US Pharm. 2021;46(9):18-20.

Breast Milk of Mothers Who Received COVID-19 Vaccine Contains Antibodies

The breast milk of lactating mothers vaccinated against COVID-19 contains a significant supply of antibodies that may help protect nursing infants from the illness, according to new research from the University of Florida (UF).

“Our findings show that vaccination results in a significant increase in antibodies against SARS-CoV-2—the virus that causes COVID-19—in breast milk, suggesting that vaccinated mothers can pass on this immunity to their babies, something we are working to confirm in our ongoing research,” said Joseph Larkin III, PhD, senior author of the study and an associate professor in the UF Department of Microbiology and Cell Science.

When babies are born, their immune systems are underdeveloped, making it hard for them to fight infections on their own. They are also often too young to respond adequately to certain types of vaccines, said Josef Neu, MD, one of the study’s coauthors and a professor in the UF College of Medicine’s Department of Pediatrics, Division of Neonatology.

During this vulnerable period, breast milk allows nursing mothers to provide infants with “passive immunity,” Dr. Neu explained.

“Think of breast milk as a toolbox full of all the different tools that help prepare the infant for life. Vaccination adds another tool to the toolbox, one that has the potential to be especially good at preventing COVID-19 illness,” Dr. Neu said. “The results of our study strongly suggest that vaccines can help protect both mom and baby, another compelling reason for pregnant or lactating women to get vaccinated.”

The study was conducted between December 2020 and March 2021, when the Pfizer and Moderna vaccines first became available to healthcare workers. For the study, researchers recruited 21 lactating healthcare workers who had never contracted COVID-19. The research team sampled the mothers’ breast milk and blood three times: before vaccination, after the first dose, and after the second dose.

“We are also excited to see many other simultaneous studies conducted around the world that also show antibodies in the breast milk of vaccinated mothers,” Dr. Neu said. “That means our study validates a growing body of evidence.”

The study was published in the journal Breastfeeding Medicine and funded by the Children’s Miracle Network.

Research Reveals Gender Differences in Pandemic Fear and Risk Perception

Research from Virginia Tech suggests that men and women worry about the impact of COVID-19 in far different ways. For example, men are more likely to be concerned about financial consequences from COVID-19, while women report greater fear and more negative expectations about health-related outcomes.

The researchers, Drs. Sheryl Ball and Alec Smith, conducted an online survey in April 2020 to measure emotions, behaviors, and expectations connected to gender and the pandemic. The study was published in Frontiers in Psychology.

“We found that women reported a higher fear of the health risks of COVID-19 than men. Men expressed more fear about the economic implications of the pandemic than women,” said Dr. Smith.

In the initial days of the pandemic, the researchers were interested in how the COVID-19 pandemic would change people’s economic preferences—things such as how willing someone is to take a financial risk or to trust someone. Previous research shows that women are often less willing to take risks than men.

“The average person is probably less afraid of COVID-19 now than in April 2020,” said Dr. Ball. “The reason we believe this is that we originally collected data in the beginning, middle, and end of April 2020, and we found that fear decreased substantially even during that month. We expect that it has continued to decrease since then.”

“The big takeaway from our research is that people have economic as well as healthcare concerns about the pandemic,” said Dr. Smith. “We know that preventative measures like mask wearing are effective. We think that messages that encourage people to take these preventative measures might want to emphasize not only the health consequences and benefits but also the economic benefits.”

Professors Ball and Smith teach in the Virginia Tech’s Department of Economics, with a focus on behavioral economics.


High Virus Count in Lungs Drives COVID-19 Deaths

A buildup of coronavirus in the lungs is likely behind the steep mortality rates seen in the pandemic, a study finds. The results contrast with previous suspicions that simultaneous infections, such as bacterial pneumonia or overreaction of the body’s immune defense system, played major roles in heightened risk of death, the investigators say.

Led by researchers at New York University (NYU) Grossman School of Medicine, the new study showed that people who died of COVID-19 had on average 10 times the amount of virus, or viral load, in their lower airways as severely ill patients who survived their illness. Meanwhile, the investigators found no evidence implicating a secondary bacterial infection as the cause of the deaths, although they cautioned that this may be due to the frequent course of antibiotics given to critically ill patients.

“Our findings suggest that the body’s failure to cope with the large numbers of virus infecting the lungs is largely responsible for COVID-19 deaths in the pandemic,” said study lead author Imran Sulaiman, MD, PhD, an adjunct professor in the Department of Medicine at NYU Langone Health.

Current guidelines from the CDC, he notes, do not encourage use of antivirals such as remdesivir for severely ill patients on mechanical ventilation. But Dr. Sulaiman says the NYU Langone study results suggest that these medications may remain a valuable tool in treating these patients.

Despite previous concerns that the virus may prompt the immune system to attack the body’s own lung tissue and lead to dangerous levels of inflammation, the investigators found no evidence that this was a major contributor to COVID-19 deaths in the group studied. In fact, Dr. Sulaiman notes that the strength of the immune response appeared proportionate to the amount of virus in the lungs.

The coronavirus has so far killed over 4 million people worldwide. Those placed on mechanical ventilators in order to breathe fare particularly poorly, with 70% nationwide succumbing to the illness. Notably, experts attribute the high mortality seen in other viral pandemics such as the Spanish flu in 1918 and swine flu in 2009 to a secondary bacterial infection. However, it remained unclear whether a similar issue afflicted people with COVID-19.

The study, published online August 31 in the journal Nature Microbiology, was designed to clarify the role of secondary infections, viral load, and immune cell populations in COVID-19 mortality, according to Dr. Sulaiman. He says the investigation provides the most detailed survey of the lower airway environment in coronavirus patients.

The research team next plans to observe how the microbe community and immune response in the lungs of coronavirus patients change over time.


COVID-19 Vaccine Elicits Antibodies in 90% Taking Immunosuppressants

COVID-19 vaccination elicited antibody responses in nearly nine out of 10 people with weakened immune systems, although their responses were only about one-third as strong as those mounted by healthy people, according to a study by researchers at Washington University School of Medicine in St. Louis.

The study, published August 30 in the Annals of Internal Medicine, looked at people taking immunosuppressive medications to treat chronic inflammatory diseases, such as inflammatory bowel disease and rheumatoid arthritis. Since a minimum level of antibodies needed for protection has not been established, it has been difficult to say whether the levels achieved by people on immune-suppressing drugs are high enough to protect them from severe COVID-19, the researchers said. The CDC recently recommended that people taking immunosuppressants receive a third dose of the vaccine to strengthen their immune responses.

Nonetheless, the discovery that COVID-19 vaccination elicits a response in people with compromised immune systems—even if not quite as strong a response—is encouraging news for a population that faces a high risk of serious illness.

“Some of our patients have been hesitant about getting vaccinated, which is unfortunate because they are at increased risk of having more severe cases of COVID-19 if they happen to get infected, compared to those not taking immune-suppressing drugs,” said cosenior author Alfred Kim, MD, PhD, an assistant professor of medicine who treats patients with autoimmune conditions at Barnes-Jewish Hospital.

Dr. Kim and colleagues are preparing to follow the same group of participants as they receive their third shots. If a third dose allows people on immunosuppressants to achieve the antibody levels seen in healthy people after a second dose, Dr. Kim said he would feel better about how well the vaccine protects his patients.

“Receiving this additional dose may help mitigate this loss of response,” he said. “It’s really important for people who are immunocompromised to receive this dose to maximize their ability to protect themselves from SARS-CoV-2.”


COVID-19 Antibody Study Shows Downside of Not Receiving Second Dose

A new study shows that 2 months after the second Pfizer/Moderna vaccination, antibody response decreases 20% in adults with prior cases of COVID-19. The study also tests how well current vaccines resist emerging variants.

The Northwestern University study underscores the importance of receiving a second dose of vaccine, not only because it is commonly known that immunity from vaccines wanes over time but also because of the risk posed by emerging variants, including the highly contagious Delta variant.

The study also showed that prior exposure to SARS-CoV-2 does not guarantee a high level of antibodies; nor does it guarantee a robust antibody response to the first vaccine dose. This directly contradicts the assumption that contracting COVID will naturally make someone immune to reinfection. The findings further support vaccination (and two doses), even for people who have contracted the virus previously.

A team of scientists, including biological anthropologist Thomas McDade and pharmacologist Alexis Demonbreun, tested blood samples from adults who had tested positive for SARS-CoV-2 to measure how long the immunity benefits of Pfizer and Moderna vaccines last and how well they protect from newer variants.

Study participants were selected from a racially and ethnically diverse, community-based sample of Chicago-area adults recruited at the start of the pandemic. Using at-home antibody testing kits developed in the laboratory, participants submitted blood samples 2 to 3 weeks after their first and second dose of vaccination and 2 months after the second dose.

“As far as protection goes after vaccination, the story is the same for all the variants, including Delta—the vaccine provides good protection, but not as good protection as the original version of the virus for which the vaccine was designed. Combine that with the fact that immunity wanes over time, you get increased vulnerability to breakthrough infection.

“So, it’s two strikes right now—Delta plus waning immunity among the first wave of the vaccinated,” Dr. McDade said.

The study “Durability of antibody response to vaccination and surrogate neutralization of emerging variants based on SARS-CoV-2 exposure history” was published in the journal Scientific Reports.

One in Three Americans Had COVID-19 by End of 2020

A new study published in the journal Nature estimates that 103 million Americans, or 31% of the U.S. population, had been infected with SARS-CoV-2 by the end of 2020. Columbia University Mailman School of Public Health researchers modeled the spread of the coronavirus, finding that fewer than one-quarter of infections (22%) were accounted for in cases confirmed through public health reports based on testing.

The study is the first to comprehensively quantify the overall burden and characteristics of COVID-19 in the U.S. during 2020. The researchers simulated the transmission of SARS-CoV-2 within and between all 3,142 U.S. counties using population, mobility, and confirmed case data.

Roughly one in 130 Americans (0.77%) was contagious with SARS-CoV-2 on December 31, 2020. A similar percentage (0.83%) was estimated to be latently infected, i.e., infected but not yet contagious. In some metropolitan areas, the percentage of individuals who were contagious at year’s end was much higher.

Looking ahead, the authors write that several factors will alter population susceptibility to infection. The virus will continue to spread to those who have not yet been infected. While vaccines protect against severe and fatal disease, breakthrough infections, including those that are mild or asymptomatic, will contribute to the spread of the virus. The current study does account for the possibility of reinfection, although there is evidence of waning antibodies and reinfection. New more contagious variants make reinfection and breakthrough infections more likely.

“While the landscape has changed with the availability of vaccines and the spread of new variants, it is important to recognize just how dangerous the pandemic was in its first year,” concludes Sen Pei, PhD, assistant professor of environmental health sciences at Columbia University Mailman School of Public Health.

The content in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

The content in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.