Reduced maternal immunity and vertical transfer of immunity against SARS-CoV-2 variants of concern with COVID-19 exposure or initial vaccination in pregnancy

Frontiers in Immunology

Immunology

Sidhartha Chaudhury¹  Rupsa C. Boelig²  Zubair H. Aghai³  Elke Bergmann-Leitner⁴  Sandra Mayer⁵  Jocelyn King⁵  Gregory D. Gromowski⁵ 

[1] Center for Enabling Capabilities, Walter Reed Army Institute of Research, Silver Spring, MD, United States;Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States;Department of Pharmacology, Physiology, and Cancer Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States;Division of Neonatology, Department of Pediatrics, Nemours, Philadelphia, PA, United States;Immunology Core, Biologics Research & Development, Walter Reed Army Institute of Research, Silver Spring, MD, United States;Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States;

关键词: COVID-19;    COVID vaccine;    SARS-CoV-2, pregnancy;    variants of concern;    maternal immunity;    neonatal immunity;   

DOI  :  10.3389/fimmu.2023.1216410

 received in 2023-05-03, accepted in 2023-08-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionAs the SARS-CoV-2 pandemic continues to evolve, we face new variants of concern with a concurrent decline in vaccine booster uptake. We aimed to evaluate the difference in immunity gained from the original SARS-CoV-2 mRNA vaccine series in pregnancy versus SARS-CoV-2 exposure during pregnancy against recent variants of concern.Study DesignThis is a retrospective analysis of previously collected samples from 192 patients who delivered between February 2021 and August 2021. Participants were categorized as 1) COVID vaccine: mRNA vaccine in pregnancy, 2) COVID-exposed, and 3) controls. The primary outcome was neutralizing capacity against wild-type, Delta, and Omicron-B1 between cohorts. Secondary outcomes include a comparison of cord-blood ID50 as well as the efficiency of vertical transfer, measured by cord-blood:maternal blood ID50 for each variant.ResultsPregnant women with COVID-19 vaccination had a greater spike in IgG titers compared to both those with COVID-19 disease exposure and controls. Both COVID exposure and vaccination resulted in immunity against Delta, but only COVID vaccination resulted in significantly greater Omicron ID-50 versus controls. The neutralizing capacity of serum from newborns was lower than that of their mothers, with COVID-vaccination demonstrating higher cord-blood ID50 vs wildtype and Delta variants compared to control or COVID-exposed, but neither COVID-exposure nor vaccination demonstrated significantly higher Omicron ID50 in cord-blood compared to controls. There was a 0.20 (0.07-0.33, p=0.004) and 0.12 (0.0-0.24, p=0.05) increase in cord-blood:maternal blood ID50 with COVID vaccination compared to COVID-19 exposure for wild-type and Delta respectively. In pair-wise comparison, vertical transfer of neutralization capacity (cord-blood:maternal blood ID50) was greatest for wild-type and progressively reduced for Delta and Omicron ID50.ConclusionPregnant patients with either an initial mRNA vaccination series or COVID-exposure demonstrated reduced immunity against newer variants compared to wild-type as has been reported for non-pregnant individuals; however, the COVID-vaccination series afforded greater cross-variant immunity to pregnant women, specifically against Omicron, than COVID-disease. Vertical transfer of immunity is greater in those with COVID vaccination vs COVID disease exposure but is reduced with progressive variants. Our results reinforce the importance of bivalent booster vaccination in pregnancy for both maternal and infant protection and also provide a rationale for receiving updated vaccines as they become available.

【 授权许可】

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Copyright © 2023 Boelig, Chaudhury, Gromowski, Mayer, King, Aghai and Bergmann-Leitner