Abstract
BACKGROUND. The significant risks posed to mothers and fetuses by COVID-19 in pregnancy have sparked a worldwide debate surrounding the pros and cons of antenatal SARS-CoV-2 inoculation, as we lack sufficient evidence regarding vaccine effectiveness in pregnant women and their offspring. We aimed to provide substantial evidence for the effect of the BNT162b2 mRNA vaccine versus native infection on maternal humoral, as well as transplacentally acquired fetal immune response, potentially providing newborn protection. METHODS. A multicenter study where parturients presenting for delivery were recruited at 8 medical centers across Israel and assigned to 3 study groups: vaccinated (n = 86); PCR-confirmed SARS-CoV-2 infected during pregnancy (n = 65), and unvaccinated noninfected controls (n = 62). Maternal and fetal blood samples were collected from parturients prior to delivery and from the umbilical cord following delivery, respectively. Sera IgG and IgM titers were measured using the Milliplex MAP SARS-CoV-2 Antigen Panel (for S1, S2, RBD, and N). RESULTS. The BNT162b2 mRNA vaccine elicits strong maternal humoral IgG response (anti-S and RBD) that crosses the placenta barrier and approaches maternal titers in the fetus within 15 days following the first dose. Maternal to neonatal anti- COVID-19 antibodies ratio did not differ when comparing sensitization (vaccine vs. infection). IgG transfer ratio at birth was significantly lower for third-trimester as compared with second trimester infection. Lastly, fetal IgM response was detected in 5 neonates, all in the infected group. CONCLUSION. Antenatal BNT162b2 mRNA vaccination induces a robust maternal humoral response that effectively transfers to the fetus, supporting the role of vaccination during pregnancy.
| Original language | American English |
|---|---|
| Article number | e150319 |
| Journal | Journal of Clinical Investigation |
| Volume | 131 |
| Issue number | 13 |
| DOIs | |
| State | Published - Jul 2021 |
Bibliographical note
Funding Information:This work was supported by an Israeli Science Foundation KillCorona grant 3777/19 (to MN, MK, SY, AM) and by a research grant from the Weizmann Institute Fondazione Henry Krenter (to MN). We would like to thank the patients who made this research possible. We acknowledge the contribution in patient recruitment, sample preparation and discussions by Gila Meir, Leonardo Solmesky, and Nava Dekel (Weizmann Institute); Adva Cahen Peretz, Michal Lipschuetz, Nadine Souri, and Sarah M. Cohen (Hadassah Medical Center); Yasmin Farhadian and Hind Odeh (Wolfson Medical Center); Shalva Fux (HaEmek Medical Center); Alina Wiener and Luchilla Zorzetti (Hillel Yaffe Medical Center); Itamar Glick (Shaare Zedek Medical Center); and Avital Diamond and Yaara Hoffman (Meir Medical Center).
Funding Information:
This work was supported by an Israeli Science Foundation KillCo-rona grant 3777/19 (to MN, MK, SY, AM) and by a research grant from the Weizmann Institute Fondazione Henry Krenter (to MN). We would like to thank the patients who made this research possible. We acknowledge the contribution in patient recruitment, sample preparation and discussions by Gila Meir, Leonardo Solmesky, and Nava Dekel (Weizmann Institute); Adva Cahen Peretz, Michal Lipschuetz, Nadine Souri, and Sarah M. Cohen (Hadassah Medical Center); Yasmin Farhadian and Hind Odeh (Wolfson Medical Center); Shalva Fux (HaEmek Medical Center); Alina Wiener and Luchilla Zorzetti (Hillel Yaffe Medical Center); Itamar Glick (Shaare Zedek Medical Center); and Avital Diamond and Yaara Hoffman (Meir Medical Center).
Publisher Copyright:
© 2021, American Society for Clinical Investigation.
