COVID-19 vaccination at any time during pregnancy provides benefits
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Women can get vaccinated against COVID-19 at any time during their pregnancy and still see significant benefits for themselves and for their children, according to a study published in Obstetrics & Gynecology.
Vaccination elicits levels of antibodies to the SARS-CoV-2 outer spike protein at the time of delivery that do not dramatically vary with vaccination timing during pregnancy, the researchers said, so there is no justification for pregnant women to delay vaccination.
The researchers analyzed how anti-spike antibody levels in the mother’s blood and baby’s umbilical cord blood at delivery varied with the timing of prior vaccination among 1,359 women who delivered 1,374 babies at New York-Presbyterian/Alexandra Cohen Hospital for Women and Newborns. Samples were taken from all 1,359 women and from 1,362 of the newborns.
For those women who completed the vaccination series, the levels of antibodies at delivery tended to be higher when the initial vaccination course occurred in the third trimester among women with no history of SARS-CoV-2 infection who received the two-dose Pfizer or Moderna mRNA vaccine, although antibody levels at delivery are still comparably high and vaccination early in pregnancy or even a few weeks before pregnancy is likely still effective, the researchers said.
A booster shot late in pregnancy could make those antibody levels much higher, the researchers added, as the 20 women who reported receiving a booster dose in the third trimester had on average higher levels of anti-spike antibodies in maternal blood and in cord blood. .
“Women often ask, ‘What is the best vaccination timing for the baby?’ Our data suggest that it’s now,” author Malavika Prabhu, MD, assistant professor of obstetrics and gynecology at Weill Cornell Medicine and an obstetrician and gynecologist at New York-Presbyterian/Weill Cornell Medical Center, said in a press release.
The researchers noted CDC recommendations for COVID-19 vaccination among pregnant women as well as previous studies indicating more severe cases of COVID-19 among pregnant women, including increased risk for preterm birth, stillbirth and other adverse outcomes.
Vaccination elicits antibodies that cross the placenta to circulate in babies’ blood after delivery, the researchers continued, adding that studies have found no increased rates of adverse side effects from vaccination for mothers or babies. The researchers concluded that pregnant women should not delay COVID-19 vaccination until late pregnancy.
“The message here is that you can get vaccinated at any point during pregnancy and it is likely going to be beneficial to you and your baby at the time of birth,” author Yawei Jenny Yang, PhD, MD, assistant professor of pathology and laboratory medicine at Weill Cornell Medicine, said in the press release.
Laura E. Riley, MD, chair of the department of obstetrics and gynecology at Weill Cornell Medicine and obstetrician and gynecologist in chief at New York-Presbyterian/Weill Cornell Medical Center, said in the release that the findings “are consistent with what we see with other maternal vaccines such as flu and Tdap, which, when given during pregnancy, protect the mother and baby.”
The researchers plan on further studies to examine vaccine and booster effects under different maternal conditions and in the context of the spread of the omicron variant of SARS-CoV-2.
Reference:
Yang YJ, et al. Obstet Gynecol. 2021;doi:10.1097/AOG.0000000000004693.