Williams Caitlin A, Murphy Elisabeth A, Gross Mackensie, Herbek Savannah, Mohammed Iman, Sukhu Ashley C, Salvatore Christine M, Prabhu Malavika, Johnston Carrie D, Riley Laura E, Permar Sallie R, Yang Yawei J
Division of Infectious Disease, Department of Pediatrics, Weill Cornell Medicine, New York, New York, USA.
Department of Pathology & Laboratory Medicine, Weill Cornell Medicine/New York Presbyterian, New York, New York, USA.
J Pediatric Infect Dis Soc. 2025 Jun 16;14(6). doi: 10.1093/jpids/piae086.
SARS-CoV-2 mRNA-LNP immunizations significantly reduce severe coronavirus disease 2019 (COVID-19) disease and have been widely administered throughout the world including those who are pregnant and postpartum. However, our understanding of the immune response within the context of pregnancy and breastfeeding, especially the antibody kinetics and function within the breast milk compartment, is limited. To address this gap, we studied longitudinal blood and breast milk samples from lactating women throughout the primary immunization schedule and for several months after. The overarching goal of this study is to delineate the antibody kinetics, binding breadth, and neutralization capacity of SARS-CoV-2 mRNA-LNP vaccine-elicited antibodies within the breast milk compartment and compare to that in serum.
We enrolled 13 participants prior to receiving SARS-CoV-2 immunization. We measured anti-SARS-CoV-2 Spike IgG or IgA in serum and self-collected breast milk in participants over a 6-month period. Breast milk was processed by removing lipids and cellular debris by cold centrifugation, and skim milk was then filtered for binding antibody multiplexed assays and neutralization assays.
Postpartum immunization with a SARS-CoV-2 mRNA-LNP vaccine elicits a robust IgG response and moderate IgA response in serum, which is transferred to breast milk. Serum was able to neutralize pseudovirus after completion of the vaccine schedule. These responses persisted for several months predominantly in persons with a potential history of SARS-CoV-2 infection.
Immunization elicits persistent anti-SARS-CoV-2 breast milk antibody responses. We found that hybrid immune individuals had enhanced neutralization and anti-Spike IgG in breast milk and serum. The impact of breast milk antibody on infant anto-SARS-CoV-2 immune responses requires further study.
严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）信使核糖核酸-脂质纳米颗粒（mRNA-LNP）疫苗接种可显著降低2019冠状病毒病（COVID-19）的重症发生率，并且已在全球广泛接种，包括孕妇和产后妇女。然而，我们对孕期和哺乳期的免疫反应，尤其是母乳中的抗体动力学和功能的了解有限。为填补这一空白，我们研究了哺乳期妇女在整个初次免疫接种计划期间及之后数月的纵向血液和母乳样本。本研究的总体目标是描绘母乳中SARS-CoV-2 mRNA-LNP疫苗诱导抗体的抗体动力学、结合广度和中和能力，并与血清中的情况进行比较。
我们在13名参与者接受SARS-CoV-2免疫接种前将其纳入研究。我们在6个月的时间里测量了参与者血清和自行采集的母乳中抗SARS-CoV-2刺突蛋白IgG或IgA的水平。母乳经冷离心去除脂质和细胞碎片进行处理，然后对脱脂乳进行过滤，用于结合抗体多重检测和中和检测。
产后接种SARS-CoV-2 mRNA-LNP疫苗可在血清中引发强烈的IgG反应和中等程度的IgA反应，这些反应会转移至母乳中。完成疫苗接种计划后，血清能够中和假病毒。这些反应在有SARS-CoV-2感染潜在病史的人群中持续了数月。
免疫接种可引发持续的抗SARS-CoV-2母乳抗体反应。我们发现混合免疫个体的母乳和血清中的中和能力及抗刺突蛋白IgG有所增强。母乳抗体对婴儿抗SARS-CoV-2免疫反应的影响需要进一步研究。
