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Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose

BACKGROUND: Post–COVID-19 vaccine boosting is a potent tool in the ongoing pandemic. Relevant data regarding this approach during pregnancy are lacking, which affects vaccination policy guidance, public acceptance, and vaccine uptake during pregnancy. We aimed to investigate the dynamics of anti–SAR...

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Autores principales: Nevo, Lea, Cahen-Peretz, Adva, Vorontsov, Olesya, Frenkel, Rachelli, Kabessa, Maor, Cohen, Sarah M., Hamrani, Adar, Oiknine-Djian, Esther, Lipschuetz, Michal, Goldman-Wohl, Debra, Walfisch, Asnat, Kovo, Michal, Neeman, Michal, Yagel, Simcha, Wolf, Dana G., Beharier, Ofer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9008977/
https://www.ncbi.nlm.nih.gov/pubmed/35430228
http://dx.doi.org/10.1016/j.ajog.2022.04.010
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author Nevo, Lea
Cahen-Peretz, Adva
Vorontsov, Olesya
Frenkel, Rachelli
Kabessa, Maor
Cohen, Sarah M.
Hamrani, Adar
Oiknine-Djian, Esther
Lipschuetz, Michal
Goldman-Wohl, Debra
Walfisch, Asnat
Kovo, Michal
Neeman, Michal
Yagel, Simcha
Wolf, Dana G.
Beharier, Ofer
author_facet Nevo, Lea
Cahen-Peretz, Adva
Vorontsov, Olesya
Frenkel, Rachelli
Kabessa, Maor
Cohen, Sarah M.
Hamrani, Adar
Oiknine-Djian, Esther
Lipschuetz, Michal
Goldman-Wohl, Debra
Walfisch, Asnat
Kovo, Michal
Neeman, Michal
Yagel, Simcha
Wolf, Dana G.
Beharier, Ofer
author_sort Nevo, Lea
collection PubMed
description BACKGROUND: Post–COVID-19 vaccine boosting is a potent tool in the ongoing pandemic. Relevant data regarding this approach during pregnancy are lacking, which affects vaccination policy guidance, public acceptance, and vaccine uptake during pregnancy. We aimed to investigate the dynamics of anti–SARS-CoV-2 antibody levels following SARS-CoV-2 infection during pregnancy and to characterize the effect of a single postinfection vaccine booster dose on the anti–SARS-CoV-2 antibody levels in parturients in comparison with the levels in naïve vaccinated and convalescent, nonboosted parturients. STUDY DESIGN: Serum samples prospectively collected from parturients and umbilical cords at delivery at our university-affiliated urban medical center in Jerusalem, Israel, from May to October 2021, were selected and analyzed in a case-control manner. Study groups comprised the following participants: a consecutive sample of parturients with a polymerase chain reaction–confirmed history of COVID-19 during any stage of pregnancy; and comparison groups selected according to time of exposure comprising (1) convalescent, nonboosted parturients with polymerase chain reaction–confirmed COVID-19; (2) convalescent parturients with polymerase chain reaction–confirmed COVID-19 who received a single booster dose of the BNT162b2 messenger RNA vaccine; and (3) infection-naïve, fully vaccinated parturients who received 2 doses of the BNT162b2 messenger RNA vaccine. Outcomes that were determined included maternal and umbilical cord blood anti–SARS-CoV-2 antibody levels detected at delivery, the reported side effects, and pregnancy outcomes. RESULTS: A total of 228 parturients aged 18 to 45 years were included. Of those, samples from 64 were studied to characterize the titer dynamics following COVID-19 at all stages of pregnancy. The boosting effect was determined by comparing (1) convalescent (n=54), (2) boosted convalescent (n=60), and (3) naïve, fully vaccinated (n=114) parturients. Anti–SARS-CoV-2 antibody levels detected on delivery showed a gradual and significant decline over time from infection to delivery (r=0.4371; P=.0003). Of the gravidae infected during the first trimester, 34.6% (9/26) tested negative at delivery, compared with 9.1% (3/33) of those infected during the second trimester (P=.023). Significantly higher anti–SARS-CoV-2 antibody levels were observed among boosted convalescent than among nonboosted convalescent (17.6-fold; P<.001) and naïve vaccinated parturients (3.2-fold; P<.001). Similar patterns were observed in umbilical cord blood. Side effects in convalescent gravidae resembled those in previous reports of mild symptoms following COVID-19 vaccination during pregnancy. CONCLUSION: Postinfection maternal humoral immunity wanes during pregnancy, leading to low or undetectable protective titers for a marked proportion of patients. A single boosting dose of the BNT162b2 messenger RNA vaccine induced a robust increase in protective titers for both the mother and newborn with moderate reported side effects.
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spelling pubmed-90089772022-04-14 Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose Nevo, Lea Cahen-Peretz, Adva Vorontsov, Olesya Frenkel, Rachelli Kabessa, Maor Cohen, Sarah M. Hamrani, Adar Oiknine-Djian, Esther Lipschuetz, Michal Goldman-Wohl, Debra Walfisch, Asnat Kovo, Michal Neeman, Michal Yagel, Simcha Wolf, Dana G. Beharier, Ofer Am J Obstet Gynecol Original Research BACKGROUND: Post–COVID-19 vaccine boosting is a potent tool in the ongoing pandemic. Relevant data regarding this approach during pregnancy are lacking, which affects vaccination policy guidance, public acceptance, and vaccine uptake during pregnancy. We aimed to investigate the dynamics of anti–SARS-CoV-2 antibody levels following SARS-CoV-2 infection during pregnancy and to characterize the effect of a single postinfection vaccine booster dose on the anti–SARS-CoV-2 antibody levels in parturients in comparison with the levels in naïve vaccinated and convalescent, nonboosted parturients. STUDY DESIGN: Serum samples prospectively collected from parturients and umbilical cords at delivery at our university-affiliated urban medical center in Jerusalem, Israel, from May to October 2021, were selected and analyzed in a case-control manner. Study groups comprised the following participants: a consecutive sample of parturients with a polymerase chain reaction–confirmed history of COVID-19 during any stage of pregnancy; and comparison groups selected according to time of exposure comprising (1) convalescent, nonboosted parturients with polymerase chain reaction–confirmed COVID-19; (2) convalescent parturients with polymerase chain reaction–confirmed COVID-19 who received a single booster dose of the BNT162b2 messenger RNA vaccine; and (3) infection-naïve, fully vaccinated parturients who received 2 doses of the BNT162b2 messenger RNA vaccine. Outcomes that were determined included maternal and umbilical cord blood anti–SARS-CoV-2 antibody levels detected at delivery, the reported side effects, and pregnancy outcomes. RESULTS: A total of 228 parturients aged 18 to 45 years were included. Of those, samples from 64 were studied to characterize the titer dynamics following COVID-19 at all stages of pregnancy. The boosting effect was determined by comparing (1) convalescent (n=54), (2) boosted convalescent (n=60), and (3) naïve, fully vaccinated (n=114) parturients. Anti–SARS-CoV-2 antibody levels detected on delivery showed a gradual and significant decline over time from infection to delivery (r=0.4371; P=.0003). Of the gravidae infected during the first trimester, 34.6% (9/26) tested negative at delivery, compared with 9.1% (3/33) of those infected during the second trimester (P=.023). Significantly higher anti–SARS-CoV-2 antibody levels were observed among boosted convalescent than among nonboosted convalescent (17.6-fold; P<.001) and naïve vaccinated parturients (3.2-fold; P<.001). Similar patterns were observed in umbilical cord blood. Side effects in convalescent gravidae resembled those in previous reports of mild symptoms following COVID-19 vaccination during pregnancy. CONCLUSION: Postinfection maternal humoral immunity wanes during pregnancy, leading to low or undetectable protective titers for a marked proportion of patients. A single boosting dose of the BNT162b2 messenger RNA vaccine induced a robust increase in protective titers for both the mother and newborn with moderate reported side effects. Published by Elsevier Inc. 2022-09 2022-04-14 /pmc/articles/PMC9008977/ /pubmed/35430228 http://dx.doi.org/10.1016/j.ajog.2022.04.010 Text en © 2022 Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Research
Nevo, Lea
Cahen-Peretz, Adva
Vorontsov, Olesya
Frenkel, Rachelli
Kabessa, Maor
Cohen, Sarah M.
Hamrani, Adar
Oiknine-Djian, Esther
Lipschuetz, Michal
Goldman-Wohl, Debra
Walfisch, Asnat
Kovo, Michal
Neeman, Michal
Yagel, Simcha
Wolf, Dana G.
Beharier, Ofer
Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose
title Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose
title_full Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose
title_fullStr Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose
title_full_unstemmed Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose
title_short Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose
title_sort boosting maternal and neonatal humoral immunity following sars-cov-2 infection using a single messenger rna vaccine dose
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9008977/
https://www.ncbi.nlm.nih.gov/pubmed/35430228
http://dx.doi.org/10.1016/j.ajog.2022.04.010
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