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Quantification of Specific Antibodies Against SARS-CoV-2 in Breast Milk of Lactating Women Vaccinated With an mRNA Vaccine

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The COVID-19 pandemic has raised questions among individuals who are breastfeeding, both because of the possibility of viral transmission to infants during breastfeeding and, more recently, of the potential risks and benefits of vaccination in this specific population. Previous studies have reported the presence of anti–SARS-CoV-2 antibodies in breast milk of COVID-19–infected lactating women,1 and recently several studies have demonstrated the passage of postvaccine antibodies through breast milk in women vaccinated with novel mRNA-based vaccines.1,2 In the present study, conducted between February and March 2021 at Parc Sanitari Sant Joan de Déu, an urban hospital in Spain, we sought to characterize the levels of specific SARS-CoV-2 antibodies in the breast milk of mRNA-vaccinated women across time, as well as their correlation with serum antibody levels.

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Article Information

Accepted for Publication: June 8, 2021.

Published: August 11, 2021. doi:10.1001/jamanetworkopen.2021.20575

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Esteve-Palau E et al. JAMA Network Open.

Corresponding Author: Vicens Diaz-Brito, MD, PhD, Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi, Barcelona, Spain (vicente.diaz@pssjd.org).

Author Contributions: Drs Diaz-Brito and Esteve-Palau had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Esteve-Palau, Diaz-Brito.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Esteve-Palau, Casadevall, Diaz-Brito.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Esteve-Palau, Casadevall, Diaz-Brito.

Obtained funding: Esteve-Palau.

Administrative, technical, or material support: Esteve-Palau, Casadevall.

Supervision: Esteve-Palau, Gonzalez-Cuevas, Guerrero, Garcia-Terol, Alvarez, Diaz-Brito.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We acknowledge the samples collection effort of Geneva Garcia, RN, from the Department of Infectious Diseases at Parc Sanitari Sant Joan de Déu. No additional compensation was provided.

References
1.
Pace  RM , Williams  JE , Järvinen  KM ,  et al.  Characterization of SARS-CoV-2 RNA, antibodies, and neutralizing capacity in milk produced by women with COVID-19.   mBio. 2021;12(1):e03192-e20. doi:10.1128/mBio.03192-20PubMedGoogle ScholarCrossref
2.
Perl  SH , Uzan-Yulzari  A , Klainer  H ,  et al.  SARS-CoV-2-specific antibodies in breast milk after COVID-19 vaccination of breastfeeding women.   JAMA. 2021;325(19):2013-2014. doi:10.1001/jama.2021.5782PubMedGoogle ScholarCrossref
3.
Collier  AY , McMahan  K , Yu  J ,  et al.  Immunogenicity of COVID-19 mRNA vaccines in pregnant and lactating women.   JAMA. 2021;325(23):2370-2380. doi:10.1001/jama.2021.7563PubMedGoogle ScholarCrossref
4.
Pace  RM , Williams  JE , Järvinen  KM ,  et al.  Characterization of SARS-CoV-2 RNA, antibodies, and neutralizing capacity in milk produced by women with COVID-19.   mBio. 2021;12(1):e03192-20. doi:10.1128/mBio.03192-20PubMedGoogle Scholar
5.
Deeks  JJ , Dinnes  J , Takwoingi  Y ,  et al; Cochrane COVID-19 Diagnostic Test Accuracy Group.  Antibody tests for identification of current and past infection with SARS-CoV-2.   Cochrane Database Syst Rev. 2020;6:CD013652. doi:10.1002/14651858.CD013652PubMedGoogle Scholar
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Demers-Mathieu  V , Do  DM , Mathijssen  GB ,  et al.  Difference in levels of SARS-CoV-2 S1 and S2 subunits- and nucleocapsid protein-reactive SIgM/IgM, IgG and SIgA/IgA antibodies in human milk.   J Perinatol. 2020;41(4):850-859. doi:10.1038/s41372-020-00805-wPubMedGoogle ScholarCrossref
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