tetano
Editor, Senior Moderator
Pediatrics
. 2024 Feb 9:e2023064252.
doi: 10.1542/peds.2023-064252. Online ahead of print. Maternal COVID-19 Vaccination and Prevention of Symptomatic Infection in Infants
Cristina V Cardemil[SUP] 1 [/SUP], Yi Cao[SUP] 2 [/SUP], Christine M Posavad[SUP] 2 [/SUP], Martina L Badell[SUP] 3 [/SUP], Katherine Bunge[SUP] 4 [/SUP], Mark J Mulligan[SUP] 5 [/SUP], Lalitha Parameswaran[SUP] 5 [/SUP], Courtney Olson-Chen[SUP] 6 [/SUP], Richard M Novak[SUP] 7 [/SUP], Rebecca C Brady[SUP] 8 [/SUP], Emily DeFranco[SUP] 8 [/SUP], Jeffrey S Gerber[SUP] 9 [/SUP], Marcela Pasetti[SUP] 10 [/SUP], Mallory Shriver[SUP] 10 [/SUP], Rhea Coler[SUP] 11 [/SUP], Bryan Berube[SUP] 11 [/SUP], Mehul S Suthar[SUP] 12 [/SUP], Alberto Moreno[SUP] 12 [/SUP], Fei Gao[SUP] 2 [/SUP], Barbra A Richardson[SUP] 13 [/SUP], Richard Beigi[SUP] 4 [/SUP], Elizabeth Brown[SUP] 13 [/SUP], Kathleen M Neuzil[SUP] 10 [/SUP], Flor M Munoz[SUP] 14 [/SUP]; MOMI-Vax Study Group
Affiliations
Background and objectives: Maternal vaccination may prevent infant coronavirus disease 2019 (COVID-19). We aimed to quantify protection against infection from maternally derived vaccine-induced antibodies in the first 6 months of an infant's life.
Methods: Infants born to mothers vaccinated during pregnancy with 2 or 3 doses of a messenger RNA COVID-19 vaccine (nonboosted or boosted, respectively) had full-length spike (Spike) immunoglobulin G (IgG), pseudovirus 614D, and live virus D614G, and omicron BA.1 and BA.5 neutralizing antibody (nAb) titers measured at delivery. Infant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was determined by verified maternal-report and laboratory confirmation through prospective follow-up to 6 months of age between December 2021 and July 2022. The risk reduction for infection by dose group and antibody titer level was estimated in separate models.
Results: Infants of boosted mothers (n = 204) had significantly higher Spike IgG, pseudovirus, and live nAb titers at delivery than infants of nonboosted mothers (n = 271), and were 56% less likely to acquire infection in the first 6 months (P = .03). Irrespective of boost, for each 10-fold increase in Spike IgG titer at delivery, the infant's risk of acquiring infection was reduced by 47% (95% confidence interval 8%-70%; P = .02). Similarly, a 10-fold increase in pseudovirus titers against Wuhan Spike, and live virus nAb titers against D614G, and omicron BA.1 and BA.5 at delivery were associated with a 30%, 46%, 56%, and 60% risk reduction, respectively.
Conclusions: Higher transplacental binding and nAb titers substantially reduced the risk of SARS-CoV-2 infection in infants, and a booster dose amplified protection during a period of omicron predominance. Until infants are age-eligible for vaccination, maternal vaccination provides passive protection against symptomatic infection during early infancy.
. 2024 Feb 9:e2023064252.
doi: 10.1542/peds.2023-064252. Online ahead of print. Maternal COVID-19 Vaccination and Prevention of Symptomatic Infection in Infants
Cristina V Cardemil[SUP] 1 [/SUP], Yi Cao[SUP] 2 [/SUP], Christine M Posavad[SUP] 2 [/SUP], Martina L Badell[SUP] 3 [/SUP], Katherine Bunge[SUP] 4 [/SUP], Mark J Mulligan[SUP] 5 [/SUP], Lalitha Parameswaran[SUP] 5 [/SUP], Courtney Olson-Chen[SUP] 6 [/SUP], Richard M Novak[SUP] 7 [/SUP], Rebecca C Brady[SUP] 8 [/SUP], Emily DeFranco[SUP] 8 [/SUP], Jeffrey S Gerber[SUP] 9 [/SUP], Marcela Pasetti[SUP] 10 [/SUP], Mallory Shriver[SUP] 10 [/SUP], Rhea Coler[SUP] 11 [/SUP], Bryan Berube[SUP] 11 [/SUP], Mehul S Suthar[SUP] 12 [/SUP], Alberto Moreno[SUP] 12 [/SUP], Fei Gao[SUP] 2 [/SUP], Barbra A Richardson[SUP] 13 [/SUP], Richard Beigi[SUP] 4 [/SUP], Elizabeth Brown[SUP] 13 [/SUP], Kathleen M Neuzil[SUP] 10 [/SUP], Flor M Munoz[SUP] 14 [/SUP]; MOMI-Vax Study Group
Affiliations
- PMID: 38332733
- DOI: 10.1542/peds.2023-064252
Background and objectives: Maternal vaccination may prevent infant coronavirus disease 2019 (COVID-19). We aimed to quantify protection against infection from maternally derived vaccine-induced antibodies in the first 6 months of an infant's life.
Methods: Infants born to mothers vaccinated during pregnancy with 2 or 3 doses of a messenger RNA COVID-19 vaccine (nonboosted or boosted, respectively) had full-length spike (Spike) immunoglobulin G (IgG), pseudovirus 614D, and live virus D614G, and omicron BA.1 and BA.5 neutralizing antibody (nAb) titers measured at delivery. Infant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was determined by verified maternal-report and laboratory confirmation through prospective follow-up to 6 months of age between December 2021 and July 2022. The risk reduction for infection by dose group and antibody titer level was estimated in separate models.
Results: Infants of boosted mothers (n = 204) had significantly higher Spike IgG, pseudovirus, and live nAb titers at delivery than infants of nonboosted mothers (n = 271), and were 56% less likely to acquire infection in the first 6 months (P = .03). Irrespective of boost, for each 10-fold increase in Spike IgG titer at delivery, the infant's risk of acquiring infection was reduced by 47% (95% confidence interval 8%-70%; P = .02). Similarly, a 10-fold increase in pseudovirus titers against Wuhan Spike, and live virus nAb titers against D614G, and omicron BA.1 and BA.5 at delivery were associated with a 30%, 46%, 56%, and 60% risk reduction, respectively.
Conclusions: Higher transplacental binding and nAb titers substantially reduced the risk of SARS-CoV-2 infection in infants, and a booster dose amplified protection during a period of omicron predominance. Until infants are age-eligible for vaccination, maternal vaccination provides passive protection against symptomatic infection during early infancy.