PT  - JOURNAL ARTICLE
AU  - Emily H. Adhikari
AU  - Pei Lu
AU  - Ye jin Kang
AU  - Ann R. McDonald
AU  - Jessica E. Pruszynski
AU  - Timothy A. Bates
AU  - Savannah K. McBride
AU  - Mila Trank-Greene
AU  - Fikadu G. Tafesse
AU  - Lenette L. Lu
TI  - Diverging maternal and infant cord antibody functions from SARS-CoV-2 infection and vaccination in pregnancy
AID  - 10.1101/2023.05.01.538955
DP  - 2023 Jan 01
TA  - bioRxiv
PG  - 2023.05.01.538955
4099  - http://biorxiv.org/content/early/2023/05/02/2023.05.01.538955.short
4100  - http://biorxiv.org/content/early/2023/05/02/2023.05.01.538955.full
AB  - Immunization in pregnancy is a critical tool that can be leveraged to protect the infant with an immature immune system but how vaccine-induced antibodies transfer to the placenta and protect the maternal-fetal dyad remains unclear. Here, we compare matched maternal-infant cord blood from individuals who in pregnancy received mRNA COVID-19 vaccine, were infected by SARS-CoV-2, or had the combination of these two immune exposures. We find that some but not all antibody neutralizing activities and Fc effector functions are enriched with vaccination compared to infection. Preferential transport to the fetus of Fc functions and not neutralization is observed. Immunization compared to infection enriches IgG1-mediated antibody functions with changes in antibody post-translational sialylation and fucosylation that impact fetal more than maternal antibody functional potency. Thus, vaccine enhanced antibody functional magnitude, potency and breadth in the fetus are driven more by antibody glycosylation and Fc effector functions compared to maternal responses, highlighting prenatal opportunities to safeguard newborns as SARS-CoV-2 becomes endemic.One Sentence Summary SARS-CoV-2 vaccination in pregnancy induces diverging maternal and infant cord antibody functionsCompeting Interest StatementThe authors have declared no competing interest.