Milk Antibody Response After 3rd Dose of COVID-19 mRNA Vaccine and SARS-CoV-2 Breakthrough Infection and Implications for Infant Protection
19 Pages Posted: 29 Dec 2022 Publication Status: Published
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Milk Antibody Response after 3rd Dose of COVID-19 mRNA Vaccine and SARS-CoV-2 Breakthrough Infection and Implications for Infant Protection
Abstract
Anti-SARS-CoV-2 antibodies have been found in human-milk after COVID-19 infection and vaccination. However, little is known about their persistence in milk after booster vaccination and breakthrough infection. In this study, human-milk, saliva and blood samples were collected from 33 lactating individuals before and after mRNA-based vaccination and COVID-19 breakthrough infections. Antibody levels were measured using ELISA and symptoms were assessed using questionnaires. Evaluation of maternal and infant symptomatology revealed that infected mothers reported more symptoms than vaccinated mothers. We found that after vaccination, human-milk anti-SARS-CoV-2 antibodies persisted for up to 8 months. In addition, distinct patterns of human milk IgA and IgG production we observed after breakthrough infection compared to 3-dose vaccination series alone, indicating a differential central and mucosal immune profiles in hybrid compared with vaccine-induced immunity. To investigate passively derived milk antibody protection in infants, we examined the persistence of these antibodies in infant saliva after breastfeeding. We found that IgA was more abundant in infant saliva compared to IgG and persist in infant saliva longer after feeding. Our results delineate the differences in milk antibody response to vaccination as compared to breakthrough infection and emphasize the importance of improving the secretion of IgA antibodies to human milk after vaccination to improve the protection of breastfeeding infants.
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Funding Information: Y.G. was supported by the Weizmann Institute of Science -National Postdoctoral Award Program for Advancing Women in Science, and of the Human Frontiers in Science Program (HFSP). M.P. was supported by the National Institutes of Health (NIAID K23AI127886), the Marino Family Foundation, and UCSF REAC award. S.L.G. was supported by the National Institutes of Health (NIAID K08AI141728).
Declaration of Interests: The authors have declared that no conflict of interest exists.
Ethics Approval Statement: The institutional review board of the University of California, San Francisco, approved the study (#21-33621). Written informed consent was obtained from all study volunteers as part of the COVID-19 Vaccine in Pregnancy and Lactation (COVIPAL) cohort study.
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