Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, United States.
Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, United States.
Front Immunol. 2021 Nov 3;12:777103. doi: 10.3389/fimmu.2021.777103. eCollection 2021.
Data regarding symptoms in the lactating mother-infant dyad and their immune response to COVID-19 mRNA vaccination during lactation are needed to inform vaccination guidelines.
From a prospective cohort of 50 lactating individuals who received mRNA-based vaccines for COVID-19 (mRNA-1273 and BNT162b2), blood and milk samples were collected prior to first vaccination dose, immediately prior to 2nd dose, and 4-10 weeks after 2nd dose. Symptoms in mother and infant were assessed by detailed questionnaires. Anti-SARS-CoV-2 antibody levels in blood and milk were measured by Pylon 3D automated immunoassay and ELISA. In addition, vaccine-related PEGylated proteins in milk were measured by ELISA. Blood samples were collected from a subset of infants whose mothers received the vaccine during lactation (4-15 weeks after mothers' 2nd dose).
No severe maternal or infant adverse events were reported in this cohort. Two mothers and two infants were diagnosed with COVID-19 during the study period before achieving full immune response. PEGylated proteins were not found at significant levels in milk after vaccination. After vaccination, levels of anti-SARS-CoV-2 IgG and IgM significantly increased in maternal plasma and there was significant transfer of anti-SARS-CoV-2-Receptor Binding Domain (anti-RBD) IgA and IgG antibodies to milk. Milk IgA levels after the 2nd dose were negatively associated with infant age. Anti-SARS-CoV-2 IgG antibodies were not detected in the plasma of infants whose mothers were vaccinated during lactation.
COVID-19 mRNA vaccines generate robust immune responses in plasma and milk of lactating individuals without severe adverse events reported.
需要了解哺乳期母婴对 COVID-19 mRNA 疫苗的症状及其免疫反应的数据，以制定疫苗接种指南。
从接受 COVID-19 mRNA 疫苗（mRNA-1273 和 BNT162b2）的 50 名哺乳期个体的前瞻性队列中，在首次接种前、第二次接种前和第二次接种后 4-10 周收集血液和乳汁样本。通过详细的问卷评估母婴的症状。通过 Pylon 3D 自动化免疫分析和 ELISA 测量血液和乳汁中的抗 SARS-CoV-2 抗体水平。此外，通过 ELISA 测量乳汁中的疫苗相关 PEG 化蛋白。从母亲在哺乳期接种疫苗的婴儿亚组中采集血液样本（母亲第二次接种后 4-15 周）。
本队列未报告严重的母婴不良事件。在获得完全免疫反应之前，研究期间有两名母亲和两名婴儿被诊断患有 COVID-19。接种疫苗后，PEG 化蛋白在乳汁中未达到显著水平。接种疫苗后，母血浆中的抗 SARS-CoV-2 IgG 和 IgM 水平显著升高，并且抗 SARS-CoV-2-受体结合域（抗-RBD）IgA 和 IgG 抗体显著转移到乳汁中。第二次接种后，乳汁 IgA 水平与婴儿年龄呈负相关。在母亲在哺乳期接种疫苗的婴儿的血浆中未检测到抗 SARS-CoV-2 IgG 抗体。
COVID-19 mRNA 疫苗在哺乳期个体的血浆和乳汁中产生了强大的免疫反应，未报告严重的不良事件。
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