期刊
CLINICAL INFECTIOUS DISEASES
卷 75, 期 1, 页码 E603-E610出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciac135
关键词
pregnancy; vaccination; COVID-19; serology; SARS-CoV-2
Maternal antibody levels and transplacental antibody transfer vary based on the gestational age at the time of SARS-CoV-2 vaccination, with lowest levels observed in those vaccinated in the first trimester. A third booster dose may enhance antibody levels and could be beneficial for those who completed the 2-dose vaccine series early in pregnancy.
Background Coronavirus disease 2019 (COVID-19) during pregnancy and early infancy can result in severe disease. Evaluating the effect of gestational age at the time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination on maternal antibody levels and transplacental antibody transfer has important implications for maternal care and vaccination strategies. Methods Maternal and cord blood sera were collected from mother-newborn dyads (n = 402), following term delivery after antenatal 2-dose SARS-CoV-2 BNT162b2 mRNA vaccination. SARS-CoV-2 spike protein (S) and receptor binding domain (RBD)-specific IgG levels were evaluated in the samples collected. Results Median anti-S and anti-RBD-specific IgG levels in maternal sera at the time of delivery were lowest following first-trimester vaccination (n = 90; anti-S IgG: 76 AU/mL; anti-RBD-specific IgG: 478 AU/mL), intermediate in those vaccinated in the second trimester (n = 124; anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1263 AU/mL), and highest after third-trimester vaccination (n = 188; anti-S IgG: 240 AU/mL; anti-RBD-specific IgG: 5855 AU/mL). Antibody levels in neonatal sera followed a similar pattern and were lowest following antenatal vaccination in the first trimester (anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1140 AU/mL). In a subgroup of parturients vaccinated in the first trimester (n = 30), a third booster dose was associated with significantly higher maternal and neonatal antibody levels. Conclusions These results suggest a considerable antibody waning throughout pregnancy in those vaccinated at early gestation. The observed boosting effect of a third vaccine dose hints at its potential benefit in those who completed the 2-dose vaccine series at early pregnancy or before conception. The impact of antenatal immunization timing on SARS-CoV-2 transplacental antibody transfer may influence neonatal seroprotection. Lower antibody titers were found after maternal vaccination at early pregnancy, suggesting considerable antibody waning throughout gestation, with a potential role of a third vaccine dose. The effect of immunization timing on the transplacental antibody transfer may influence neonatal seroprotection.
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