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:10.1038/s41541-024-00948-3

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

NPJ Vaccines. 2024 Aug 27;9(1):156. doi: 10.1038/s41541-024-00948-3.

Authors

Lin Li^#^{1

2}, Yusuke Matsui^#^{3

4}, Mary K Prahl^{5

6}, Arianna G Cassidy¹, Yarden Golan⁷, Unurzul Jigmeddagva², Nida Ozarslan^{1

2}, Christine Y Lin¹, Sirirak Buarpung^{1

2}, Veronica J Gonzalez¹, Megan A Chidboy¹, Emilia Basilio¹, Kara L Lynch⁸, Dongli Song⁹, Priya Jegatheesan⁹, Daljeet S Rai¹⁰, Balaji Govindaswami¹¹, Jordan Needens¹², Monica Rincon¹³, Leslie Myatt¹³, Taha Y Taha^{3

4

7}, Mauricio Montano^{3

4}, Melanie Ott^{3

4

14

15}, Warner C Greene^{16

17

18

19}, Stephanie L Gaw^{20

21}

Affiliations

¹ Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
² Department of Obstetrics, Gynecology, and Reproductive Sciences, Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
³ Gladstone Institute of Virology, San Francisco, CA, USA.
⁴ Michael Hulton Center for HIV Cure Research at Gladstone, San Francisco, CA, USA.
⁵ Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.
⁶ Division of Pediatric Infectious Diseases and Global Health, University of California San Francisco, San Francisco, CA, USA.
⁷ Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA.
⁸ Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.
⁹ Division of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA, USA.
¹⁰ Stanford-O'Connor Family Medicine Residency Program, Division of Family Medicine, Stanford University, Palo Alto, CA, USA.
¹¹ Division of Neonatology, Department of Pediatrics, Marshall University Joan C Edwards School of Medicine, Huntington, WV, USA.
¹² Department of Obstetrics and Gynecology, Marshall University Joan C Edwards School of Medicine, Huntington, WV, USA.
¹³ Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.
¹⁴ Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
¹⁵ Departments of Microbiology and Immunology, University of California San Francisco, San Francisco, CA, USA.
¹⁶ Gladstone Institute of Virology, San Francisco, CA, USA. warner.greene@gladstone.ucsf.edu.
¹⁷ Michael Hulton Center for HIV Cure Research at Gladstone, San Francisco, CA, USA. warner.greene@gladstone.ucsf.edu.
¹⁸ Department of Medicine, University of California San Francisco, San Francisco, CA, USA. warner.greene@gladstone.ucsf.edu.
¹⁹ Departments of Microbiology and Immunology, University of California San Francisco, San Francisco, CA, USA. warner.greene@gladstone.ucsf.edu.
²⁰ Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA. stephanie.gaw@ucsf.edu.
²¹ Department of Obstetrics, Gynecology, and Reproductive Sciences, Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA. stephanie.gaw@ucsf.edu.

^# Contributed equally.

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.

Abstract

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