tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2024 Nov 1;43(11):1065-1073.
doi: 10.1097/INF.0000000000004510. Epub 2024 Aug 13. Enhanced D614G and Omicron Variants Antibody Persistence in Infants at 2 Months of Age Following Maternal mRNA Booster Vaccination During Pregnancy or Postpartum
Flor M Munoz[SUP] 1 [/SUP], Richard Beigi[SUP] 2 [/SUP], Christine M Posavad[SUP] 3 [/SUP], Clifton Kelly[SUP] 4 [/SUP], Martina L Badell[SUP] 5 [/SUP], Katherine Bunge[SUP] 2 [/SUP], Mark J Mulligan[SUP] 6 [/SUP], Lalitha Parameswaran[SUP] 6 [/SUP], Barbra A Richardson[SUP] 7 [/SUP], Courtney Olsen-Chen[SUP] 8 [/SUP], Richard M Novak[SUP] 9 [/SUP], Rebecca C Brady[SUP] 10 [/SUP], Emily DeFranco[SUP] 10 [/SUP], Jeffrey S Gerber[SUP] 11 [/SUP], Mallory Shriver[SUP] 12 [/SUP], Mehul S Suthar[SUP] 13 [/SUP], Rhea Coler[SUP] 14 [/SUP], Bryan J Berube[SUP] 14 [/SUP], So Hee Kim[SUP] 4 [/SUP], Jeanna M Piper[SUP] 15 [/SUP], Joy Miedema[SUP] 16 [/SUP], Marcela Pasetti[SUP] 12 [/SUP], Kathleen M Neuzil[SUP] 12 [/SUP], Cristina V Cardemil[SUP] 15 [/SUP]; DMID Study Group
Affiliations
Background: Following maternal COVID-19 vaccination, the persistence of antibodies in sera and breast milk for mothers and infants is not well characterized. We sought to describe the persistence of antibodies through 2 months after delivery in maternal and infant serum and breast milk following maternal COVID-19 mRNA vaccination and to examine differences by receipt of booster dose during pregnancy or postpartum.
Methods: This is a prospective cohort study with enrollment from July 2021 to January 2022 at 9 US academic sites. Pregnant or postpartum participants and their infants were enrolled after COVID-19 mRNA monovalent vaccination during pregnancy (primary 2-dose series) with booster (third dose) vaccination during pregnancy or within 2 months post-partum. SARS-CoV-2-binding and functional antibody responses at delivery and 2 months after delivery in mothers and infants were measured by spike and receptor-binding domain immunoglobulin (Ig) G, pseudovirus and live neutralizing antibody (nAb) titers to ancestral and Omicron BA.1 and BA.5 strains. Breast milk spike and receptor-binding domain IgG and IgA titers were also measured.
Results: A total of 237 maternal/infant dyads were included (110 primary series during pregnancy, 99 pregnancy booster and 28 postpartum booster). A pregnancy booster resulted in 2.2-4.7-fold higher IgG and nAb at delivery and 2 months for both mothers and infants compared to the primary series alone (P < 0.001 for all comparisons). While infant IgG and nAb titers decreased by 2 months of age, the proportion of infants with detectable nAb at 2 months was greater in infants of mothers boosted during pregnancy compared with primary series for all variants (D614G: 99% vs. 56%; BA.1: 56% vs. 4% and BA.5: 57% vs. 9%; P < 0.001 for all comparisons). Breast milk spike IgA and IgG were present in 64%-100% and 100% of participants, respectively, and those boosted during pregnancy or postpartum had 3.1-4.6-fold higher levels of breast milk antibodies at 2 months compared to primary series during pregnancy (P < 0.001).
Conclusions: mRNA COVID-19 monovalent booster vaccination during pregnancy results in significantly higher maternal and infant serum-binding IgG and nAb titers compared to a primary 2-dose series, including against Omicron variants, through 2 months of age. Breast milk antibodies following maternal vaccination during pregnancy or postpartum may provide additional protection during early infancy.
. 2024 Nov 1;43(11):1065-1073.
doi: 10.1097/INF.0000000000004510. Epub 2024 Aug 13. Enhanced D614G and Omicron Variants Antibody Persistence in Infants at 2 Months of Age Following Maternal mRNA Booster Vaccination During Pregnancy or Postpartum
Flor M Munoz[SUP] 1 [/SUP], Richard Beigi[SUP] 2 [/SUP], Christine M Posavad[SUP] 3 [/SUP], Clifton Kelly[SUP] 4 [/SUP], Martina L Badell[SUP] 5 [/SUP], Katherine Bunge[SUP] 2 [/SUP], Mark J Mulligan[SUP] 6 [/SUP], Lalitha Parameswaran[SUP] 6 [/SUP], Barbra A Richardson[SUP] 7 [/SUP], Courtney Olsen-Chen[SUP] 8 [/SUP], Richard M Novak[SUP] 9 [/SUP], Rebecca C Brady[SUP] 10 [/SUP], Emily DeFranco[SUP] 10 [/SUP], Jeffrey S Gerber[SUP] 11 [/SUP], Mallory Shriver[SUP] 12 [/SUP], Mehul S Suthar[SUP] 13 [/SUP], Rhea Coler[SUP] 14 [/SUP], Bryan J Berube[SUP] 14 [/SUP], So Hee Kim[SUP] 4 [/SUP], Jeanna M Piper[SUP] 15 [/SUP], Joy Miedema[SUP] 16 [/SUP], Marcela Pasetti[SUP] 12 [/SUP], Kathleen M Neuzil[SUP] 12 [/SUP], Cristina V Cardemil[SUP] 15 [/SUP]; DMID Study Group
Affiliations
- PMID: 39774938
- PMCID: PMC11711698 (available on 2025-11-01)
- DOI: 10.1097/INF.0000000000004510
Background: Following maternal COVID-19 vaccination, the persistence of antibodies in sera and breast milk for mothers and infants is not well characterized. We sought to describe the persistence of antibodies through 2 months after delivery in maternal and infant serum and breast milk following maternal COVID-19 mRNA vaccination and to examine differences by receipt of booster dose during pregnancy or postpartum.
Methods: This is a prospective cohort study with enrollment from July 2021 to January 2022 at 9 US academic sites. Pregnant or postpartum participants and their infants were enrolled after COVID-19 mRNA monovalent vaccination during pregnancy (primary 2-dose series) with booster (third dose) vaccination during pregnancy or within 2 months post-partum. SARS-CoV-2-binding and functional antibody responses at delivery and 2 months after delivery in mothers and infants were measured by spike and receptor-binding domain immunoglobulin (Ig) G, pseudovirus and live neutralizing antibody (nAb) titers to ancestral and Omicron BA.1 and BA.5 strains. Breast milk spike and receptor-binding domain IgG and IgA titers were also measured.
Results: A total of 237 maternal/infant dyads were included (110 primary series during pregnancy, 99 pregnancy booster and 28 postpartum booster). A pregnancy booster resulted in 2.2-4.7-fold higher IgG and nAb at delivery and 2 months for both mothers and infants compared to the primary series alone (P < 0.001 for all comparisons). While infant IgG and nAb titers decreased by 2 months of age, the proportion of infants with detectable nAb at 2 months was greater in infants of mothers boosted during pregnancy compared with primary series for all variants (D614G: 99% vs. 56%; BA.1: 56% vs. 4% and BA.5: 57% vs. 9%; P < 0.001 for all comparisons). Breast milk spike IgA and IgG were present in 64%-100% and 100% of participants, respectively, and those boosted during pregnancy or postpartum had 3.1-4.6-fold higher levels of breast milk antibodies at 2 months compared to primary series during pregnancy (P < 0.001).
Conclusions: mRNA COVID-19 monovalent booster vaccination during pregnancy results in significantly higher maternal and infant serum-binding IgG and nAb titers compared to a primary 2-dose series, including against Omicron variants, through 2 months of age. Breast milk antibodies following maternal vaccination during pregnancy or postpartum may provide additional protection during early infancy.