COVID-19 VACCINE DURING PREGNANCY RESULTS OF TRANSPLACENTAL ANTIBODY TRANSFER TO INFANTS AND THROUGH BREAST MILK: A LITERATURE REVIEW
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Background: This comprehensive literature review investigates the outcomes of administering the BNT162B2 COVID-19 vaccine during pregnancy, focusing on transmitting antibodies through both the placenta and breast milk to infants. The study evaluates existing research findings to provide a nuanced understanding of the immunological implications for newborns born to vaccinated mothers. Methods: This literature review employed the PICO method to develop the review question, focusing on studies published between 2020 and 2023, identified through PubMed, Google Scholar, ScienceDirect, and Scopus using specific keywords related to antibody transfer, COVID-19 vaccine, neonatal immunity, and pregnancy. Result: Nine articles met the inclusion criteria. The review found that COVID-19 vaccination during pregnancy promoted transplacental antibody transfer to infants and the presence of antibodies in breast milk. Conclusion: The results of this study of the literature show that administering the mRNA vaccination in the latter half or third of pregnancy boosts IgA along with IgG levels through transplacental transmission or breastfeeding. BNT162b2 vaccination of mothers in the second trimester is recommended. Breastfeeding has advantages, but limited evidence suggests significant SARS-CoV-2 antibody transfer postpartum. Prospective mothers are urged to vaccinate pre-delivery and consider breastfeeding for antibody transfer.
Borghi, S. et al. (2020). ‘Fcrn, But Not Fcgammars, Drives Maternal-Fetal Transplacental Transport of Human Igg Antibodies', Proceedings of the National Academy of Sciences of the United States of America, 117(23), pp. 12943–51.
Cassidy, A. G. et al. (2023) ‘Assessment of Adverse Reactions, Antibody Patterns, and 12-month Outcomes in the Mother-Infant Dyad After COVID-19 mRNA Vaccination in Pregnancy', JAMA network open, 6(7), e2323405.
Collier, A. Y. et al. (2021) ‘Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women', JAMA, 325(23), pp. 2370–2380. https://doi.org/10.1001/jama.2021.7563
Dagan, N. et al. (2021) ‘Effectiveness of The BNT162b2 Mrna COVID-19 Vaccine In Pregnancy', Nature medicine, 27(10), pp. 1693–1695. https://doi.org/10.1038/s41591-021-01490-8.
Gray K. J. et. al. (2021) ‘Coronavirus Disease 2019 Vaccine Response In Pregnant And Lactating Women: A Cohort Study', American Journal of Obstetrics and Gynecology, 70. 10.1016/j.ajog.2021.03.023
Halasa N. B. et al. (2022) ‘Overcoming COVID-19 Investigators; Overcoming COVID-19 Network. Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19-Associated Hospitalization in Infants Aged <6 Months - 17 States', MMWR Morb Mortal Wkly Rep, 71(7), pp. 264-270. doi: 10.15585/mmwr.mm7107e3.
Jorgensen, S.C.J., Burry, L., and Tabbara, N. (2022) ‘Role of Maternal COVID-19 Vaccination In Providing Immunological Protection To The Newborn. Pharmacotherapy', 42, pp. 58–70. doi:10.1002/phar.2649.
Khoury, D.S. et al. (2021) ‘Neutralizing Antibody Levels Are Highly Predictive Of Immune Protection From Symptomatic SARS-Cov-2 Infection', Nature medicine, 27(7), pp. 1205-1211.
Kigel, A. et. al. (2023) ‘Maternal Immunization During the Second Trimester With BNT162b2 Mrna Vaccine Induces A Robust Iga Response In Human Milk: A Prospective Cohort Study', The American Journal of Clinical Nutrition, 118(3), pp. 572-578.
Krammer F. (2021) ‘A Correlate of Protection for SARS-Cov-2 Vaccines Is Urgently Needed', Nature medicine, 27(7), pp. 1147–1148. https://doi.org/10.1038/s41591-021-01432-4.
Kugelman, N. et al. (2021) ‘The Rapid SARS-Cov-2 Antibody Qualitative Test Is Accurate For Assessing Immunity Following Vaccination During Pregnancy', American Journal of Obstetrics and Gynecology, 226, pp. 325.
LaCourse, S. M. et al. (2023) ‘Hybrid Immunity To SARS-Cov-2 During Pregnancy Provides More Durable Infant Antibody Responses Compared To Natural Infection Alone', The Journal of infectious diseases, jiad 592. Advance online publication. https://doi.org/10.1093/infdis/jiad592
Muyldermans, J. et al. (2022) ‘The Effects of COVID-19 Vaccination on Lactating Women: A Systematic Review of the Literature', Frontiers in immunology, 13, 852928. https://doi.org/10.3389/fimmu.2022.852928.
Narayanaswamy, V. et al. (2022) ‘Neutralizing Antibodies and Cytokines in Breast Milk After Coronavirus Disease 2019 (COVID-19) mRNA Vaccination', Obstetrics and gynecology, 139(2), pp. 181–191. https://doi.org/10.1097/AOG.0000000000004661.
Nir, O. et al. (2022) ‘Maternal-Neonatal Transfer Of SARS-Cov-2 Immunoglobulin G Antibodies Among Parturient Women Treated with BNT162b2 Messenger RNA Vaccine During Pregnancy', American journal of obstetrics & gynecology MFM, 4(1), 100492. https://doi.org/10.1016/j.ajogmf.2021.100492.
Perl, S. H. et al. (2021) ‘SARS-CoV-2-Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women', JAMA, 325(19), pp. 2013–2014 https://doi.org/10.1001/jama.2021.5782
Sajadi, M. M. et al. (2023) ‘Maternal Transfer of Iga And Igg SARS-Cov-2 Specific Antibodies Transplacentally And Via Breast Milk Feeding', PloS one, 18(4), e0284020. https://doi.org/10.1371/journal.pone.0284020.
Sotoodeh G. S. et al. (2023) ‘Effectiveness, Immunogenicity and Safety of COVID-19 Vaccination in Pregnant Women: A Rapid Review Study', Medical journal of the Islamic Republic of Iran, 37, pp. 72. https://doi.org/10.47176/mjiri.37.72.
Treger, S. et al. (2022) ‘Transplacental Transfer Of Sars-Cov-2 Antibodies In Recovered And Bnt162b2-Vaccinated Patients', American Journal of Obstetrics and Gynecology, 226(2), pp. 587-589. https://doi.org/10.1016/j.ajog.2021.11.1365.
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