Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
Contributed equally as co-first authors.
Pediatrics. 2021 Nov;148(5). doi: 10.1542/peds.2021-052286. Epub 2021 Aug 18.
Passive and active immunity transfer through human milk (HM) constitutes a key element in the infant's developing immunity. Certain infectious diseases and vaccines have been described to induce changes in the immune components of HM.
We conducted a prospective cohort single-institution study from February 2 to April 4, 2021. Women who reported to be breastfeeding at the time of their coronavirus disease 2019 (COVID-19) vaccination were invited to participate. Blood and milk samples were collected on day 14 after their second dose of the vaccine. Immunoglobulin G (IgG) antibodies against nucleocapsid protein as well as IgG, immunoglobulin M and immunoglobulin A (IgA) antibodies against the spike 1 protein receptor-binding domain against severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2 RBD-S1) were analyzed in both serum and HM samples.
Most of the participants (ie, 94%) received the BNT162b2 messenger RNA COVID-19 vaccine. The mean serum concentration of anti-SARS-CoV-2 RBD-S-IgG antibodies in vaccinated individuals was 3379.6 ± 1639.5 binding antibody units per mL. All vaccinated study participants had anti-SARS-CoV-2 RBD-S1-IgG, and 89% of them had anti-SARS-CoV-2 RBD-S-IgA in their milk. The antibody concentrations in the milk of mothers who were breastfeeding 24 months were significantly higher than in mothers with breastfeeding periods <24 months ( < .001).
We found a clear association between COVID-19 vaccination and specific immunoglobulin concentrations in HM. This effect was more pronounced when lactation periods exceeded 23 months. The influence of the lactation period on immunoglobulins was specific and independent of other variables.
通过人乳（HM）传递被动和主动免疫是婴儿发育免疫的关键因素。某些传染病和疫苗已被描述为诱导 HM 中免疫成分发生变化。
我们进行了一项前瞻性队列单机构研究，时间为 2021 年 2 月 2 日至 4 月 4 日。报告在新冠肺炎（COVID-19）疫苗接种时正在母乳喂养的女性被邀请参加。在她们接种第二剂疫苗后的第 14 天采集血液和奶样。分析血清和 HM 样本中针对核衣壳蛋白的 IgG 抗体以及针对严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）刺突 1 蛋白受体结合域的 IgG、IgM 和 IgA 抗体（抗-SARS-CoV-2 RBD-S1）。
大多数参与者（即 94%）接受了 BNT162b2 信使 RNA COVID-19 疫苗。接种疫苗者血清中抗-SARS-CoV-2 RBD-S1-IgG 抗体的平均浓度为 3379.6±1639.5 结合抗体单位/mL。所有接种研究疫苗的参与者均具有抗-SARS-CoV-2 RBD-S1-IgG，其中 89%的人在其奶中具有抗-SARS-CoV-2 RBD-S1-IgA。母乳喂养 24 个月的母亲的奶中抗体浓度明显高于母乳喂养期<24 个月的母亲（<0.001）。
我们发现 COVID-19 疫苗接种与 HM 中特定免疫球蛋白浓度之间存在明确关联。当哺乳期超过 23 个月时，这种影响更为明显。哺乳期对免疫球蛋白的影响是特定的，独立于其他变量。
