Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, and Texas Children's Hospital, Houston, TX 77030, United States.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98109, United States.
Vaccine. 2023 Aug 14;41(36):5296-5303. doi: 10.1016/j.vaccine.2023.06.032. Epub 2023 Jun 13.
The immune response to COVID-19 booster vaccinations during pregnancy for mothers and their newborns and the functional response of vaccine-induced antibodies against Omicron variants are not well characterized. We conducted a prospective, multicenter cohort study of participants vaccinated during pregnancy with primary or booster mRNA COVID-19 vaccines from July 2021 to January 2022 at 9 academic sites. We determined SARS-CoV-2 binding and live virus and pseudovirus neutralizing antibody (nAb) titers pre- and post-vaccination, and at delivery for both maternal and infant participants. Immune responses to ancestral and Omicron BA.1 SARS-CoV-2 strains were compared between primary and booster vaccine recipients in maternal sera at delivery and in cord blood, after adjusting for days since last vaccination. A total of 240 participants received either Pfizer or Moderna mRNA vaccine during pregnancy (primary 2-dose series: 167; booster dose: 73). Booster vaccination resulted in significantly higher binding and nAb titers, including to the Omicron BA.1 variant, in maternal serum at delivery and in cord blood compared to a primary 2-dose series (range 0.44-0.88 log higher, p < 0.0001 for all comparisons). Live virus nAb to Omicron BA.1 were present at delivery in 9 % (GMT ID50 12.7) of Pfizer and 22 % (GMT ID50 14.7) of Moderna primary series recipients, and in 73 % (GMT ID50 60.2) of mRNA boosted participants (p < 0.0001), although titers were significantly lower than to the D614G strain. Transplacental antibody transfer was efficient for all regimens with median transfer ratio range: 1.55-1.77 for IgG, 1.00-1.78 for live virus nAb and 1.79-2.36 for pseudovirus nAb. COVID-19 mRNA vaccination during pregnancy elicited robust immune responses in mothers and efficient transplacental antibody transfer to the newborn. A booster dose during pregnancy significantly increased maternal and cord blood binding and neutralizing antibody levels, including against Omicron BA.1. Findings support the use of a booster dose of COVID-19 vaccine during pregnancy.
在怀孕期间接种 COVID-19 加强针疫苗后，母体和新生儿对疫苗的免疫反应以及针对奥密克戎变异株的疫苗诱导抗体的功能反应尚未得到充分描述。我们在 9 个学术场所进行了一项前瞻性、多中心队列研究，研究对象为 2021 年 7 月至 2022 年 1 月期间在怀孕期间接种初级或加强型 mRNA COVID-19 疫苗的参与者。我们在接种疫苗前后以及产妇分娩时测定了母体和婴儿参与者的 SARS-CoV-2 结合和活病毒及假病毒中和抗体（nAb）滴度。在调整末次接种疫苗后的天数后，我们比较了母体血清中以及脐带血中初级和加强型疫苗接种者对原始和奥密克戎 BA.1 SARS-CoV-2 株的免疫反应。共有 240 名参与者在怀孕期间接受了辉瑞或 Moderna mRNA 疫苗接种（初级 2 剂系列：167 人；加强剂量：73 人）。与初级 2 剂系列相比，加强接种在分娩时的母体血清和脐带血中产生了更高的结合和 nAb 滴度，包括针对奥密克戎 BA.1 变异株的滴度（范围为 0.44-0.88 个 log 更高，所有比较的 p 值均<0.0001）。在接种原始疫苗的 Pfizer 组中有 9%（GMT ID50 12.7）和 Moderna 组中有 22%（GMT ID50 14.7）的产妇在分娩时存在针对奥密克戎 BA.1 的活病毒 nAb，而在接受 mRNA 加强接种的产妇中有 73%（GMT ID50 60.2）存在（p<0.0001），尽管滴度明显低于对 D614G 株的滴度。所有方案的胎盘抗体转移均有效，IgG 的中位数转移比范围为 1.55-1.77，活病毒 nAb 的中位数转移比范围为 1.00-1.78，假病毒 nAb 的中位数转移比范围为 1.79-2.36。怀孕期间接种 COVID-19 mRNA 疫苗可在母体中引发强烈的免疫反应，并有效地将抗体转移给新生儿。怀孕期间接种加强针可显著提高母体和脐带血中的结合和中和抗体水平，包括针对奥密克戎 BA.1 的抗体水平。这些发现支持在怀孕期间接种 COVID-19 疫苗加强针。
Am J Obstet Gynecol. 2023-1
NPJ Vaccines. 2025-8-13
Am J Obstet Gynecol MFM. 2023-2
MMWR Morb Mortal Wkly Rep. 2022-11-11
N Engl J Med. 2022-7-14
BMC Pregnancy Childbirth. 2022-5-12
Zotero 插件