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ResearchIn-Press PreviewCOVID-19Infectious disease Open Access | 10.1172/jci.insight.157354

Neutralizing antibody activity against SARS-CoV-2 variants in gestational age-matched mother-infant dyads after infection or vaccination

Yusuke Matsui,1 Lin Li,2 Mary Prahl,3 Arianna G. Cassidy,2 Nida Ozarslan,2 Yarden Golan,4 Veronica J. Gonzalez,2 Christine Y. Lin,2 Unurzul Jigmeddagva,2 Megan A. Chidboy,2 Mauricio Montano,6 Taha Y. Taha,6 Mir M. Khalid,6 Bharath Sreekumar,6 Jennifer M. Hayashi,6 Pei-Yi Chen,6 G. Renuka Kumar,6 Lakshmi Warrier,7 Alan H.B. Wu,8 Dongli Song,9 Priya Jegatheesan,9 Daljeet S. Rai,10 Balaji Govindaswami,11 Jordan M. Needens,12 Monica Rincon,13 Leslie Myatt,14 Ifeyinwa V. Asiodu,7 Valerie J. Flaherman,3 Yalda Afshar,15 Vanessa L. Jacoby,16 Amy P. Murtha,16 Joshua F. Robinson,16 Melanie Ott,17 Warner C. Greene,17 and Stephanie L Gaw16

1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

Find articles by Matsui, Y. in: PubMed | Google Scholar

1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

Find articles by Li, L. in: PubMed | Google Scholar |

1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

Find articles by Golan, Y. in: PubMed | Google Scholar |

1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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1Gladstone Institute of Virology, Gladstone Institutes, San Francisco, United States of America

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3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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2Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, San Francisco, United States of America

3Department of Pediatrics, UCSF, San Francisco, United States of America

4Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, United States of America

5Department of Obstetrics, Gynecology, and Reproductive Sciences, UCSF, san Francisco, United States of America

6Gladstone Institute of Virology and Immunology, Gladstone Institutes, San Francisco, United States of America

7Department of Family Health Care Nursing, UCSF, San Francisco, United States of America

8Department of Laboratory Medicine, UCSF, San Francisco, United States of America

9Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, United States of America

10Division of Family Medicine, Stanford University, Palo Alto, United States of America

11Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

12Department of Obstetrics & Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, United States of America

13Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, United States of America

14Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, United States of America

15Department of Obstetrics and Gynecology, UCLA, Los Angeles, United States of America

16Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, United States of America

17Department of Medicine, UCSF, San Francisco, United States of America

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Published May 17, 2022 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.157354.
Copyright © 2022, Matsui et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published May 17, 2022 - Version history
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Abstract

Pregnancy confers unique immune responses to infection and vaccination across gestation. To date, there is limited data comparing vaccine versus infection-induced nAb to COVID-19 variants in mothers during pregnancy. We analyzed paired maternal and cord plasma samples from 60 pregnant individuals. Thirty women vaccinated with mRNA vaccines (from December 2020 through August 2021) were matched with 30 naturally infected women (from March 2020 through January 2021) by gestational age of exposure. Neutralization activity against the five SARS-CoV-2 Spike sequences was measured by a SARS-CoV-2 pseudotyped Spike virion assay. Effective nAbs against SARS-CoV-2 were present in maternal and cord plasma after both infection and vaccination. Compared to wild type Spike, these nAbs were less effective against the Delta and Mu Spike variants. Vaccination during the third trimester induced higher cord nAb levels at delivery than infection during the third trimester. In contrast, vaccine-induced nAb levels were lower at the time of delivery compared to infection during the first trimester. The transfer ratio (cord nAb level/maternal nAb level) was greatest in mothers vaccinated in the second trimester. SARS-CoV-2 vaccination or infection in pregnancy elicit effective nAbs with differing neutralization kinetics that is impacted by gestational time of exposure.

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