{"doi":"10.1172/jci.insight.191930","title":"Pregnancy and lactation induce distinct immune responses to COVID-19 booster vaccination and SARS-CoV-2 breakthrough infection","abstract":"The widespread uptake of COVID-19 vaccines by women provided a unique opportunity to study the effects of pregnancy and lactation on immune responses to vaccination. Leveraging a cohort with well-defined SARS-CoV-2 exposure history, we found that the magnitude of humoral and cellular immune responses to vaccine-delivered SARS-CoV-2 spike was not affected by pregnancy or lactation status. However, vaccination during pregnancy elicited more stem-like SARS-CoV-2-specific CD4+ T cells. Moreover, breakthrough infection promoted spike-specific IgG in pregnant individuals in contrast with IgA in those lactating, suggesting that the pregnancy-to-lactation transition favors mucosal antibody responses. Breakthrough infection also reduced peripheral cytolytic SARS-CoV-2-specific CD8+ T cell frequencies during lactation but not pregnancy, which may reflect trafficking of the cells to mammary glands. Our study also uncovered an impact of pregnancy and lactation on global T cell phenotypes. In particular, lactating individuals preferentially exhibited a state of diminished T cell activation. Furthermore, breakthrough infection during pregnancy, but not lactation, diminished frequencies of activated CD8+ T cells, tissue-homing CD8+ T cells, and γδ T cells. Our findings support the notion that immunity during pregnancy and lactation adapts to benefit the fetus or breastfed infant, with implications for eliciting effective long-term immunity for these uniquely vulnerable groups.","journal":"JCI Insight","year":2025,"id":528522,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"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":0.9454,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":807006,"name":"Lin Li","orcid":"0000-0001-8974-4636","position":1,"is_corresponding":false},{"id":71686,"name":"Xiaoyu Luo","orcid":"0000-0001-6059-0434","position":2,"is_corresponding":false},{"id":246058,"name":"Jason Neidleman","orcid":"0000-0003-3525-8047","position":3,"is_corresponding":false},{"id":807005,"name":"Arianna G. Cassidy","orcid":"0000-0003-1452-5177","position":4,"is_corresponding":false},{"id":807004,"name":"Yarden Golan","orcid":"0000-0002-3043-3638","position":5,"is_corresponding":false},{"id":305910,"name":"Nida Özarslan","orcid":"0000-0003-3235-1238","position":6,"is_corresponding":false},{"id":643993,"name":"Christine Y. Lin","orcid":"0000-0003-2219-2448","position":7,"is_corresponding":false},{"id":645186,"name":"Unurzul Jigmeddagva","orcid":null,"position":8,"is_corresponding":false},{"id":999056,"name":"Mikias Ilala","orcid":null,"position":9,"is_corresponding":false},{"id":807007,"name":"Megan A. Chidboy","orcid":"0000-0002-0562-0191","position":10,"is_corresponding":false},{"id":273912,"name":"Mary Prahl","orcid":"0000-0003-0091-2731","position":11,"is_corresponding":false},{"id":273919,"name":"Stephanie L. Gaw","orcid":"0000-0003-0891-6964","position":12,"is_corresponding":false},{"id":71692,"name":"Nadia R. Roan","orcid":"0000-0002-5464-1976","position":13,"is_corresponding":false},{"id":962501,"name":"Kailin Yin","orcid":"0000-0002-9827-7774","position":0,"is_corresponding":true}],"reference_count":61,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:50:48.492873Z","pmid":"40693463","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":[]}