Which stage of pregnancy is best for the COVID-19 vaccine? Scientists know the answer
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There is no justification for delaying COVID-19 vaccination in expectant mothers. The vaccine produces the same level of antibodies to SARS-CoV-2 at delivery, regardless of when it is taken, researchers from Weill Cornell Medicine and New York-Presbyterian (USA) reported in Obstetrics & Gynecology.

The authors analyzed whether and how the level of antibodies to the SARS-CoV-2 spike protein – both in the mother’s blood and in the child’s umbilical cord blood – is affected at delivery by the time the woman takes the vaccine. The research group consisted of almost 1400 pregnant women and their children.

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They found that levels of these antibodies at birth are usually slightly higher when the primary vaccination course (i.e. two doses) has taken place during the third trimester of pregnancy. However, this was a minimal difference; if vaccination was given in early pregnancy or even several weeks before pregnancy, antibody levels were comparably high. In addition, protection was significantly enhanced by taking a booster dose in late pregnancy.

«Women often ask what is the best time to get vaccinated in terms of their health and the health of the fetus. Our results suggest that this moment is now, right now, ”says Dr. Malavika Prabhu, obstetrician gynecologist and lead author.

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She adds that the U.S. Centers for Disease Control and Prevention recommend that all pregnant women be vaccinated. Previous research suggests that COVID-19 is more severe in this group; coronavirus infection increases the risk of premature birth, stillbirth and other adverse effects on the mother and child. It is worth remembering that vaccination protects not only women: antibodies produced in the mother’s body cross the placenta and circulate in the blood of the newborn after birth. In addition, the studies of commonly used preparations to date have not shown an increased rate of undesirable side effects neither in women nor in their offspring.

The results of Dr. Prabhu’s team’s latest experiment showed that antibodies to the spike protein at birth were detectable in both maternal blood and umbilical cord blood of all fully vaccinated women, regardless of when the first dose of the vaccine was given. Among women who had never had COVID-19 and who had received a two-dose Pfizer or Moderna vaccine, antibody levels at birth were lowest if vaccinated before pregnancy or during the first trimester, and highest after vaccination in the third trimester. However, as the researchers point out, these differences were minimal.

There were also no significant differences among the relatively small number of women who received the single-dose Johnson & Johnson vaccine.

Among fully vaccinated patients who had been infected with SARS-CoV-2 in the past, the levels of antibodies to the spike protein (maternal blood and cord blood) were slightly higher than in the previously mentioned group, with even smaller variations depending on the timing of vaccination.

And in expectant mothers who had not received the full vaccination course, antibody levels were significantly lower than in all other cohorts, including the earliest vaccinated cohort.

These findings suggest that pregnant women should not postpone COVID-19 vaccination until later in pregnancy.

“Our message is that you can get vaccinated at any time during pregnancy and it will be beneficial for both the woman and her baby. And the earlier the inoculation, the faster the protection »- explains Dr. Yawei Jenny Yang, co-author of the publication.

He added that the obtained results are consistent with what has been observed for years in the case of other vaccines used in pregnant women, e.g. those against influenza or Tdap. Their administration during pregnancy effectively protects the mother and the baby.

Author: Katarzyna Czechowicz

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