Department of Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Int J Infect Dis. 2022 Sep;122:905-909. doi: 10.1016/j.ijid.2022.06.055. Epub 2022 Jul 5.
Vaccination is the best strategy against COVID-19. We aimed to determine antibodies against SARS-CoV-2 in breastmilk and serum of mothers vaccinated with the mRNA vaccine.
This prospective study included 18 lactating women vaccinated with the BNT162b2 vaccine. Serum and breastmilk were collected before the first dose (T0), at the second dose (T1), 3 weeks after the second dose (T2), and 6 months after the first dose (T3). Serum anti-SARS-CoV-2 Spike (S) Immunoglobulin G (IgG) and Immunoglobulin A (IgA) were measured using a semi-quantitative enzyme-linked immunosorbent assay (ELISA) and secretory antibody (s) IgG and IgA in breastmilk using quantitative analysis.
We detected serum anti-S IgG and IgA in all women after vaccination. Specific IgG and IgA were higher at T1, T2, and T3 compared with T0 (P <0.0001). Higher antibody levels were observed at T2 and lower values at T3 versus T2 (P = 0.007). After 6 months, all patients had serum IgG, but three of 18 (16%) had serum IgA. In breastmilk, sIgA was present at T1 and T2 and decreased after 6 months at T3 (P = 0.002). Breastmilk sIgG levels increased at T1 and T2 and peaked at T3 (P = 0.008).
Secretory antibodies were transmitted through breastmilk until 6 months after anti-COVID-19 mRNA vaccination. Protection of the newborn through breastfeeding needs to be addressed.
接种疫苗是应对 COVID-19 的最佳策略。我们旨在确定接种 mRNA 疫苗的母亲的母乳和血清中的 SARS-CoV-2 抗体。
这项前瞻性研究纳入了 18 名接种 BNT162b2 疫苗的哺乳期妇女。在第一剂（T0）前、第二剂（T1）时、第二剂后 3 周（T2）和第一剂后 6 个月（T3）采集血清和母乳。使用半定量酶联免疫吸附试验（ELISA）检测血清抗 SARS-CoV-2 刺突（S）免疫球蛋白 G（IgG）和免疫球蛋白 A（IgA），并使用定量分析检测母乳中的分泌抗体（s）IgG 和 IgA。
我们在所有接种疫苗的女性中均检测到血清抗 S IgG 和 IgA。与 T0 相比，T1、T2 和 T3 时特异性 IgG 和 IgA 更高（P<0.0001）。与 T2 相比，T3 时抗体水平更高，而与 T2 相比，T3 时抗体水平更低（P=0.007）。6 个月后，所有患者均有血清 IgG，但 18 例中有 3 例（16%）有血清 IgA。在母乳中，sIgA 在 T1 和 T2 时存在，并在 6 个月后的 T3 时下降（P=0.002）。sIgG 水平在 T1 和 T2 时升高，并在 T3 时达到峰值（P=0.008）。
抗 COVID-19 mRNA 疫苗接种后，通过母乳喂养可将分泌型抗体传递至 6 个月。需要解决通过母乳喂养保护新生儿的问题。
