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Publications

Journal Article Epublish 3 citations

PubMed: 40804265 DOI: 10.1038/s41541-025-01236-4

Pregnancy reduces COVID-19 vaccine immunity against novel variants.

NPJ Vaccines 10(1):191

Authors: Maclaine A Parish, Jaiprasath Sachithanandham, Lizeth Gutierrez, Han-Sol Park, Anna Yin, Katerina Roznik, Patrick Creisher, John S Lee, Laura A St Clair, Annie Werner, Catherine Pilgrim-Grayson, Lea Berhane, Hana Golding, Patrick Shea, Katherine Fenstermacher, Richard Rothman, Irina Burd, Jeanne Sheffield, Andrea L Cox, Andrew Pekosz, Sabra L Klein

Affiliations

  • W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
  • Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
  • Division of Rare Diseases and Medical Genetics, Pediatrics, Urologic and Reproductive Medicine, U.S. Food and Drug Administration, Silver Spring, MD, USA.
  • Division of Clinical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
  • Division of Viral Products, Center of Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
  • Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
  • Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Department of Obstetrics and Gynecology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
  • W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
  • Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Abstract

Pregnant women are at heightened risk for severe outcomes from infectious diseases like COVID-19, yet were not included in initial vaccine trials, which may contribute to low booster uptake (15% or lower). We explored the serological and cellular responses to COVID-19 mRNA booster vaccines (i.e., ancestral and BA.5) in pregnant and age-matched, non-pregnant females to identify how pregnancy affects immunity against the vaccine and novel variants. Antibodies from pregnant women were less cross-reactive to non-vaccine antigens, including XBB.1.5 and JN.1. Non-pregnant females showed greater IgG1:IgG3 ratios and neutralization against all variants. In contrast, pregnant women had lower IgG1:IgG3 ratios and neutralization but increased antibody-dependent NK cell cytokine production and neutrophil phagocytosis, especially against novel variants. Pregnancy increased memory CD4+ T cells, IFNγ production, monofunctional dominance, and fatty acid oxidation. Pregnancy may reduce the breadth, composition, and magnitude of humoral and cellular immunity, particularly in response to novel variants.

MeSH

Pregnant Women, Cells, Pregnancy, Vaccines, Covid-19 Vaccines, Covid-19, Immunity