Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, Texas, USA.
Breastfeed Med. 2022 Jun;17(6):475-483. doi: 10.1089/bfm.2021.0353. Epub 2022 Mar 22.
CDC guidelines have recommended coronavirus disease-19 (COVID-19) vaccination for all people 5 years and older, including people who are breastfeeding. Breast milk has shown to be a valuable source of protection for immune-immature neonates. It has been shown that breast milk from mothers who have received vaccinations can transfer antibodies. This systematic review and meta-analysis investigate the presence of antibodies to SARS-CoV-2 in human breast milk after vaccination. Studies that evaluated immunoglobulins in breast milk of women receiving a SARS-CoV-2 vaccination were included. PubMed, Embase, Web of Science were searched for articles published between December 1, 2019 and September 30, 2021. Data from relevant articles were extracted manually or by WebPlotDigitizer version 4.1 to obtain the numeric values of antibody levels on peak days and the peak day then condensed into Excel. Additional raw data and information were supplied by corresponding authors. One hundred ninety-two articles were obtained from the search. After excluding duplicates, screening titles and abstracts, 18 cohort studies were identified. For the rate of SARS-CoV-2 antibodies in breast milk after the first vaccine dose but before the second vaccine dose, we found 64% (95% CI 51-78%) were positive for IgA and 30% (95% CI 13.1-46%) were positive for IgG. For the rate for SARS-CoV-2 antibodies in breast milk after the second vaccine dose, we found 70% (95% CI 55-86%) were positive for IgA and 91% (95% CI 80-103%) were positive for IgG. Our analysis of the data published worldwide showed high rates of positivity for antibodies in breast milk following COVID-19 immunizations. Further research is necessary to find if the rate of positivity of IgA and IgG against SARS-CoV-2 in breast milk persists months after the full immunization, and their impact on the prevention of SARS-CoV-2 infection in infants.
美国疾病控制与预防中心(CDC)指南建议所有 5 岁及以上人群(包括哺乳期妇女)接种新型冠状病毒疾病-19(COVID-19)疫苗。母乳被证明是免疫不成熟新生儿的宝贵保护来源。研究表明,接种疫苗的母亲的母乳可以转移抗体。本系统评价和荟萃分析调查了接种疫苗后母乳中针对严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)的抗体的存在情况。纳入了评估接受 SARS-CoV-2 疫苗接种的女性母乳中免疫球蛋白的研究。检索了 2019 年 12 月 1 日至 2021 年 9 月 30 日期间发表的文章,使用 PubMed、Embase、Web of Science 进行检索。通过手动或 WebPlotDigitizer 版本 4.1 从相关文章中提取数据,以获取峰值日抗体水平的数值,然后将峰值日数据浓缩到 Excel 中。额外的原始数据和信息由相应的作者提供。从搜索中获得了 192 篇文章。排除重复项、筛选标题和摘要后,确定了 18 项队列研究。对于第一剂疫苗后但第二剂疫苗前母乳中 SARS-CoV-2 抗体的阳性率,我们发现 64%(95%CI51-78%)的 IgA 阳性,30%(95%CI13.1-46%)的 IgG 阳性。对于第二剂疫苗后母乳中 SARS-CoV-2 抗体的阳性率,我们发现 70%(95%CI55-86%)的 IgA 阳性,91%(95%CI80-103%)的 IgG 阳性。我们对全球发表的数据进行分析后发现,COVID-19 免疫接种后母乳中抗体的阳性率很高。需要进一步研究以确定 IgA 和 IgG 对 SARS-CoV-2 的阳性率在完全免疫接种后几个月是否持续存在,以及它们对婴儿预防 SARS-CoV-2 感染的影响。
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