Published October 1, 2021 - More info
BACKGROUND The significant risks posed to mothers and fetuses by COVID-19 in pregnancy have sparked a worldwide debate surrounding the pros and cons of antenatal SARS-CoV-2 inoculation, as we lack sufficient evidence regarding vaccine effectiveness in pregnant women and their offspring. We aimed to provide substantial evidence for the effect of the BNT162b2 mRNA vaccine versus native infection on maternal humoral, as well as transplacentally acquired fetal immune response, potentially providing newborn protection.METHODS A multicenter study where parturients presenting for delivery were recruited at 8 medical centers across Israel and assigned to 3 study groups: vaccinated (n = 86); PCR-confirmed SARS-CoV-2 infected during pregnancy (n = 65), and unvaccinated noninfected controls (n = 62). Maternal and fetal blood samples were collected from parturients prior to delivery and from the umbilical cord following delivery, respectively. Sera IgG and IgM titers were measured using the Milliplex MAP SARS-CoV-2 Antigen Panel (for S1, S2, RBD, and N).RESULTS The BNT162b2 mRNA vaccine elicits strong maternal humoral IgG response (anti-S and RBD) that crosses the placenta barrier and approaches maternal titers in the fetus within 15 days following the first dose. Maternal to neonatal anti-COVID-19 antibodies ratio did not differ when comparing sensitization (vaccine vs. infection). IgG transfer ratio at birth was significantly lower for third-trimester as compared with second trimester infection. Lastly, fetal IgM response was detected in 5 neonates, all in the infected group.CONCLUSION Antenatal BNT162b2 mRNA vaccination induces a robust maternal humoral response that effectively transfers to the fetus, supporting the role of vaccination during pregnancy.FUNDING Israel Science Foundation and the Weizmann Institute Fondazione Henry Krenter.
Ofer Beharier, Romina Plitman Mayo, Tal Raz, Kira Nahum Sacks, Letizia Schreiber, Yael Suissa-Cohen, Rony Chen, Rachel Gomez-Tolub, Eran Hadar, Rinat Gabbay-Benziv, Yuval Jaffe Moshkovich, Tal Biron-Shental, Gil Shechter-Maor, Sivan Farladansky-Gershnabel, Hen Yitzhak Sela, Hedi Benyamini-Raischer, Nitzan D. Sela, Debra Goldman-Wohl, Ziv Shulman, Ariel Many, Haim Barr, Simcha Yagel, Michal Neeman, Michal Kovo
Original citation: J Clin Invest. 2021;131(13):e150319. https://doi.org/10.1172/JCI150319
Citation for this corrigendum: J Clin Invest. 2021;131(19):e154834. https://doi.org/10.1172/JCI154834
For clarity, the authors are updating Figure 1, the flow chart for this study, to better illustrate the excluded samples and criteria for exclusion. The HTML and PDF versions of the figure and its legend have been updated.
Patient selection flow chart. Patients were recruited from 8 medical centers in Israel and were all SARS-CoV-2 RT-PCR negative at delivery. The original study groups included all the paired samples from the vaccinated (n = 92) and SARS-CoV-2 (n = 74) groups together with the original matched control group (n = 66). Samples were thereafter excluded for technical testing problems, leading to a total of n = 62, n = 65, and n = 86 analyzed samples for the control, SARS-CoV-2, and vaccinated groups, respectively. Seropositivity for nucleocapsid (N) was set at the level of the top 90% of the PCR-positive recovered group and verified by positivity for S1, S2, and RBD (see Supplemental Figures 1 and 2). The same threshold was used to reveal seropositive cases in the vaccinated and the control groups.