npj Vaccines (Aug 2024)

Neutralizing and binding antibody responses to SARS-CoV-2 with hybrid immunity in pregnancy

  • Lin Li,
  • Yusuke Matsui,
  • Mary K. Prahl,
  • Arianna G. Cassidy,
  • Yarden Golan,
  • Unurzul Jigmeddagva,
  • Nida Ozarslan,
  • Christine Y. Lin,
  • Sirirak Buarpung,
  • Veronica J. Gonzalez,
  • Megan A. Chidboy,
  • Emilia Basilio,
  • Kara L. Lynch,
  • Dongli Song,
  • Priya Jegatheesan,
  • Daljeet S. Rai,
  • Balaji Govindaswami,
  • Jordan Needens,
  • Monica Rincon,
  • Leslie Myatt,
  • Taha Y. Taha,
  • Mauricio Montano,
  • Melanie Ott,
  • Warner C. Greene,
  • Stephanie L. Gaw

DOI
https://doi.org/10.1038/s41541-024-00948-3
Journal volume & issue
Vol. 9, no. 1
pp. 1 – 12

Abstract

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Abstract Hybrid immunity against SARS-CoV-2 has not been well studied in pregnancy. We conducted a comprehensive analysis of neutralizing antibodies (nAb) and binding antibodies in pregnant individuals who received mRNA vaccination, natural infection, or both. A third vaccine dose augmented nAb levels compared to the two-dose regimen or natural infection alone; this effect was more pronounced in hybrid immunity. There was reduced anti-Omicron nAb, but the maternal-fetal transfer efficiency remained comparable to that of other variants. Vaccine-induced nAbs were transferred more efficiently than infection-induced nAbs. Anti-spike receptor binding domain (RBD) IgG was associated with nAb against wild-type (Wuhan-Hu-1) following breakthrough infection. Both vaccination and infection-induced anti-RBD IgA, which was more durable than anti-nucleocapsid IgA. IgA response was attenuated in pregnancy compared to non-pregnant controls. These data provide additional evidence of augmentation of humoral immune responses in hybrid immunity in pregnancy.