Increase in SARS-CoV-2 RBD-Specific IgA and IgG Antibodies in Human Milk From Lactating Women Following the COVID-19 Booster Vaccination

Abstract

Background:

The United States Centers for Disease Control and Prevention recommended a third dose or booster of the Pfizer-BioNTech Comirnaty (BNT162b2) COVID-19 mRNA vaccine in September 2021 for high-risk individuals. Pregnant and high-risk lactating women were encouraged to receive the booster to obtain potential prolonged protection for themselves and their infants.

Research Aim:

To investigate the ability of the booster vaccine to increase IgA and IgG antibodies specific to the receptor-binding domain of the SARS-CoV-2 spike protein in human milk compared to levels pre-booster.

Methods:

This was a prospective one-group study with a pretest-posttest design. Six of 12 participants were recruited prospectively. Participants were instructed to collect ≥ 2 ounces of milk in the morning at 30 days and 1-day pre-booster, and 7, 14, 21, 30, 45, and 60 days post-booster. Levels of IgA and IgG antibodies specific to the receptor-binding domain of the SARS-CoV-2 spike protein were quantified in human milk via an ELISA assay.

Results:

We found a significant increase in anti-receptor-binding domain-specific IgA and IgG antibodies in human milk 1–2 weeks after the Pfizer-BioNTech booster and at the study endpoint (45- and 60-days post-booster)

Conclusions:

This suggests that the booster vaccination enhances SARS-CoV-2 specific immunity in human milk, which may be protective for infants.

Keywords

booster breastfeeding Covid-19 IgA and IgG Antibodies in Human Milk immunology lactation passive immunity SARS-CoV-2 United States vaccination

Get full access to this article

View all access options for this article.

References

Abu Raya

Srugo

Kessel

Peterman

Bader

Peri

Ashtamker

Gonen

Bamberger

. (2014). The induction of breast milk pertussis specific antibodies following gestational tetanus-diphtheria-acellular pertussis vaccination. Vaccine, 32(43), 5632–5637. https://doi.org/10.1016/j.vaccine.2014.08.006

American Academy of Pediatrics. (2022). Children and COVID-19: State-level data report. http://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/

Baird

J. K.

Jensen

S. M.

Urba

W. J.

Fox

B. A.

Baird

J. R.

(2021). SARS-CoV-2 antibodies detected in mother’s milk post-vaccination. Journal of Human Lactation, 37(3), 492–498. https://doi.org/10.1177/08903344211030168

Biewenga

Faber

Pronk

J. C.

Haaijman

J. J.

(1986). Production and characterization of pepsin fragments of human IgA1 to determine domain-specificity of monoclonal anti-IgA antibodies. Immunology, 59(1), 153–158. https://doi.org/10.1177/000456329102800311

Biewenga

Stoop

A. E.

Baker

H. E.

Swart

S. J.

Nauta

J. J. P.

van Kamp

G. J.

van der Baan

(1991). Nasal secretions from patients with polyps and healthy individuals, collected with a new aspiration system: Evaluation of total protein and immunoglobulin concentrations. Annals of Clinical Biochemistry, 28(3), 260–266. https://doi.org/10.1177/000456329102800311

Dagan

Barda

Biron-Shental

Makov-Assif

Key

Kohane

I. S.

Hernán

M. A.

Lipsitch

Hernandez-Diaz

Reis

B. Y.

Balicer

R. D.

(2021). Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy. Nature Medicine, 27(10), 1693–1695. https://doi.org/10.1038/s41591-021-01490-8

De Schutter

Maertens

Baerts

De Meester

Van Damme

Leuridan

. (2015). Quantification of vaccine-induced antipertussis toxin secretory IgA antibodies in breast milk: Comparison of different vaccination strategies in women. The Pediatric Infectious Disease Journal, 34(6), e149–152. https://doi.org/10.1097/INF.0000000000000675

Fouda

G. G.

Yates

N. L.

Pollara

Shen

Overman

G. R.

Mahlokozera

Wilks

A. B.

Kang

H. H.

Salazar-Gonzalez

J. F.

Salazar

M. G.

Kalilani

Meshnick

S. R.

Hahn

B. H.

Shaw

G. M.

Lovingood

R. V.

Denny

T. N.

Haynes

Letvin

N. L.

Ferrari

, . . . Center for HIV/AIDS Vaccine Immunology. (2011). HIV-specific functional antibody responses in breast milk mirror those in plasma and are primarily mediated by IgG antibodies. Journal of Virology, 85(18), 9555–9567. https://doi.org/10.1128/JVI.05174-11

Goldman

A. S.

Goldblum

R. M.

(1989). Immunoglobulins in human milk. In Atkinson

S. A.

Lonngerdal

, Proteins and non-protein nitrogen in human milk. 43–51. CRC Press. https://doi.org/10.1201/9780367812805

10.

Gray

K. J.

Bordt

E. A.

Atyeo

Deriso

Akinwunmi

Young

Baez

A. M.

Shook

L. L.

Cvrk

James

De Guzman

Brigida

Diouf

Goldfarb

Bebell

L. M.

Yonker

L. M.

Fasano

Rabi

S. A.

Elovitz

M. A.

. . . Edlow

A. G.

(2021). Coronavirus disease 2019 vaccine response in pregnant and lactating women: A cohort study. American Journal of Obstetrics and Gynecology, 225(3), 303.e1–303.e17. https://doi.org/10.1016/j.ajog.2021.03.023

11.

Low

J. M.

M. S. F.

Amin

Lee

L. Y.

Y. P. M.

Shunmuganathan

B. D.

Niu

Gupta

Tambyah

P. A.

MacAry

P. A.

Wang

L. W.

Zhong

(2021). Codominant IgG and IgA expression with minimal vaccine mRNA in milk of BNT162b2 vaccinees. NPJ Vaccines, 6, 105. https://doi.org/10.1038/s41541-021-00370-z

12.

Mazur

N. I.

Horsley

N. M.

Englund

J. A.

Nederend

Magaret

Kumar

Jacobino

S. R.

de Haan

C. A. M.

Khatry

S. K.

LeClerq

S. C.

Steinhoff

M. C.

Tielsch

J. M.

Katz

Graham

B. S.

Bont

L. J.

Leusen

J. H. W.

Chu

H. Y.

(2019). Breast Milk prefusion F Immunoglobulin G as a correlate of protection against respiratory syncytial virus acute respiratory illness. The Journal of Infectious Diseases, 219(1), 59–67. https://doi.org/10.1093/infdis/jiy477

13.

Meek

J. Y.

Noble

(2022). Breastfeeding and the use of human milk. 150(1): e2022057988. https://doi.org/10.1542/peds.2022-057988

14.

Pace

R. M.

Williams

J. E.

Järvinen

K. M.

Belfort

M. B.

Pace

C. D. W.

Lackey

K. A.

Gogel

A. C.

Nguyen-Contant

Kanagaiah

Fitzgerald

Ferri

Young

Rosen-Carole

Diaz

Meehan

C. L.

Caffé

Sangster

M. Y.

Topham

McGuire

M. A.

. . . McGuire

M. K.

(2021). Characterization of SARS-CoV-2 RNA, antibodies, and neutralizing capacity in milk produced by women with COVID-19. MBio, 12(1), e03192–20. https://doi.org/10.1128/mBio.03192-20

15.

Perl

S. H.

Uzan-Yulzari

Klainer

Asiskovich

Youngster

Rinott

Youngster

(2021). SARS-CoV-2-specific antibodies in breast milk after COVID-19 vaccination of breastfeeding women. JAMA, 325(19), 2013–2014. https://doi.org/10.1001/jama.2021.5782

16.

Sriraman

N. K.

Kellams

(2016). Breastfeeding: What are the barriers? Why women struggle to achieve their goals. Journal of Women’s Health, 25(7), 714–722. https://doi.org/10.1089/jwh.2014.5059

17.

United States Centers for Disease Control and Prevention. (2020). COVID data tracker. https://covid.cdc.gov/covid-data-tracker

18.

United States Centers for Disease Control and Prevention. (2021a) Coronavirus disease 2019. https://www.cdc.gov/media/releases/2021/p0924-booster-recommendations-.html

19.

United States Centers for Disease Control and Prevention. (2021b). Facts about nationwide breastfeeding goals. https://www.cdc.gov/breastfeeding/data/facts.html

20.

Valcarce

Stafford

L. S.

Neu

Cacho

Parker

Mueller

Burchfield

D. J.

Larkin

(2021). Detection of SARS-CoV-2-specific IgA in the human milk of COVID-19 vaccinated lactating health care workers. Breastfeeding Medicine, 16(12), 1004–1009. https://doi.org/10.1089/bfm.2021.0122

21.

World Health Organization. (2021). Infant and young child feeding. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding

22.

Young

B. E.

Seppo

A. E.

Diaz

Rosen-Carole

Nowak-Wegrzyn

Cruz Vasquez

J. M.

Ferri-Huerta

Nguyen-Contant

Fitzgerald

Sangster

M. Y.

Topham

D. J.

Järvinen

K. M.

(2022). Association of human milk antibody induction, persistence, and neutralizing capacity with SARS-CoV-2 infection vs. mRNA vaccination. JAMA Pediatrics, 176(2), 159–168. https://doi.org/10.1001/jamapediatrics.2021.4897

23.

Collier

A.-R. Y.

Rowe

Mardas

Ventura

J. D.

Wan

Miller

Powers

Chung

Siamatu

Hachmann

N. P.

Surve

Nampanya

Chandrashekar

Barouch

D. H.

(2022). Neutralization of the SARS-CoV-2 Omicron BA.1 and BA.2 variants. The New England Journal of Medicine, 386(16), 1579–1580. https://doi.org/10.1056/NEJMc2201849

24.

Zaman

Roy

Arifeen

S. E.

Rahman

Raqib

Wilson

Omer

S. B.

Shahid

N. S.

Breiman

R. F.

Breiman

R. E.

Steinhoff

M. C.

(2008). Effectiveness of maternal influenza immunization in mothers and infants. The New England Journal of Medicine, 359(15), 1555–1564. https://doi.org/10.1056/NEJMoa0708630

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.95 MB