The Effect of Gestational Age at BNT162b2 mRNA Vaccination on Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Levels

Amihai Rottenstreich; Gila Zarbiv; Esther Oiknine-Djian; Olesya Vorontsov; Roy Zigron; Geffen Kleinstern; Dana G. Wolf; Shay Porat

doi:10.1093/cid/ciac135

The Effect of Gestational Age at BNT162b2 mRNA Vaccination on Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Levels

Amihai Rottenstreich, Gila Zarbiv, Esther Oiknine-Djian, Olesya Vorontsov, Roy Zigron, Geffen Kleinstern, Dana G. Wolf, Shay Porat

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) during pregnancy and early infancy can result in severe disease. Evaluating the effect of gestational age at the time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination on maternal antibody levels and transplacental antibody transfer has important implications for maternal care and vaccination strategies. METHODS: Maternal and cord blood sera were collected from mother-newborn dyads (n = 402), following term delivery after antenatal 2-dose SARS-CoV-2 BNT162b2 mRNA vaccination. SARS-CoV-2 spike protein (S) and receptor binding domain (RBD)-specific IgG levels were evaluated in the samples collected. RESULTS: Median anti-S and anti-RBD-specific IgG levels in maternal sera at the time of delivery were lowest following first-trimester vaccination (n = 90; anti-S IgG: 76 AU/mL; anti-RBD-specific IgG: 478 AU/mL), intermediate in those vaccinated in the second trimester (n = 124; anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1263 AU/mL), and highest after third-trimester vaccination (n = 188; anti-S IgG: 240 AU/mL; anti-RBD-specific IgG: 5855 AU/mL). Antibody levels in neonatal sera followed a similar pattern and were lowest following antenatal vaccination in the first trimester (anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1140 AU/mL). In a subgroup of parturients vaccinated in the first trimester (n = 30), a third booster dose was associated with significantly higher maternal and neonatal antibody levels. CONCLUSIONS: These results suggest a considerable antibody waning throughout pregnancy in those vaccinated at early gestation. The observed boosting effect of a third vaccine dose hints at its potential benefit in those who completed the 2-dose vaccine series at early pregnancy or before conception. The impact of antenatal immunization timing on SARS-CoV-2 transplacental antibody transfer may influence neonatal seroprotection.

Original language	English
Pages (from-to)	e603
Journal	Clinical Infectious Diseases
Volume	75
Issue number	1
DOIs	https://doi.org/10.1093/cid/ciac135 https://doi.org/10.1093/cid/ciac135
State	Published - 24 Aug 2022
Externally published	Yes

Bibliographical note

M1 - (Rottenstreich A.; Zarbiv G.; Zigron R.; Porat S.) Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel

M1 - (Oiknine-Djian E.; Vorontsov O.; Wolf D.G.) Clinical virology unit, Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

M1 - (Kleinstern G.) School of Public Health, University of Haifa, Haifa, Israel

Keywords

article
conception
controlled study
coronavirus disease 2019
female
first trimester pregnancy
gene expression
gestational age
human
immunization
immunoglobulin blood level
major clinical study
maternal serum
newborn
nonhuman
passive immunization
pregnancy
protein domain
receptor binding
second trimester pregnancy
serology
Severe acute respiratory syndrome coronavirus 2
third trimester pregnancy
vaccination
endogenous compound
immunoglobulin G
messenger RNA
SARS-CoV-2 antibody
tozinameran
virus spike protein
COVID-19
SARS-CoV-2

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Rottenstreich, A., Zarbiv, G., Oiknine-Djian, E., Vorontsov, O., Zigron, R., Kleinstern, G., Wolf, D. G., & Porat, S. (2022). The Effect of Gestational Age at BNT162b2 mRNA Vaccination on Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Levels. Clinical Infectious Diseases, 75(1), e603. https://doi.org/10.1093/cid/ciac135, https://doi.org/10.1093/cid/ciac135

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abstract = "BACKGROUND: Coronavirus disease 2019 (COVID-19) during pregnancy and early infancy can result in severe disease. Evaluating the effect of gestational age at the time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination on maternal antibody levels and transplacental antibody transfer has important implications for maternal care and vaccination strategies. METHODS: Maternal and cord blood sera were collected from mother-newborn dyads (n = 402), following term delivery after antenatal 2-dose SARS-CoV-2 BNT162b2 mRNA vaccination. SARS-CoV-2 spike protein (S) and receptor binding domain (RBD)-specific IgG levels were evaluated in the samples collected. RESULTS: Median anti-S and anti-RBD-specific IgG levels in maternal sera at the time of delivery were lowest following first-trimester vaccination (n = 90; anti-S IgG: 76 AU/mL; anti-RBD-specific IgG: 478 AU/mL), intermediate in those vaccinated in the second trimester (n = 124; anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1263 AU/mL), and highest after third-trimester vaccination (n = 188; anti-S IgG: 240 AU/mL; anti-RBD-specific IgG: 5855 AU/mL). Antibody levels in neonatal sera followed a similar pattern and were lowest following antenatal vaccination in the first trimester (anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1140 AU/mL). In a subgroup of parturients vaccinated in the first trimester (n = 30), a third booster dose was associated with significantly higher maternal and neonatal antibody levels. CONCLUSIONS: These results suggest a considerable antibody waning throughout pregnancy in those vaccinated at early gestation. The observed boosting effect of a third vaccine dose hints at its potential benefit in those who completed the 2-dose vaccine series at early pregnancy or before conception. The impact of antenatal immunization timing on SARS-CoV-2 transplacental antibody transfer may influence neonatal seroprotection.",

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author = "Amihai Rottenstreich and Gila Zarbiv and Esther Oiknine-Djian and Olesya Vorontsov and Roy Zigron and Geffen Kleinstern and Wolf, {Dana G.} and Shay Porat",

note = "M1 - (Rottenstreich A.; Zarbiv G.; Zigron R.; Porat S.) Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel M1 - (Oiknine-Djian E.; Vorontsov O.; Wolf D.G.) Clinical virology unit, Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel M1 - (Kleinstern G.) School of Public Health, University of Haifa, Haifa, Israel",

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month = aug,

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doi = "10.1093/cid/ciac135",

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Rottenstreich, A, Zarbiv, G, Oiknine-Djian, E, Vorontsov, O, Zigron, R, Kleinstern, G, Wolf, DG & Porat, S 2022, 'The Effect of Gestational Age at BNT162b2 mRNA Vaccination on Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Levels', Clinical Infectious Diseases, vol. 75, no. 1, pp. e603. https://doi.org/10.1093/cid/ciac135, https://doi.org/10.1093/cid/ciac135

TY - JOUR

T1 - The Effect of Gestational Age at BNT162b2 mRNA Vaccination on Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Levels

AU - Rottenstreich, Amihai

AU - Zarbiv, Gila

AU - Oiknine-Djian, Esther

AU - Vorontsov, Olesya

AU - Zigron, Roy

AU - Kleinstern, Geffen

AU - Wolf, Dana G.

AU - Porat, Shay

N1 - M1 - (Rottenstreich A.; Zarbiv G.; Zigron R.; Porat S.) Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel M1 - (Oiknine-Djian E.; Vorontsov O.; Wolf D.G.) Clinical virology unit, Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel M1 - (Kleinstern G.) School of Public Health, University of Haifa, Haifa, Israel

PY - 2022/8/24

Y1 - 2022/8/24

N2 - BACKGROUND: Coronavirus disease 2019 (COVID-19) during pregnancy and early infancy can result in severe disease. Evaluating the effect of gestational age at the time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination on maternal antibody levels and transplacental antibody transfer has important implications for maternal care and vaccination strategies. METHODS: Maternal and cord blood sera were collected from mother-newborn dyads (n = 402), following term delivery after antenatal 2-dose SARS-CoV-2 BNT162b2 mRNA vaccination. SARS-CoV-2 spike protein (S) and receptor binding domain (RBD)-specific IgG levels were evaluated in the samples collected. RESULTS: Median anti-S and anti-RBD-specific IgG levels in maternal sera at the time of delivery were lowest following first-trimester vaccination (n = 90; anti-S IgG: 76 AU/mL; anti-RBD-specific IgG: 478 AU/mL), intermediate in those vaccinated in the second trimester (n = 124; anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1263 AU/mL), and highest after third-trimester vaccination (n = 188; anti-S IgG: 240 AU/mL; anti-RBD-specific IgG: 5855 AU/mL). Antibody levels in neonatal sera followed a similar pattern and were lowest following antenatal vaccination in the first trimester (anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1140 AU/mL). In a subgroup of parturients vaccinated in the first trimester (n = 30), a third booster dose was associated with significantly higher maternal and neonatal antibody levels. CONCLUSIONS: These results suggest a considerable antibody waning throughout pregnancy in those vaccinated at early gestation. The observed boosting effect of a third vaccine dose hints at its potential benefit in those who completed the 2-dose vaccine series at early pregnancy or before conception. The impact of antenatal immunization timing on SARS-CoV-2 transplacental antibody transfer may influence neonatal seroprotection.

AB - BACKGROUND: Coronavirus disease 2019 (COVID-19) during pregnancy and early infancy can result in severe disease. Evaluating the effect of gestational age at the time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination on maternal antibody levels and transplacental antibody transfer has important implications for maternal care and vaccination strategies. METHODS: Maternal and cord blood sera were collected from mother-newborn dyads (n = 402), following term delivery after antenatal 2-dose SARS-CoV-2 BNT162b2 mRNA vaccination. SARS-CoV-2 spike protein (S) and receptor binding domain (RBD)-specific IgG levels were evaluated in the samples collected. RESULTS: Median anti-S and anti-RBD-specific IgG levels in maternal sera at the time of delivery were lowest following first-trimester vaccination (n = 90; anti-S IgG: 76 AU/mL; anti-RBD-specific IgG: 478 AU/mL), intermediate in those vaccinated in the second trimester (n = 124; anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1263 AU/mL), and highest after third-trimester vaccination (n = 188; anti-S IgG: 240 AU/mL; anti-RBD-specific IgG: 5855 AU/mL). Antibody levels in neonatal sera followed a similar pattern and were lowest following antenatal vaccination in the first trimester (anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1140 AU/mL). In a subgroup of parturients vaccinated in the first trimester (n = 30), a third booster dose was associated with significantly higher maternal and neonatal antibody levels. CONCLUSIONS: These results suggest a considerable antibody waning throughout pregnancy in those vaccinated at early gestation. The observed boosting effect of a third vaccine dose hints at its potential benefit in those who completed the 2-dose vaccine series at early pregnancy or before conception. The impact of antenatal immunization timing on SARS-CoV-2 transplacental antibody transfer may influence neonatal seroprotection.

KW - article

KW - conception

KW - controlled study

KW - coronavirus disease 2019

KW - female

KW - first trimester pregnancy

KW - gene expression

KW - gestational age

KW - human

KW - immunization

KW - immunoglobulin blood level

KW - major clinical study

KW - maternal serum

KW - newborn

KW - nonhuman

KW - passive immunization

KW - pregnancy

KW - protein domain

KW - receptor binding

KW - second trimester pregnancy

KW - serology

KW - Severe acute respiratory syndrome coronavirus 2

KW - third trimester pregnancy

KW - vaccination

KW - endogenous compound

KW - immunoglobulin G

KW - messenger RNA

KW - SARS-CoV-2 antibody

KW - tozinameran

KW - virus spike protein

KW - COVID-19

KW - SARS-CoV-2

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DO - 10.1093/cid/ciac135

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SN - 1537-6591

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The Effect of Gestational Age at BNT162b2 mRNA Vaccination on Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Levels

Abstract

Bibliographical note

Keywords

UN SDGs

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