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Does maternal immunity to SARS-CoV-2 protect against SARS-CoV-2 infection in infants under 12 months old in Scotland?

母亲对 SARS-CoV-2 的免疫力能否保护苏格兰 12 个月以下婴儿免受 SARS-CoV-2 感染？

基本信息

批准号：
MR/W030454/1
负责人：
Louisa Pollock
金额：
$ 31.54万
依托单位：
University of Glasgow
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2022
资助国家：
英国
起止时间：
2022 至无数据
项目状态：
未结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FW030454%2F1
关键词：
Does maternal immunity SARS CoV

项目摘要

COVID-19 disease in children is generally less severe than in adults, most children with the COVID-19 virus (SARS-CoV-2) have mild or no symptoms. However, among children with SARS-CoV-2 infection, younger infants are at greatest risk of severe illness.Current COVID-19 vaccines are not approved for use in children under 12 years old in the UK, and any future child vaccine programme would still not protect the very youngest infants. Maternal immunity to infection is important in protecting infants against infectious diseases, including tetanus, pertussis and influenza. Young babies can be protected by antibodies which pass from mother to baby through the placenta, or through breast-milk. In addition, if a mother is immune to a virus, she may be less likely to catch it and pass it on to her baby. We know that COVID-19 antibodies from mothers can be transferred to babies in the womb and in breast milk. We don't yet know how well those antibodies might protect infants against SARS-CoV-2 infection, or whether vaccinating mothers reduces the risk of infection in their babies. This added benefit would make vaccines more cost-effective, and might encourage more women to be vaccinated. As the pandemic continues, and the time between initial vaccination and pregnancy increases, this study might also help decide whether a booster vaccination in pregnant women would be useful. It would also help us predict how many infants might be infected over time as more mothers become immune.We want to know how effective maternal COVID-19 vaccines are in protecting infants against SARS-Cov-2 infection, and whether maternal COVID-19 immunity, from either vaccination or prior infection, can reduce the risk to babies. To answer these questions we will undertake two studies.The first study will include babies born in Scotland between 1st August 2021 and 31st July 2022. Using NHS surveillance data, we will identify which of these infants have laboratory-confirmed SARS-CoV-2 infection before their 1st birthday. Using birth, death, GP records and surveillance data, these infant "cases" will be matched to "controls", infants born within one week of the case, who did not have a positive SARS-CoV-2 test before their 1st birthday. We will then link these infants to maternal records, and use routinely collected NHS data, including maternity records, vaccination records, SARS-CoV-2 testing data, to compare the two groups. We aim to include all cases that year, matched to at least 4 controls. Our key objectives will be to compare the odds of maternal vaccination, or prior maternal COVID-19 infection, in infants with and without confirmed SARS-CoV-2 infection in the first year of life. We will also look at other factors which might change the risk of SARS-CoV-2 infection including gestation, maternal age, ethnicity, deprivation, and urban/rural location. In the second study, we will identify cases and controls as above, but limited to infants born within NHS Greater Glasgow & Clyde healthboard. Using blood left over from maternal antenatal screening for infectious diseases, we will be able to measure maternal COVID-19 antibody levels druing early pregnancy. We will aim to collect samples from mothers of 500 cases and 1000 controls. We will then determine whether the presence of maternal COVID-19 antibodies (either from vaccine or natural infection) is associated with reduced risk of infection in their infants.For both studies all patient-identifiable data will be managed within the NHS Safe Haven and use approved processes of pseudo-anonymisation to ensure patient data are kept private. Individual patients will not provide consent, but use of this data for public benefit will be approved by ethics and privacy committees.These studies will help us understand how maternal COVID-19 immunity can help protect infants. This will help us plan vaccine programmes, and help inform vaccine choices for women in Scotland and elsewhere.

儿童COVID-19疾病的严重程度通常低于成人，大多数感染COVID-19病毒（SARS-CoV-2）的儿童症状轻微或无症状。然而，在感染SARS-CoV-2的儿童中，年龄较小的婴儿患严重疾病的风险最大。目前的COVID-19疫苗在英国未被批准用于12岁以下的儿童，未来的任何儿童疫苗计划仍然无法保护最年幼的婴儿。母亲对感染的免疫力对于保护婴儿免受破伤风、百日咳和流感等传染病的侵害十分重要。幼儿可以通过胎盘或母乳从母亲传给婴儿的抗体来保护。此外，如果母亲对病毒有免疫力，她可能不太可能感染病毒并将其传给婴儿。我们知道，来自母亲的COVID-19抗体可以在子宫和母乳中转移给婴儿。我们还不知道这些抗体如何保护婴儿免受SARS-CoV-2感染，或者接种疫苗的母亲是否会降低婴儿感染的风险。这一额外的好处将使疫苗更具成本效益，并可能鼓励更多的妇女接种疫苗。随着大流行的持续，以及初次接种疫苗和怀孕之间的时间增加，这项研究也可能有助于决定孕妇加强接种疫苗是否有用。我们想知道母亲接种COVID-19疫苗对保护婴儿免受SARS-Cov-2感染的有效性如何，以及母亲接种COVID-19疫苗或先前感染的COVID-19免疫力是否可以降低婴儿的风险。为了回答这些问题，我们将进行两项研究。第一项研究将包括2021年8月1日至2022年7月31日期间在苏格兰出生的婴儿。使用NHS监测数据，我们将确定这些婴儿中哪些在1岁生日前有实验室确认的SARS-CoV-2感染。根据出生、死亡、全科医生记录和监测数据，这些婴儿“病例”将与“对照”相匹配，“对照”是在病例发生一周内出生的婴儿，他们在1岁生日前没有进行阳性SARS-CoV-2检测。然后，我们将这些婴儿与产妇记录联系起来，并使用常规收集的NHS数据，包括产妇记录，疫苗接种记录，SARS-CoV-2检测数据，来比较两组。我们的目标是包括当年的所有病例，与至少4个对照组相匹配。我们的主要目标将是比较母亲接种疫苗的几率，或先前的母亲COVID-19感染，在出生后第一年有和没有确诊的SARS-CoV-2感染的婴儿中。我们还将研究可能改变SARS-CoV-2感染风险的其他因素，包括妊娠、母亲年龄、种族、贫困和城市/农村位置。在第二项研究中，我们将如上所述确定病例和对照，但仅限于NHS大格拉斯哥和克莱德卫生局内出生的婴儿。利用孕妇产前传染病筛查留下的血液，我们将能够测量孕妇在怀孕早期的COVID-19抗体水平。我们的目标是从500例病例和1000例对照的母亲那里收集样本。然后，我们将确定母体COVID-19抗体（来自疫苗或自然感染）的存在是否与婴儿感染风险降低相关。对于这两项研究，所有患者可识别数据将在NHS安全港内管理，并使用经批准的伪匿名化流程，以确保患者数据保密。个别患者不会提供同意书，但将这些数据用于公共利益将得到伦理和隐私委员会的批准。这些研究将帮助我们了解母亲的COVID-19免疫力如何帮助保护婴儿。这将有助于我们规划疫苗计划，并帮助苏格兰和其他地方的妇女了解疫苗选择。