{"doi":"10.1101/2022.05.17.22275154","title":"COVID-19 booster dose antibody response in pregnant, lactating, and nonpregnant women","abstract":"Abstract BACKGROUND While emerging data during the SARS-CoV-2 pandemic have demonstrated robust mRNA vaccine-induced immunogenicity across populations, including pregnant and lactating individuals, the rapid waning of vaccine-induced immunity and the emergence of variants of concern motivated the use of mRNA vaccine booster doses. Whether all populations, including pregnant and lactating individuals, will mount a comparable response to a booster dose is not known. OBJECTIVE We sought to profile the humoral immune response to a COVID-19 mRNA booster dose in a cohort of pregnant, lactating, and age-matched nonpregnant women. STUDY DESIGN We characterized the antibody response against ancestral Spike and Omicron in a cohort of 31 pregnant, 12 lactating and 20 nonpregnant age-matched controls who received a BNT162b2 or mRNA-1273 booster dose after primary COVID-19 vaccination. We also examined the vaccine-induced antibody profiles of 15 maternal:cord dyads at delivery. RESULTS Receipt of a booster dose during pregnancy resulted in increased IgG1 against Omicron Spike (post-primary vaccination vs post-booster, p = 0.03). Pregnant and lactating individuals exhibited equivalent Spike-specific total IgG1, IgM and IgA levels and neutralizing titers against Omicron compared to nonpregnant women. Subtle differences in Fc-receptor binding and antibody subclass profiles were observed in the immune response to a booster dose in pregnant compared to nonpregnant individuals. Analysis of maternal and cord antibody profiles at delivery demonstrated equivalent total Spike-specific IgG1 in maternal and cord blood, yet higher Spike-specific FcγR3a-binding antibodies in the cord relative to maternal blood (p = 0.002), consistent with preferential transfer of highly functional IgG. Spike-specific IgG1 levels in the cord were positively correlated with time elapsed since receipt of the booster dose (Spearman R 0.574, p = 0.035). CONCLUSIONS These data suggest that receipt of a booster dose during pregnancy induces a robust Spike-specific humoral immune response, including against Omicron. If boosting occurs in the third trimester, higher Spike-specific cord IgG1 levels are achieved with greater time elapsed between receipt of the booster and delivery. Receipt of a booster dose has the potential to augment maternal and neonatal immunity.","journal":"medRxiv","year":2022,"id":301297,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9563,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":243033,"name":"Lydia L. Shook","orcid":"0000-0002-5859-8610","position":1,"is_corresponding":false},{"id":875486,"name":"Nadege Nziza","orcid":null,"position":2,"is_corresponding":false},{"id":615248,"name":"Elizabeth A. DeRiso","orcid":"0000-0002-4922-0819","position":3,"is_corresponding":false},{"id":849866,"name":"Cordelia Muir","orcid":"0000-0003-1083-1476","position":4,"is_corresponding":false},{"id":850420,"name":"Arantxa Medina Baez","orcid":null,"position":5,"is_corresponding":false},{"id":622305,"name":"Rosiane Lima","orcid":null,"position":6,"is_corresponding":false},{"id":850419,"name":"Stepan Demidkin","orcid":null,"position":7,"is_corresponding":false},{"id":615251,"name":"Sara Brigida","orcid":"0000-0002-2118-5572","position":8,"is_corresponding":false},{"id":289981,"name":"Rose M. De Guzman","orcid":"0000-0002-4563-8628","position":9,"is_corresponding":false},{"id":620795,"name":"Madeleine D. Burns","orcid":"0000-0003-4850-4446","position":10,"is_corresponding":false},{"id":108262,"name":"Alejandro B. Balazs","orcid":"0000-0002-1767-3944","position":11,"is_corresponding":false},{"id":227641,"name":"Alessio Fasano","orcid":"0000-0002-2134-0261","position":12,"is_corresponding":false},{"id":243044,"name":"Lael M. Yonker","orcid":"0000-0003-1711-8227","position":13,"is_corresponding":false},{"id":243047,"name":"Kathryn J. Gray","orcid":"0000-0002-3541-3724","position":14,"is_corresponding":false},{"id":106757,"name":"Galit Alter","orcid":"0000-0002-7680-9215","position":15,"is_corresponding":false},{"id":243048,"name":"Andrea G. Edlow","orcid":"0000-0003-2915-5949","position":16,"is_corresponding":false},{"id":106723,"name":"Caroline Atyeo","orcid":"0000-0002-7489-0232","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T00:32:02.193874Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}