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Letter
Use of single-dose tocilizumab for treatment of severe COVID-19 in pregnancy: implications for the timing of live infant vaccines
  1. Ingrid Burkhardt1,
  2. Elizabeth Whittaker2
  1. 1 Children's Services, Imperial College Healthcare NHS Trust, London, UK
  2. 2 Paediatrics, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Dr Ingrid Burkhardt, Children's Services, Imperial College Healthcare NHS Trust, London, W2 1NY, UK; burkhardt.ingrid{at}gmail.com

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Tocilizumab (a monoclonal antibody inhibiting interleukin-6) is used as standard of care in the treatment of severe COVID-19 pneumonia. This treatment is also prescribed on a case-by-case basis during pregnancy, despite limited data on the impact on the infant immune response.

Data from regular use of monoclonal antibodies during pregnancy are limited, but as they are actively transported across the placenta, concerns regarding immunosuppression in early infancy exist. Therefore, live vaccines are currently contraindicated in infants until 6 months of age in the case of antenatal exposure to monoclonal antibodies.1

The impact of antenatal exposure to anti-tumor necrosis factor (TNF) monoclonal antibodies was recently reviewed2 suggesting that however likely safe before that point, the BCG vaccination should be delayed to 6 …

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Footnotes

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  • Contributors IB was the primary author. EW reviewed the content and contributed additional valuable input.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.