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. 2023 Jul;162(1):154-162.
doi: 10.1002/ijgo.14648. Epub 2023 Jan 19.

Antibody response, neutralizing potency, and transplacental antibody transfer following SARS-CoV-2 infection versus mRNA-1273, BNT162b2 COVID-19 vaccination in pregnancy

Carolynn M Dude  1 , Naima T Joseph  2 , Alexandra D Forrest  1 , Hans P Verkerke  3 , Narayanaiah Cheedarla  4 , Sakthivel Govindaraj  4   5 , Les'Shon S Irby  1 , Kirk A Easley  6 , Alicia K Smith  1 , Sean R Stowell  3 , Andrew Neish  4 , Rama Rao Amara  4   5 , Denise J Jamieson  1 , Anne L Dunlop  1 , Martina L Badell  1 , Vijayakumar Velu  4   5
Affiliations

Antibody response, neutralizing potency, and transplacental antibody transfer following SARS-CoV-2 infection versus mRNA-1273, BNT162b2 COVID-19 vaccination in pregnancy

Carolynn M Dude et al. Int J Gynaecol Obstet. 2023 Jul.

Abstract

Objective: To improve our understanding of the immune response, including the neutralization antibody response, following COVID-19 vaccination in pregnancy.

Methods: This was a prospective cohort study comprising patients with PCR-confirmed SARS-CoV-2 infection and patients who received both doses of mRNA COVID-19 vaccine (mRNA-1273, BNT162b2) in pregnancy recruited from two hospitals in Atlanta, GA, USA. Maternal blood and cord blood at delivery were assayed for anti-receptor binding domain (RBD) IgG, IgA and IgM, and neutralizing antibody. The detection of antibodies, titers, and maternal to fetal transfer ratios were compared.

Results: Nearly all patients had detectable RBD-binding IgG in maternal and cord samples. The vaccinated versus infected cohort had a significantly greater proportion of cord samples with detectable neutralizing antibody (94% vs. 28%, P < 0.001) and significantly higher transfer ratios for RBD-specific IgG and neutralizing antibodies with a transfer efficiency of 105% (vs. 80%, P < 0.001) and 110% (vs. 90%, P < 0.001), respectively. There was a significant linear decline in maternal and cord blood RBD-specific IgG and neutralizing antibody titers as time from vaccination to delivery increased.

Conclusions: Those who receive the mRNA COVID-19 vaccine mount an immune response that is equivalent to-if not greater than-those naturally infected by SARS-CoV-2 during pregnancy.

Keywords: SARS-CoV-2; pregnancy; reproductive immunity; vaccine.

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References

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