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Comparing Human Milk Antibody Response After 4 Different Vaccines for COVID-19

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

COVID-19 usually has a mild course in children; however, newborns and infants are more susceptible to severe disease.1 Human milk is suggested to play an important role to protect against infections, mostly owing to disease-specific antibodies.2 Antibodies against SARS-CoV-2 are present in the human milk of previously infected women,3 as well as following vaccination with a SARS-CoV-2 vaccine,4 and are capable of neutralizing the virus. Because maternal vaccination during lactation may protect not only the mother but also her breastfed infant, knowledge of its effect is important to guide health care workers and lactating women in decision-making regarding SARS-CoV-2 vaccination. Therefore, this study aims to compare the antibody response in human milk after vaccination with mRNA-based and vector-based vaccines.

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Article Information

Accepted for Publication: January 5, 2022.

Published Online: March 14, 2022. doi:10.1001/jamapediatrics.2022.0084

Corresponding Author: Johannes B. van Goudoever, MD, PhD, Emma Children’s Hospital, Amsterdam UMC, Meibergdreef 9, 1000 DE, Amsterdam, the Netherlands (h.vangoudoever@amsterdamumc.nl).

Author Contributions: Drs van Goudoever and van Keulen 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: Juncker, Mulleners, Coenen, van Goudoever, van Keulen.

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

Drafting of the manuscript: Juncker, Mulleners, Coenen, van Goudoever, van Keulen.

Critical revision of the manuscript for important intellectual content: van Goudoever, van Gils, van Keulen.

Statistical analysis: Juncker, Mulleners, Coenen, van Keulen.

Obtained funding: van Goudoever, van Keulen.

Administrative, technical, or material support: All authors.

Supervision: van Goudoever, van Keulen.

Conflict of Interest Disclosures: Dr van Goudoever reported grants from the Support Foundation Emma Children's Hospital during the conduct of the study, as well as being founder and director of the Dutch National Human Milk Bank, and a member of the Health Council. No other disclosures were reported.

Funding/Support: This research was funded by Stichting Steun Emma Kinderziekenhuis and the Amsterdam Infection and Immunity Institute (COVID-19 grant 24175).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank all participating mothers, students, and research assistants for helping with this study. Participants were not compensated for their contributions.

References
1.
Götzinger  F , Santiago-García  B , Noguera-Julián  A ,  et al; ptbnet COVID-19 Study Group.  COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.   Lancet Child Adolesc Health. 2020;4(9):653-661. doi:10.1016/S2352-4642(20)30177-2PubMedGoogle ScholarCrossref
2.
Hanson  LA .  Session 1: Feeding and infant development breast-feeding and immune function.   Proc Nutr Soc. 2007;66(3):384-396. doi:10.1017/S0029665107005654PubMedGoogle ScholarCrossref
3.
van Keulen  BJ , Romijn  M , Bondt  A ,  et al.  Human milk from previously COVID-19-infected mothers: the effect of pasteurization on specific antibodies and neutralization capacity.   Nutrients. 2021;13(5):1645. doi:10.3390/nu13051645PubMedGoogle ScholarCrossref
4.
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
5.
Atyeo  C , Alter  G .  The multifaceted roles of breast milk antibodies.   Cell. 2021;184(6):1486-1499. doi:10.1016/j.cell.2021.02.031PubMedGoogle ScholarCrossref
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