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多地点观察性母婴 COVID-19 疫苗研究(MOMI-vax):研究方案。

Multi-site observational maternal and infant COVID-19 vaccine study (MOMI-vax): a study protocol.

机构信息

Departments of Pediatrics and Molecular Virology and Microbiology, Section of Infectious Diseases, Baylor College of Medicine, 1102 Bates St. Suite 1150, Houston, TX, 77030, USA.

Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, UPMC Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA, 15213, USA.

出版信息

BMC Pregnancy Childbirth. 2022 May 12;22(1):402. doi: 10.1186/s12884-022-04500-w.


DOI:10.1186/s12884-022-04500-w
PMID:35550037
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9096328/
Abstract

BACKGROUND: Pregnant women were excluded from investigational trials of COVID-19 vaccines. Limited data are available to inform pregnant and postpartum women on their decisions to receive a COVID-19 vaccine. METHODS: The goal of this observational, prospective cohort study is to evaluate the immunogenicity and safety of various Emergency Use Authorization (EUA) or licensed COVID-19 vaccines administered to pregnant or lactating women and describe the transplacental antibody transfer and kinetics of antibodies in mothers and infants. The study is adaptive, allowing additional groups to be added as new vaccines or vaccine regimens are authorized. Up to 20 clinical research institutions in the United States (U.S.) will be included. Approximately 200 pregnant women and 65 postpartum women will be enrolled per EUA or licensed COVID-19 vaccine formulation in the U.S. This study will include pregnant and postpartum women of all ages with and without chronic medical conditions. Their infants will be enrolled and followed beginning at birth in the pregnant cohort and beginning at the earliest possible time point in the postpartum cohort. Blood samples will be collected for immunogenicity outcomes and pregnancy and birth outcomes assessed among women and infants. Primary analyses will be descriptive and done by vaccine type and/or platform. DISCUSSION: Given the long-standing and legitimate challenges of enrolling pregnant individuals into clinical trials early in the vaccine development pipeline, this study protocol describes our current study and provides a template to inform the collection of data for pregnant individuals receiving COVID-19 or other vaccines. TRIAL REGISTRATION: NCT05031468 .

摘要

背景:新冠疫苗的临床试验排除了孕妇。目前仅有有限的数据可以为孕妇和产后女性提供关于接种新冠疫苗的决策依据。

方法:本观察性、前瞻性队列研究旨在评估在孕妇或哺乳期妇女中使用各种紧急使用授权(EUA)或已获许可的新冠疫苗的免疫原性和安全性,并描述抗体在母婴间的胎盘转移和动力学。该研究具有适应性,可根据新疫苗或疫苗方案的授权情况添加额外组别。美国将有多达 20 个临床研究机构参与。在美国,每种 EUA 或已许可的新冠疫苗制剂将招募约 200 名孕妇和 65 名产后女性。本研究将纳入所有年龄段的孕妇和产后女性,包括有和无慢性疾病的女性。她们的婴儿将在孕妇队列中从出生开始入组并进行随访,在产后队列中则从最早可能的时间点开始入组。将采集血样以评估免疫原性结局以及母婴的妊娠和分娩结局。主要分析将按疫苗类型和/或平台进行描述性分析。

讨论:鉴于在疫苗开发早期将孕妇纳入临床试验存在长期存在且合理的挑战,本研究方案描述了我们目前的研究,并为收集接受新冠或其他疫苗的孕妇个体的数据提供了模板。

试验注册:NCT05031468。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/383d/9097397/0966894cec0d/12884_2022_4500_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/383d/9097397/0966894cec0d/12884_2022_4500_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/383d/9097397/0966894cec0d/12884_2022_4500_Fig1_HTML.jpg

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[1]
Multi-site observational maternal and infant COVID-19 vaccine study (MOMI-vax): a study protocol.

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引用本文的文献

[1]
Enhanced D614G and Omicron Variants Antibody Persistence in Infants at 2 Months of Age Following Maternal mRNA Booster Vaccination During Pregnancy or Postpartum.

Pediatr Infect Dis J. 2024-11-1

[2]
Maternal COVID-19 Vaccination and Prevention of Symptomatic Infection in Infants.

Pediatrics. 2024-3-1

[3]
COVID-19 booster vaccination during pregnancy enhances maternal binding and neutralizing antibody responses and transplacental antibody transfer to the newborn.

Vaccine. 2023-8-14

[4]
An Update on COVID-19 Vaccination and Pregnancy.

J Pers Med. 2023-5-6

本文引用的文献

[1]
COVID-19 mRNA vaccines drive differential antibody Fc-functional profiles in pregnant, lactating, and nonpregnant women.

Sci Transl Med. 2021-10-27

[2]
Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. Reply.

N Engl J Med. 2021-7-15

[3]
The Advisory Committee on Immunization Practices' Interim Recommendation for Use of Pfizer-BioNTech COVID-19 Vaccine in Adolescents Aged 12-15 Years - United States, May 2021.

MMWR Morb Mortal Wkly Rep. 2021-5-21

[4]
Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women.

JAMA. 2021-6-15

[5]
Updated Recommendations from the Advisory Committee on Immunization Practices for Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients - United States, April 2021.

MMWR Morb Mortal Wkly Rep. 2021-4-30

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Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study.

JAMA Pediatr. 2021-8-1

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Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons.

N Engl J Med. 2021-6-17

[8]
SARS-CoV-2-Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women.

JAMA. 2021-5-18

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A systematic review of pregnant women with COVID-19 and their neonates.

Arch Gynecol Obstet. 2021-7

[10]
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MMWR Morb Mortal Wkly Rep. 2021-3-5

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