Is the Immunization of Pregnant Women against COVID-19 Justified?
Is the Immunization of Pregnant Women against COVID-19 Justified?
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DOI：
10.3390/vaccines9090970
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发表时间：
2021-08-30
期刊：
影响因子：
7.8
通讯作者：
Esposito S
中科院分区：
文献类型：
--
作者：
Principi N;Esposito S
针对某些传染病的孕产妇免疫接种可为妇女提供重大优势，预防孕产妇发病率和死亡率，或为后代提供预防胎儿疾病和给予新生儿被动免疫的优势。最近，已经计划、启动并在某些情况下完成了专门评估一些现有的新冠肺炎疫苗在孕妇和哺乳期妇女中的免疫原性、安全性和耐受性的临床试验。本文讨论了孕妇接种新冠肺炎是否合理，并介绍了对这些受试者使用新冠肺炎基因疫苗的免疫原性和安全性的知识。最近的研究结果表明，与同龄的非孕妇相比，孕妇患严重疾病的风险更高。用mRNA疫苗进行的研究表明，这些预防措施在孕妇和同龄非孕妇中的免疫原性、安全性和耐受性没有差异。此外，抗体可以有效地通过胎盘转移，并可以在母乳中检测到，这表明有可能预防儿童的感染。所有这些发现都授权在孕妇中使用信使核糖核酸疫苗来保护母亲和孩子。然而，需要进行更大样本量的进一步研究，并对在不同孕期接种疫苗的孕妇及其子女进行随访，以更好地描述孕妇的免疫反应，确定何时应接种这些疫苗以获得最佳保护，并衡量疫苗对母亲和婴儿对病毒变异的效力。基于不同技术平台的新冠肺炎疫苗目前不能使用，应该澄清它们在孕妇中的作用。
Maternal immunization against some infectious diseases can offer significant advantages for women, preventing maternal morbidity and mortality, or for offspring, preventing fetal disease and conferring passive immunity to neonates. Recently, clinical trials specifically to evaluate the immunogenicity, safety, and tolerability of some of the available coronavirus disease 2019 (COVID-19) vaccines in pregnant and lactating women have been planned, initiated and, in some cases, completed. This paper discusses whether the immunization of pregnant women against COVID-19 is justified and presents knowledge about the immunogenicity and safety of mRNA COVID-19 vaccines for these subjects. The results of recent studies indicate that pregnant women are at increased risk of developing severe disease compared with nonpregnant women of the same age. Studies carried out with mRNA vaccines indicate that the immunogenicity, safety and tolerability of these preventive measures in pregnant women are not different from those in nonpregnant women of the same age. Moreover, antibodies are efficiently transferred through the placenta and can be detected in breastmilk, suggesting a potential prevention of infection in the child. All these findings authorize the use of mRNA vaccines in pregnant women to protect both the mother and the child. However, further studies with larger sample size and with follow-up of the pregnant women vaccinated during different periods of pregnancy and their children are needed to better characterize the immune response of pregnant women, to define when these vaccines should be administered to obtain the best protection, and to measure vaccine efficacy against virus variants in both mothers and infants. COVID-19 vaccines based on different technological platforms cannot presently be used, and their role in pregnant women should be clarified.
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