Reduced maternal immunity and vertical transfer of immunity against SARS-CoV-2 variants of concern with COVID-19 exposure or initial vaccination in pregnancy.
Reduced maternal immunity and vertical transfer of immunity against SARS-CoV-2 variants of concern with COVID-19 exposure or initial vaccination in pregnancy.
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DOI：
10.3389/fimmu.2023.1216410
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发表时间：
2023
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
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作者：
随着SARS-CoV-2大流行的继续发展，我们面临着新的令人担忧的变异，同时疫苗加强剂的吸收也在下降。我们的目的是评估妊娠期原始SARS-CoV-2 mRNA疫苗系列与妊娠期SARS-CoV-2暴露对最近关注的变体的免疫力差异。这是对先前从2021年2月至2021年8月期间分娩的192名患者中收集的样本进行的回顾性分析。参与者被分类为1）COVID疫苗：怀孕期间的mRNA疫苗，2）COVID暴露，3）对照。主要结果是队列之间对野生型、Delta和Omron-B1的中和能力。次要结果包括脐带血ID 50的比较以及通过脐带血测量的垂直转移效率：每种变体的母血ID 50。与COVID-19疾病暴露和对照组相比，接种COVID-19疫苗的孕妇的IgG滴度峰值更大。COVID暴露和疫苗接种均导致对Delta的免疫力，但仅COVID疫苗接种导致Omicron ID-50显著高于对照组。新生儿血清的中和能力低于其母亲，与对照或COVID暴露相比，COVID疫苗接种显示出与野生型和Delta变体相比更高的脐带血ID 50，但与对照相比，COVID暴露和疫苗接种均未显示脐带血中Omicron ID 50显著更高。对于野生型和Delta，与COVID-19暴露相比，COVID疫苗接种的脐带血：母体血液ID 50分别增加0.20（0.07-0.33，p=0.004）和0.12（0.0-0.24，p=0.05）。在成对比较中，中和能力的垂直转移（脐带血：母血ID 50）对于野生型最大，对于Delta和Omicron ID 50逐渐降低。与野生型相比，初始mRNA疫苗接种系列或COVID暴露的妊娠患者表现出对新变体的免疫力降低，如非妊娠个体所报告的那样;然而，COVID疫苗接种系列为妊娠女性提供了更大的交叉变体免疫力，特别是针对Omicron，而不是COVID疾病。接种COVID疫苗的人与COVID疾病暴露的人相比，免疫力的垂直转移更大，但随着进行性变异而减少。我们的结果强化了怀孕期间二价加强疫苗接种对于孕产妇和婴儿保护的重要性，并为在更新疫苗上市后接受更新疫苗提供了依据。
As 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. This 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. Pregnant 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. Pregnant 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.
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DOI：
10.15585/mmwr.mm6944e3
发表时间：
2020-11-06
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Zambrano LD;Ellington S;Strid P;Galang RR;Oduyebo T;Tong VT;Woodworth KR;Nahabedian JF 3rd;Azziz-Baumgartner E;Gilboa SM;Meaney-Delman D;CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team
通讯作者：
CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team
DOI：
10.15585/mmwr.mm6944e2
发表时间：
2020-11-06
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Woodworth KR;Olsen EO;Neelam V;Lewis EL;Galang RR;Oduyebo T;Aveni K;Yazdy MM;Harvey E;Longcore ND;Barton J;Fussman C;Siebman S;Lush M;Patrick PH;Halai UA;Valencia-Prado M;Orkis L;Sowunmi S;Schlosser L;Khuwaja S;Read JS;Hall AJ;Meaney-Delman D;Ellington SR;Gilboa SM;Tong VT;CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team;COVID-19 Pregnancy and Infant Linked Outcomes Team (PILOT)
通讯作者：
COVID-19 Pregnancy and Infant Linked Outcomes Team (PILOT)
影响因子：
26.1
作者：
Villar J;Ariff S;Gunier RB;Thiruvengadam R;Rauch S;Kholin A;Roggero P;Prefumo F;do Vale MS;Cardona-Perez JA;Maiz N;Cetin I;Savasi V;Deruelle P;Easter SR;Sichitiu J;Soto Conti CP;Ernawati E;Mhatre M;Teji JS;Liu B;Capelli C;Oberto M;Salazar L;Gravett MG;Cavoretto PI;Nachinab VB;Galadanci H;Oros D;Ayede AI;Sentilhes L;Bako B;Savorani M;Cena H;García-May PK;Etuk S;Casale R;Abd-Elsalam S;Ikenoue S;Aminu MB;Vecciarelli C;Duro EA;Usman MA;John-Akinola Y;Nieto R;Ferrazi E;Bhutta ZA;Langer A;Kennedy SH;Papageorghiou AT
通讯作者：
Papageorghiou AT
影响因子：
7.1
作者：
Saccone, Gabriele;Sen, Cihat;D'Antonio, Francesco
通讯作者：
D'Antonio, Francesco
影响因子：
120.7
作者：
Collier, Ai-ris Y.;McMahan, Katherine;Barouch, Dan H.
通讯作者：
Barouch, Dan H.