tetano
Editor, Senior Moderator
Am J Clin Nutr
. 2024 Feb;119(2):485-495.
doi: 10.1016/j.ajcnut.2023.10.008. Epub 2023 Dec 14. SARS-CoV-2 antibodies and their neutralizing capacity against live virus in human milk after COVID-19 infection and vaccination: prospective cohort studies
Samantha Ismail[SUP] 1 [/SUP], Sharon Unger[SUP] 2 [/SUP], Patrick Budylowski[SUP] 3 [/SUP], Susan Poutanen[SUP] 4 [/SUP], Yvonne Yau[SUP] 5 [/SUP], Carleigh Jenkins[SUP] 6 [/SUP], Shaista Anwer[SUP] 7 [/SUP], Natasha Christie-Holmes[SUP] 8 [/SUP], Alex Kiss[SUP] 9 [/SUP], Tony Mazzulli[SUP] 4 [/SUP], Jennie Johnstone[SUP] 4 [/SUP], Allison McGeer[SUP] 4 [/SUP], Wendy Whittle[SUP] 10 [/SUP], Boriana Parvez[SUP] 11 [/SUP], Scott D Gray-Owen[SUP] 12 [/SUP], Debbie Stone[SUP] 13 [/SUP], Deborah L O'Connor[SUP] 14 [/SUP]
Affiliations
Background: There is limited understanding of the impact of coronavirus disease 2019 (COVID-19) infection and vaccination type and interval on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human milk antibodies and their neutralizing capacity.
Objectives: These cohort studies aimed to determine the presence of antibodies and live virus neutralizing capacity in milk from females infected with COVID-19, unexposed milk bank donors, and vaccinated females and examine impacts of vaccine interval and type.
Methods: Milk was collected from participants infected with COVID-19 during pregnancy or lactation (Cohort-1) and milk bank donors (Cohort-2) from March 2020-July 2021 at 3 sequential 4-wk intervals and COVID-19 vaccinated participants with varying dose intervals (Cohort-3) (January-October 2021). Cohort-1 and Cohort-3 were recruited from Sinai Health (patients) and through social media. Cohort-2 included Ontario Milk Bank donors. Milk was examined for SARS-CoV-2 antibodies and live virus neutralization.
Results: Of females with COVID-19, 53% (Cohort-1, n = 55) had anti-SARS-CoV-2 IgA antibodies in ≥1 milk sample. IgA+ samples (40%) were more likely neutralizing than IgA- samples (odds ratio [OR]: 2.18; 95% confidence interval [CI]: 1.03, 4.60; P = 0.04); however, 25% of IgA- samples were neutralizing. Both IgA positivity and neutralization decreased ∼6 mo after symptom onset (0-100 compared with 201+ d: IgA OR: 14.30; 95% CI: 1.08, 189.89; P = 0.04; neutralizing OR: 4.30; 95% CI: 1.55, 11.89; P = 0.005). Among milk bank donors (Cohort-2, n = 373), 4.3% had IgA antibodies; 23% of IgA+ samples were neutralizing. Vaccination (Cohort-3, n = 60) with mRNA-1273 and shorter vaccine intervals (3 to <6 wk) resulted in higher IgA and IgG than BNT162b2 (P < 0.04) and longer intervals (6 to <16 wk) (P≤0.02), respectively. Neutralizing capacity increased postvaccination (P = 0.04) but was not associated with antibody positivity.
Conclusions: SARS-CoV-2 infection and vaccination (type and interval) impacted milk antibodies; however, antibody presence did not consistently predict live virus neutralization. Although human milk is unequivocally the best way to nourish infants, guidance on protection to infants following maternal infection/vaccination may require more nuanced messaging. This study was registered at clinicaltrials.gov as NCT04453969 and NCT04453982.
Keywords: COVID-19; antibody; human milk; milk bank; neutralizing capacity; vaccine.
. 2024 Feb;119(2):485-495.
doi: 10.1016/j.ajcnut.2023.10.008. Epub 2023 Dec 14. SARS-CoV-2 antibodies and their neutralizing capacity against live virus in human milk after COVID-19 infection and vaccination: prospective cohort studies
Samantha Ismail[SUP] 1 [/SUP], Sharon Unger[SUP] 2 [/SUP], Patrick Budylowski[SUP] 3 [/SUP], Susan Poutanen[SUP] 4 [/SUP], Yvonne Yau[SUP] 5 [/SUP], Carleigh Jenkins[SUP] 6 [/SUP], Shaista Anwer[SUP] 7 [/SUP], Natasha Christie-Holmes[SUP] 8 [/SUP], Alex Kiss[SUP] 9 [/SUP], Tony Mazzulli[SUP] 4 [/SUP], Jennie Johnstone[SUP] 4 [/SUP], Allison McGeer[SUP] 4 [/SUP], Wendy Whittle[SUP] 10 [/SUP], Boriana Parvez[SUP] 11 [/SUP], Scott D Gray-Owen[SUP] 12 [/SUP], Debbie Stone[SUP] 13 [/SUP], Deborah L O'Connor[SUP] 14 [/SUP]
Affiliations
- PMID: 38309831
- DOI: 10.1016/j.ajcnut.2023.10.008
Background: There is limited understanding of the impact of coronavirus disease 2019 (COVID-19) infection and vaccination type and interval on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human milk antibodies and their neutralizing capacity.
Objectives: These cohort studies aimed to determine the presence of antibodies and live virus neutralizing capacity in milk from females infected with COVID-19, unexposed milk bank donors, and vaccinated females and examine impacts of vaccine interval and type.
Methods: Milk was collected from participants infected with COVID-19 during pregnancy or lactation (Cohort-1) and milk bank donors (Cohort-2) from March 2020-July 2021 at 3 sequential 4-wk intervals and COVID-19 vaccinated participants with varying dose intervals (Cohort-3) (January-October 2021). Cohort-1 and Cohort-3 were recruited from Sinai Health (patients) and through social media. Cohort-2 included Ontario Milk Bank donors. Milk was examined for SARS-CoV-2 antibodies and live virus neutralization.
Results: Of females with COVID-19, 53% (Cohort-1, n = 55) had anti-SARS-CoV-2 IgA antibodies in ≥1 milk sample. IgA+ samples (40%) were more likely neutralizing than IgA- samples (odds ratio [OR]: 2.18; 95% confidence interval [CI]: 1.03, 4.60; P = 0.04); however, 25% of IgA- samples were neutralizing. Both IgA positivity and neutralization decreased ∼6 mo after symptom onset (0-100 compared with 201+ d: IgA OR: 14.30; 95% CI: 1.08, 189.89; P = 0.04; neutralizing OR: 4.30; 95% CI: 1.55, 11.89; P = 0.005). Among milk bank donors (Cohort-2, n = 373), 4.3% had IgA antibodies; 23% of IgA+ samples were neutralizing. Vaccination (Cohort-3, n = 60) with mRNA-1273 and shorter vaccine intervals (3 to <6 wk) resulted in higher IgA and IgG than BNT162b2 (P < 0.04) and longer intervals (6 to <16 wk) (P≤0.02), respectively. Neutralizing capacity increased postvaccination (P = 0.04) but was not associated with antibody positivity.
Conclusions: SARS-CoV-2 infection and vaccination (type and interval) impacted milk antibodies; however, antibody presence did not consistently predict live virus neutralization. Although human milk is unequivocally the best way to nourish infants, guidance on protection to infants following maternal infection/vaccination may require more nuanced messaging. This study was registered at clinicaltrials.gov as NCT04453969 and NCT04453982.
Keywords: COVID-19; antibody; human milk; milk bank; neutralizing capacity; vaccine.