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Maternal Preconception COVID-19 Vaccination and Its Protective Effect on Infants after a Breakthrough Infection
Yuting Yang1, Jie Hu2,3, Haijun Deng2
1National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400015, China.
Insights
Maternal preconception COVID-19 vaccination and infection during pregnancy provide infants with significant antibody protection. This protection, primarily IgG1, wanes over four months but offers crucial early immunity.
Area of Science:
- Immunology
- Maternal-fetal medicine
- Vaccinology
Background:
- Transplacental transfer of maternal antibodies is vital for infant immunity.
- Evaluating the impact of maternal preconception COVID-19 vaccination on infant protection is crucial.
Purpose of the Study:
- To assess the protective effect of maternal preconception COVID-19 vaccination on infants.
- To analyze antibody titers and cross-neutralizing activity in infants born to vaccinated mothers.
Main Methods:
- Prospective cohort study conducted from July 2022 to April 2023 in Chongqing, China.
- Included infants born to mothers with preconception COVID-19 vaccination and/or SARS-CoV-2 infection during pregnancy.
- Measured SARS-CoV-2 immunoglobulin G (IgG) titers and cross-neutralizing activity against variants.
Main Results:
- Infants born to mothers with both preconception vaccination and breakthrough infection had the highest antibody titers.
- Transplacental antibody transmission decreased with infant age, persisting for approximately four months.
- IgG1 was the predominant antibody subclass, showing a positive correlation with overall IgG titers.
Conclusions:
- Maternal preconception COVID-19 vaccination is a promising strategy for infant postnatal protection.
- Vaccination is recommended for women planning pregnancy or who are pregnant to enhance infant immunity.
- Promoting vaccination among eligible women is essential for public health.
Background And Aims:
The transplacental vertical transfer of maternal antibodies was determined to be a crucial factor in conferring protective immunity to infants following delivery, and this study aimed to evaluate the protective effect of maternal preconception COVID-19 vaccination on infants.
Methods:
A prospective cohort study was conducted at the National Clinical Medical Research Center for Child Health and Diseases in Chongqing, China, spanning from July 2022 to April 2023. The study included infants from mothers with a preconception COVID-19 vaccination and (or) a SARS-CoV-2 infection during pregnancy. Titers of SARS-CoV-2 immunoglobulin G (IgG) and cross-neutralizing activity against SARS-CoV-2 variants were detected.
Results:
In this cohort study comprising 158 infants, it was observed that infants born to mothers who experienced a pregnancy-related breakthrough infection following a preconception vaccination had the highest titers of SARS-CoV-2 IgG and cross-neutralizing antibody activity against different variants compared to those with either of these factors alone. The transplacental vertical transmission of anti-SARS-CoV-2 antibodies decreased significantly with increasing age, from 3.16 ODs at birth to 2.29 ODs at two months, and persisted for approximately four months after birth. The predominant subclass of passively transmitted antibodies via the placenta was found to be IgG1, and a positive correlation was observed between the titers of SARS-CoV-2 IgG and IgG1 (R = 0.59, p < 0.001; Slope: 0.49 ± 0.070, p < 0.001).
Conclusions:
Maternal preconception COVID-19 vaccination represents a promising immunological strategy for conferring postnatal protection to infants, especially during the period of heightened risk of exposure to SARS-CoV-2 infection. It is imperative to underscore the significance of vaccination for women who are preparing to become pregnant or are pregnant, and concerted efforts must be made to promote vaccination among eligible women.
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