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Beharier O, Plitman Mayo R, Raz T, Nahum Sacks K, Schreiber L, Suissa-Cohen Y, Chen R, Gomez-Tolub R, Hadar E, Gabbay-Benziv R, Moshkovich YJ, Biron-Shental T, Shechter-Maor G, Farladansky-Gershnabel S, Yitzhak Sela H, Benyamini-Raischer H, Sela ND, Goldman-Wohl D, Shulman Z, Many A, Barr H, Yagel S, Neeman M, Kovo M. Efficient maternal to neonatal transfer of antibodies against SARS-CoV-2 and BNT162b2 mRNA COVID-19 vaccine. J Clin Invest 2021; 131:154834. [PMID: 34596052 DOI: 10.1172/jci154834] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Beharier O, Plitman Mayo R, Raz T, Nahum Sacks K, Schreiber L, Suissa-Cohen Y, Chen R, Gomez-Tolub R, Hadar E, Gabbay-Benziv R, Jaffe Moshkovich Y, Biron-Shental T, Shechter-Maor G, Farladansky-Gershnabel S, Yitzhak Sela H, Benyamini-Raischer H, Sela ND, Goldman-Wohl D, Shulman Z, Many A, Barr H, Yagel S, Neeman M, Kovo M. Efficient maternal to neonatal transfer of antibodies against SARS-CoV-2 and BNT162b2 mRNA COVID-19 vaccine. J Clin Invest 2021; 131:150319. [PMID: 34014840 DOI: 10.1172/jci150319] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/19/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUNDThe 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.METHODSA 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).RESULTSThe 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.CONCLUSIONAntenatal BNT162b2 mRNA vaccination induces a robust maternal humoral response that effectively transfers to the fetus, supporting the role of vaccination during pregnancy.FUNDINGIsrael Science Foundation and the Weizmann Institute Fondazione Henry Krenter.
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Affiliation(s)
- Ofer Beharier
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.,Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Romina Plitman Mayo
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Tal Raz
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food & Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Kira Nahum Sacks
- Department Obstetrics and Gynecology, Wolfson Medical Center, Holon; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Letizia Schreiber
- Department of Pathology, Wolfson Medical Center, Holon; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Suissa-Cohen
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Rony Chen
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Rachel Gomez-Tolub
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Rinat Gabbay-Benziv
- The Hillel Yaffe Medical Center, Hadera, Israel; affiliated to the Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Yuval Jaffe Moshkovich
- The Hillel Yaffe Medical Center, Hadera, Israel; affiliated to the Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Shechter-Maor
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sivan Farladansky-Gershnabel
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hen Yitzhak Sela
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Hedi Benyamini-Raischer
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel affiliated with Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Nitzan D Sela
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel affiliated with Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Debra Goldman-Wohl
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ziv Shulman
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Ariel Many
- Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Barr
- The Nancy and Stephen Grand Israel National Center for Personalized Medicine (G-INCPM), Weizmann Institute of Science, Rehovot, Israel
| | - Simcha Yagel
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Michal Neeman
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Michal Kovo
- Department Obstetrics and Gynecology, Wolfson Medical Center, Holon; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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