail Mustafa

et al. 2023

Am J Perinatol

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show abstract

“…According to previous studies, the COVID-19 vaccine of pregnant women during the second trimester could be effective to achieve maternal protection and newborn safety during the pandemic. 21,24,25 In this study, we have found that the levels of SARS-CoV-2 antibodies were higher in infants from mothers…”

Section: Discussionmentioning

confidence: 54%

“…According to previous studies, the COVID‐19 vaccine of pregnant women during the second trimester could be effective to achieve maternal protection and newborn safety during the pandemic. 21 , 24 , 25 In this study, we have found that the levels of SARS‐CoV‐2 antibodies were higher in infants from mothers immunizing the COVID‐19 vaccine than unvaccinated before pregnancy. Although the level of SARS‐CoV‐2 IgG antibody decreased with the age of infants, significantly higher SARS‐CoV‐2 IgG antibodies levels in infants from the maternal 3‐dose of inactivated COVID‐19 vaccine before pregnancy compared with the 2‐dose.…”

Section: Discussionmentioning

confidence: 64%

Transplacental transmission of SARS‐CoV‐2 immunoglobulin G antibody to infants from maternal COVID‐19 vaccine immunization before pregnancy

Yang

Xing

Zhao

2022

Journal of Medical Virology

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The coronavirus disease 2019 (COVID‐19) vaccine generates functional antibodies in maternal circulation that are detectable in infants, while the information is restricted to the usage of COVID‐19 vaccine during pregnancy. In this study, we aimed to evaluate the effect of maternal COVID‐19 vaccines before pregnancy. Infants were included from mothers with no inactivated COVID‐19 vaccine, 1‐, 2‐, and 3‐dose before pregnancy, and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) immunoglobulin G (IgG) antibodies were tested. Comparative analysis was done between the groups. A total of 130 infants were enrolled in the study. Significantly higher levels of SARS‐CoV‐2 IgG antibodies in infants born to mothers with 3‐dose COVID‐19 vaccine before pregnancy compared with 1‐ and 2‐dose groups (p < 0.0001). The levels of antibodies decreased significantly with age in infants born to mothers with the 3‐dose COVID‐19 vaccine before pregnancy (r = −0.338, p = 0.035), and it was still higher than that 2‐dose COVID‐19 vaccine group. The maternal SARS‐CoV‐2 antibodies produced from the inactivated COVID‐19 vaccine before pregnancy can be transferred to newborns via the placenta. Maternal immunization with 3‐dose of the COVID‐19 vaccine before pregnancy could be more beneficial for both mothers and infants.

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Maternal antibody transfer rate of vaccination against SARS‐CoV‐2 before or during early pregnancy and its protective effectiveness on offspring

Liu,

Wang,

Shi

et al. 2023

Journal of Medical Virology

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This study focuses on maternal antibody transfer following vaccination against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) before or during early pregnancy and its potential protective effects on infants, providing scientific evidence for vaccination strategies. This prospective study tested the samples for SARS‐CoV‐2 IgG antibody titers and neutralizing capacity and tracked the infections after birth. Perform multivariate analysis of factors influencing antibody transfer rate, newborn antibody titers, and infant infection. Total 87.1% (122/140) women received coronavirus disease 2019 (COVID‐19) vaccine before or during early pregnancy, and 28 of them had breakthrough infection. The maternal and neonatal IgG positive rates at delivery were 60.7% (85/140) and 60.8% (87/143), respectively. A positive correlation was found between neonatal and maternal IgG antibody titers. Compared with the median IgG antibody transfer rate of infected pregnant women, that of vaccinated but not infected pregnant women was higher (1.21 versus: 1.53 [two doses], 1.71 [three doses]). However, neonatal IgG antibodies were relatively low (174.91 versus: 0.99 [two doses], 8.18 [three doses]), and their neutralizing capacity was weak. The overall effectiveness of maternal vaccination in preventing infant infection was 27.0%, and three doses had higher effectiveness than two doses (64.3% vs. 19.6%). Multivariate analysises showed that in vaccination group women receiving three doses or in infection group women with longer interval between infection and delivery had a higher antibody transfer rate and neonatal IgG antibody titer. More than half of women vaccinated before or during early pregnancy can achieve effective antibody transfer to newborns. However, the neonatal IgG antibody titer is low and has a weak neutralizing capacity, providing limited protection to infants.

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SARS-CoV-2 immunoglobulin G antibody levels in infants following messenger RNA COVID-19 vaccination during pregnancy

Cited by 5 publications

References 5 publications

Maternal and Cord Anti-SARS-CoV-2-Spike IgG following COVID-19 Vaccination versus Infection during Pregnancy: A Prospective Study, Israel October 2021–March 2022

Maternal and Cord Anti-SARS-CoV-2-Spike IgG following COVID-19 Vaccination versus Infection during Pregnancy: A Prospective Study, Israel October 2021–March 2022

Transplacental transmission of SARS‐CoV‐2 immunoglobulin G antibody to infants from maternal COVID‐19 vaccine immunization before pregnancy

Maternal antibody transfer rate of vaccination against SARS‐CoV‐2 before or during early pregnancy and its protective effectiveness on offspring

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