COVID-19 mRNA vaccines drive differential antibody Fc-functional profiles in pregnant, lactating, and nonpregnant women

• DOI: 10.1126/scitranslmed.abi8631
• Publication Date: 2021-10-21T23:37:55Z
• Authors: Caroline Atyeo; Elizabeth A. DeRiso; Christine Davis; Evan A. Bordt; Rose M. De Guzman; Lydia L. Shook; Lael M. Yonker; Alessio Fasano; Babatunde Akinwunmi; Douglas A. Lauffe...; Michal A. Elovitz; Kathryn J. Gray; Andrea G. Edlow; Galit Alter
• Keywords: Antibody titer

Substantial immunological changes occur throughout pregnancy to render the mother immunologically tolerant fetus and allow fetal growth. However, additional local systemic adaptations also occur, allowing maternal immune system continue protect dyad against pathogens both during after birth through lactation. This fine balance of tolerance immunity, along with physiological hormonal changes, contributes increased susceptibility particular infections in pregnancy, including more severe coronavirus disease 2019 (COVID-19). Whether these make pregnant women less responsive vaccination or induce altered responses remains incompletely understood. To define potential vaccine response lactation, we undertook deep sequencing humoral a group lactating nonpregnant age-matched controls. Vaccine-specific titers were comparable between women, Fc receptor (FcR) binding antibody effector functions induced delayed kinetics compared first dose, which normalized second dose. Vaccine boosting resulted high FcR-binding breastmilk. These data suggest that promotes resistance generating proinflammatory antibodies indicates there is critical need follow prime-boost timelines this vulnerable population ensure full immunity attained.