Maternal COVID-19 Vaccination Provides COVID-19 Antibodies in Newborn

Evidence suggests that newborns may have some protection against coronavirus disease 2019 (COVID-19) from maternal vaccination.

Pregnant individuals are at an increased risk of severe coronavirus disease 2019 (COVID-19), and pregnancy-related complications such as preterm birth can occur.¹ As COVID-19 vaccination continues across the United States, many states have begun vaccinating vulnerable individuals and have included pregnant patients in the eligibility criteria. There is limited data available on COVID-19 vaccines in pregnant patients. Since COVID-19 vaccines are not live, major safety issues are not expected in pregnant patients.²

Influenza and Tdap vaccination during pregnancy is recommended by the CDC to protect mothers and their newborns (by passing antibodies during pregnancy), and this has been well studied.³ The American College of Obstetricians and Gynecologists recommends that COVID-19 vaccines not be withheld from patients, and they can be administered at any setting.⁴ Growing evidence suggests that COVID-19 vaccination in pregnant women is safe and may provide protection in newborns.^5-7

Case Report

The first reported US case of a newborn with detectable COVID-19 antibodies after the mother received 1 dose of the Moderna COVID-19 vaccine was published on the preprint server medRxiv.⁵ A South Florida health care worker, who was not previously infected with COVID-19, received her first dose of the Moderna COVID-19 vaccine at 36 weeks pregnant and delivered a healthy full-term baby girl 3 weeks later.^5,6 SARS-CoV-2 IgG antibodies were detected in the newborn’s cord blood sample.5 The mother received her second dose of the Moderna vaccine post-partum, 28 days after her first dose while breastfeeding.⁵ It is unknown how long the antibody protection will last in the newborn, and future studies should evaluate the timing of vaccination during pregnancy for optimal protection.⁵

Public Health Implications

The case report provides important information about COVID-19 vaccination during pregnancy.One recent study in Israel, found COVID-19 antibodies in all 20 pregnant women and their newborns.⁷ All pregnant women received 2 doses of the Pfizer COVID-19 vaccine during their third trimesters.⁷

Pfizer and BioNTech began evaluating the safety and efficacy of their COVID-19 vaccine in approximately 4000 pregnant women in a global phase 2/3 randomized, placebo-controlled study.⁸ Two doses of the vaccine will be administered 21 days apart during 24-34 weeks’ gestation, and the study will assess safety in infants of vaccinated pregnant women and the transfer of COVID-19 antibodies.8 Additionally, infants will be monitored through approximately 6 months of age.⁸

As of March 15, 2021, over 51,000 v-safe (smartphone tool for health check-ins after COVID-19 vaccination) participants reported they were pregnant at the time they were vaccinated.⁹ The CDC is currently analyzing the data, and individuals can also sign up for the v-safe COVID-19 Vaccine Pregnancy Registry.⁹ To date, no safety concerns have been identified in pregnant patients who have been vaccinated. 

REFERENCES

1. CDC. People with certain medical conditions. Updated March 15, 2021. Accessed March 18, 2021. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html.
2. CDC. Information about COVID-19 vaccines for people who are pregnant or breastfeeding. Updated March 18, 2021. Accessed March 18, 2021.https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html.
3. CDC. Vaccines during pregnancy FAQs. Last reviewed August 24, 2020. Accessed March 18, 2021. https://www.cdc.gov/vaccinesafety/concerns/vaccines-during-pregnancy.html.
4. ACOG. Vaccinating pregnant and lactating patients against COVID-19. Updated March 4, 2021. Accessed March 18, 2021. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19.
5. Gilbert P, Rudnick C. Newborn antibodies to SARS-CoV-2 detected in cord blood after maternal vaccination. medRxiv 2021.02.03.21250579; doi: https://doi.org/10.1101/2021.02.03.21250579.
6. Lewis S. First baby in U.S. born with antibodies against COVID-19 after mom receives dose of Moderna vaccine while pregnant. CBS News. Published March 18, 2021. Accessed March 18, 2021. https://www.cbsnews.com/news/covid-vaccine-moderna-baby-born-antibodies/.
7. Rottenstreich A, Zarbiv G, Oiknine-Djian E, Zigron R, Wolf DG, Porat S. Efficient maternofetal transplacental transfer of anti- SARS-CoV-2 spike antibodies after antenatal SARS-CoV-2 BNT162b2 mRNA vaccination. medRxiv 2021.03.11.21253352; doi: https://doi.org/10.1101/2021.03.11.21253352.
8. Pfizer. Pfizer and BioNTech commence global clinical trial to evaluate COVID-19 vaccine in pregnant women. Published February 18, 2021. Accessed March 18, 2021. https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-commence-global-clinical-trial-evaluate.
9. CDC. v-safe COVID-19 vaccine pregnancy registry. Updated March 15, 2021. Accessed March 18, 2021. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafepregnancyregistry.html.