ArticleFrontiers in public health2026
Comparative immunogenicity of COVID-19 vaccination in pregnant and non-pregnant women: a real-world cohort study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pregnant individuals are at increased risk of severe COVID-19-related morbidity and adverse obstetric outcomes, highlighting the importance of effective vaccination. Although COVID-19 vaccine safety during pregnancy is well established, real-world evidence on vaccine-induced humoral immunity remains limited. This study compared neutralizing antibody responses after COVID-19 vaccination in pregnant and non-pregnant women and evaluated the effects of vaccine dose number, platform, and timing during pregnancy. Methods: This retrospective cohort study included 171 vaccinated women of reproductive age, comprising 95 pregnant and 76 non-pregnant participants. Neutralizing antibody titers were measured using a surrogate virus neutralization test. Vaccine platforms included mRNA vaccines (BNT162b2, Pfizer-BioNTech), inactivated vaccines (CoronaVac, Sinovac), and a small number of heterologous regimens. Antibody levels were compared using the Mann-Whitney Results: Pregnant women had significantly lower neutralizing antibody titers than non-pregnant controls (median 5.62 vs. 16.25 AU/mL; Conclusion: COVID-19 vaccination elicits robust neutralizing antibody responses in pregnant women, with overall humoral responsiveness preserved despite quantitative differences in antibody magnitude. Lower antibody levels are predominantly explained by differences in cumulative vaccine exposure rather than pregnancy-related immune impairment, although a residual independent association of pregnancy cannot be fully excluded. Completing recommended vaccine schedules is essential to optimize maternal and neonatal protection.
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