Abstract
The COVID-19 pandemic has demonstrated the urgent need to develop vaccine strategies optimized for pregnant people and their newborns, as both populations are at risk of developing severe disease. Although not included in COVID-19 vaccine development trials, pregnant people have had access to these vaccines since their initial release in the US and abroad. The rapid development and distribution of novel COVID-19 vaccines to people at risk, including those who are pregnant and lactating, presents an unprecedented opportunity to further our understanding of vaccine-induced immunity in these populations. In this review, we aim to summarize the literature to date on COVID-19 vaccination in pregnancy and lactation and highlight opportunities for investigation that may inform future maternal vaccine development and implementation strategies.
Highlights
Vaccination against infectious pathogens is one of the most impactful public health interventions, reducing global morbidity and mortality related to infection (Woodworth et al, 2020; CDC, a, 2021)
With increasing numbers of pregnant people receiving the vaccine during all trimesters of pregnancy and during lactation, several key questions have arisen, including: what is the safety profile of mRNA vaccines in pregnancy and lactation? Which vaccines induce the most robust maternal immune response? Does the efficiency of transplacental and breastmilk antibody transfer differ by timing of COVID-19 Vaccination: Pregnancy and Lactation administration or vaccine platform? What factors govern efficiency of placental and breastmilk transfer? Does the transfer of humoral immunity from mother to baby confer long-lasting protection?
We aim to review the literature to date on COVID-19 vaccination in pregnancy and lactation and highlight opportunities for future investigation
Summary
Vaccination against infectious pathogens is one of the most impactful public health interventions, reducing global morbidity and mortality related to infection (Woodworth et al, 2020; CDC, a, 2021). Both COVID-19 mRNA vaccines (Pfizer/BioNTech, Moderna) and the Ad26-vector vaccine (Janssen) are highly immunogenic in non-pregnant populations (Walsh et al, 2020; Chu et al, 2021; Stephenson et al, 2021), generating robust postvaccination anti-SARS-CoV-2-specific antibody titers in most study participants (Walsh et al, 2020).
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