Organizer Insights on COVID-19, Vaccination and Pregnancy

As the world deploys new vaccines against COVID-19 to quell the global pandemic, it has become clear that not all vaccines are the same, and not everybody responds to the same vaccine in the same way. Although we still don't understand many of the factors that dictate individual responses to vaccination, the pandemic has brought to light the impact of biological sex and pregnancy on vaccine efficacy and adverse side effects. The upcoming eSymposia on Maternal-Fetal Newborn Immunity will explore this emerging area of research, as we continue to discover new insights from the pandemic and vaccination programs. Here we catch up with Dr. Sabra Klein, co-organizer of the upcoming meeting, and professor at the Johns Hopkins Bloomberg School of Public Health and co-director of the Center for Women's Health, Sex, and Gender Research, about the meeting, and her research into this crucial topic.

Join Dr. Sabra Klein and colleagues for the upcoming eSymposia on Maternal-Fetal Newborn Immunity!

I think all too often pregnant women have been excluded from clinical trials; they're often not studied in meaningful ways,” says Klein. “I think if there's one thing that Zika and the current pandemic have done, it’s continued to raise awareness and public demand for more information pertaining to pregnancy and immunity to vaccines.

Dr. Klein is studying just that: the many questions surrounding infection and vaccination for health outcomes of pregnant women, fetuses, and newborns. What is the strength, quality and duration of immunity raised by vaccination or infection? Are there adverse reactions to vaccinations? How do biological sex and pregnancy impact these answers?

Pregnancy causes huge biological changes in the body: from fluctuating hormone levels, to altered maternal organs, to the many ways the immune system adjusts to protect the fetus without compromising the health of the mother. “In order to answer a question about how pregnant women respond to vaccines, I think we have to start with the fact that the immunological profile during pregnancy—it changes,” says Dr. Klein. “Not for every cell population, not for every response, but for many. And when we're talking about vaccinating pregnant women, we think about how the immune response to that immunogen, might be affected by the condition of being pregnant.”

Although COVID-19 vaccines have not been around for long, and many questions about them remain unanswered, they are safe and effective for pregnant women, says Dr. Klein. Meanwhile, COVID-19 infection itself can cause adverse pregnancy outcomes, raising concerns about fetal health and development in infected mothers. “It is fact that vaccination of pregnant woman reduces the probability of severe COVID outcomes... pregnant women should be getting vaccinated,” says Klein. She is now researching whether immunity is transferred from the mother to the fetus, and the durability of that immunity, i.e., how long the immunity lasts after birth.

Dr. Klein is also interested more generally in the differences between vaccination responses in men and women:

Across very diverse vaccines we see that women tend to mount more robust immune responses than do men,” says Dr. Klein. “In human work that we have going on, as well as in our mouse models, we find that the durability of that immunity is greater over time for females over males.

This work has important implications for booster shots, as it implies that women might not need them at the same time as men, or at the same dose. As the United States government weighs the risks, costs, and benefits of approved boosters, this research could steer policy as well as clinical recommendations. In the future, it may guide other vaccination regimens as well, for example, for flu shots.

Watch the full interview with Dr. Sabra Klein about emerging research on COVID-19, vaccination and pregnancy:

Dr. Klein was asked to help organize the Keystone eSymposia on Maternal-Fetal and Newborn Immunity because of her virology background, adding depth and diversity to the scientific program which spans everything from microbiology to neonatology. “The COVID pandemic has brought people in: immunologists, vaccinologists, people who didn't traditionally work in this area of pregnancy or maternal-fetal immunity, it has brought them into the fold,” says Dr. Klein. “And with that they're bringing their technologies, they're bringing their ways of measuring responses to vaccination.”

The international diversity of meeting participants is especially important, as maternal-fetal immunity is a relevant topic everywhere, but particularly in low- and middle- income countries around the world where infant morbidity and mortality is highest. Zika virus, for example, hit hardest in South America, where there was the greatest incidence of microcephaly in infants due to Zika infection in pregnant women. Despite the importance of this research to public health in these countries, they have traditionally not been able to participate in such meetings due to travel costs-- a factor that is overcome by the virtual meeting format.

I do think that diverse representation is important,” says Klein. “That international diversity, and diverse thought, can change perspectives... it can change maybe even our experimental designs or the kinds of questions we ask.

Dr. Klein hopes that the networking facilitated by the virtual platform will connect scientists and clinicians in new ways and spark new questions for the field and collaborations for the future. “I love when you are frantically taking notes during talks, not just because you're making notes about the knowledge that you're gaining, but you're applying it in real time to things you're working on and wondering how you can make new connections.”

This eSymposia will highlight the breadth of the maternal-fetal immunity field, in terms of science, medicine, geography and culture, but most importantly will spur an interdisciplinary community to drive new frontiers in maternal-fetal research and medicine.

Dr. Sabra Klein gives us a sneak peek into the upcoming eSymposia on Maternal-Fetal Newborn Immunity in this exclusive KSQA interview:

Join Dr. Sabra Klein and colleagues for the upcoming eSymposia on Maternal-Fetal Newborn Immunity!

About the Author

Alison Gilchrist

I graduated with my doctorate in molecular, cellular, and developmental biology from the University of Colorado Boulder in December 2020. During my PhD I studied flaviviruses, which is a group of viruses that includes dengue, Zika, and yellow fever viruses, among others. Then I moved to New York University to study the COVID-19 vaccines and our immune response to new vaccine platforms.

Throughout 2020 and into 2021, working with Keystone kept me involved in the scientific community beyond my thesis work and immediate lab surroundings, which I very much appreciated, since travel and in-person meetings were out of the question!

Every virtual meeting has taught me about new techniques and scientific discoveries, and it has been a treat to see so many possibilities on the future just as I was making decisions for my own scientific career. 

Connect with Alison on Twitter @AlisonAbridged or email alison.r.gilchrist@gmail.com

See Alison’s podcasts on @BuffsTalkSci or buffstalkscience.com