Health
COVID-19 vaccine and neglected pregnancy
Healthcare workers, people over the age of 65, and people with cardiovascular disease, chronic respiratory disease, cancer, diabetes, or obesity are preferred for initial vaccination. Despite representing a cohort at high risk of serious COVID-19 complications, pregnant women do not appear to form a high priority group. Increasing evidence suggests that pregnant women are at increased risk of COVID-19 morbidity and mortality. I am not pregnant.
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COVID-19 is also associated with increased stillbirth rates.
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COVID-19 shows a persistent T cell and neutralizing antibody response to the severe acute respiratory syndrome coronavirus 2 trimer spike glycoprotein in nonpregnant healthy adult participants. Replication-defective adenoviruses are ideal vectors because, when chemically attenuated, they can accommodate large transgenes and can encode proteins without integrating the virus into the host cell genome.
Previously shown to safely induce a strong humoral and cell-mediated immune response from Rift Valley fever in pregnant sheep vaccinated during mid-gestation, without the risk of maternal viremia or miscarriage It has been.
Mouse studies of Zika virus gorilla adenovirus vector vaccines have also been shown to prevent intrauterine transmission of Zika virus.
The immune paradox during pregnancy favors resistance to the fetus (that is, prevents the maternal immune system from rejecting the fetus), but increases the susceptibility of the mother to viral infections and thus the monkey adenovirus vector Can be used opportunistically. The ChAdOx1 vaccine platform is non-replicating and can be used to deliver proteins to the mother to induce an immune response without adversely affecting the fetus. Maternally-induced transplacental transfer of antibody may occur, but no transfer of viral vector to the fetus. Unfortunately, pregnant women have historically been excluded from drug research because of their intentional but misguided concerns about fetal safety.
SAM reports grants and personal fees from the Bill & Melinda Gates Foundation, Pfizer, Minervax, and GlaxoSmithKline, but is unrelated to this communication. All other authors declare no competing interests.
References
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COVID-19 A global framework for the fair and equitable distribution of products. WHO member country information session.
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Laboratory-identified laboratory-identified females of reproductive age with SARS-CoV-2 infection by pregnancy status — USA, January 22-June 7, 2020.
MMWR Morb Mortal Wkly Rep. 2020; 69: 769-775
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A brief report by the Swedish Public Health Service: Pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden.
Acta Obstet Gynecol Scand. 2020; 99: 819-822
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COVID-19 Changes in incidence of stillbirth and preterm birth during a pandemic.
JAMA. 2020; 324: 705-706
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Safety and Immunogenicity of the ChAdOx1 nCoV-19 Vaccine Against SARS-CoV-2: Preliminary Report of a Phase 1/2, Single-Blind Randomized Controlled Trial.
Lancet. 2020; 396: 467-478
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Immunogenicity and Safety of the Recombinant Adenovirus Type 5 Vector COVID-19 Vaccine in Healthy Adults Over 18 Years of Age: A Randomized, Double-Blind, Placebo-Controlled, Phase 2 Study.
Lancet. 2020; 396: 479-488
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Safety and efficacy of ChAdOx1 RVF vaccine against Rift Valley fever in pregnant sheep and goats.
NPJ vaccine. 2019; Four: 44
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A gorilla adenovirus-based vaccine against Zika virus induces durable immunity and provides protection during pregnancy.
Cell charge 2019; 28: 2634-2646
Article information
Publication history
Release Date: August, 27th, 2020
identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
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