COVID-19 booster dose induces robust antibody response in pregnant, lactating, and nonpregnant women - 22/12/22
, Andrea G. Edlow, MD, MSc b, c, ⁎
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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.
Le texte complet de cet article est disponible en PDF.Key words : antibodies, booster, COVID-19, humoral immune response, messenger RNA vaccine, immune response, immunity, SARS-CoV-2, transplacental antibody transfer, vaccination
Plan
| C.A. and L.L.S. contributed equally to this work. |
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| G.A. and A.G.E. jointly supervised this work. |
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| This study received funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant numbers 1R01HD100022-01 and 3R01HD100022-02S2 [A.G.E.] and grant number 1K12HD103096 [L.L.S.]); the National Institute of Allergy and Infectious Diseases (grant numbers U19AI167899-01 [G.A. and A.G.E.] and grant numbers 3R37AI080289-11S1 [G.A.], R01AI146785, U19AI42790-01, and U19AI135995-02 [A.G.E.]); the March of Dimes Grant (grant number 6-FY20-223 [A.G.E.]); the National Institutes of Health/National Heart, Lung, and Blood Institute (grant number K08HL1469630-03 and 3K08HL146963-02S1 [K.J.G.]); the Ragon Institute of MGH, MIT and Harvard and the MGH ECOR Scholars award (G.A.); the Nancy Zimmerman, SAMANA Kay MGH Research Scholars award (G.A.); an anonymous donor, the Massachusetts Consortium on Pathogen Readiness (grant numbers 1U01CA260476-01 and CIVIC5N93019C00052 [G.A.]); the Gates Foundation Global Health Vaccine Accelerator Platform funding (grant number OPP1146996 and INV-001650 [G.A.]); and the Musk Foundation. |
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| K.J.G. has consulted for Illumina, BillionToOne, Aetion, and Roche outside the scope of the submitted work. G.A. is the founder of SeromYx. A.G.E. reported serving as a medical advisor for Mirvie. A.F. reported serving as a cofounder of and owning stock in Alba Therapeutics and serving on scientific advisory boards for NextCure and Viome outside the submitted work. All other authors report no conflict of interest. |
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| Cite this article as: Atyeo C, Shook LL, Nziza N, et al. COVID-19 booster dose induces robust antibody response in pregnant, lactating, and nonpregnant women. Am J Obstet Gynecol 2023;228:68.e1-12. |
Vol 228 - N° 1
P. 68.e1-68.e12 - janvier 2023 Retour au numéro
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