Ai-ris Collier, MD, is an instructor in obstetrics, gynecology, and reproductive biology at Beth Israel Deaconess Medical Center, where she specializes in maternal-fetal medicine. Her research, reported in JAMA earlier this summer, supported the safety and effectiveness of the COVID-19 mRNA vaccines in pregnant women.
What drew you to obstetrics/gynecology and to focus on maternal-fetal medicine and research?
I went to Harvard Medical School in the Health Sciences and Technology (HST) program thinking I would specialize in pediatric cardiology or another medical sub-specialty, and then I fell in love with OB/Gyn. I found pregnancy and reproductive health so interesting from basic physiology to patient care, where you become so involved in the most intimate and memorable moments—both happy and sad—of peoples’ lives. Eventually, both my clinical and research interests drew me towards maternal-fetal medicine. In retrospect, I grew up in a very woman-centered family with three younger sisters, so it makes perfect sense!
I’ve always wanted to be a scientist, and since medical school, I’ve been interested in cellular immunology and understanding the mechanisms of immune tolerance. I’ve translated what I learned studying immune tolerance in a type one diabetes model and a tumor model to human pregnancy. The maternal adaptive immune tolerance that allows for the fetus to grow is largely still not understood.
“Since completing the course, I’ve received positive feedback at conferences after my presentations. It’s one thing to do great research, but to effectively communicate and engage your audience is super important.”
Did Harvard Catalyst courses help you as a physician-scientist to develop the research side of your interests?
I’ve definitely taken advantage of available courses, for example, when I got my K award [an NIH career development multi-year grant], I joined GRASP (Grant Review and Support Program). Their annual in-person meetings were super helpful in guiding me, as was their work planning tool. The program helped me understand the grant-writing process, what a NIH biosketch is, and how you can make your personal narrative better.
And I would definitely give a shout out to the Effectively Communicating Research two-day course. Since completing the course, I’ve received positive feedback at conferences after my presentations. It’s one thing to do great research, but to effectively communicate and engage your audience is super important.
Talk about pivoting to COVID-19 research and what your vaccine findings mean for pregnant women.
I work in the lab of my mentor, Dan Barouch, the William Bosworth Castle Professor of Medicine and director of the Center for Virology and Vaccine Research. After the research shutdown, we pivoted to focus on just COVID. Other parts of the lab were developing vaccines. As a maternal-fetal medicine specialist, I made it my agenda to make sure pregnancy data were included. We needed to be able to provide information on vaccine safety and efficacy for those who are pregnant, lactating, and considering pregnancy.
Because pregnant or lactating individuals were not included in any of the vaccine phase 3 clinical trials, I focused on studying vaccinated participants who were pregnant or lactating. Our study published in JAMA included our first 30 pregnant participants. Although the sample size doesn’t allow us to make broad statements about efficacy and safety, it does show that the vaccine works just as well from an immune standpoint in pregnant people as in the non-pregnant. I also tell my patients who are considering vaccination that vaccination in pregnancy likely provides some neonatal protection from the transfer of the mom’s antibodies through the placenta.
We continue to enroll pregnant people and follow up on them because there are many other questions to be answered. When is the optimal time to give a vaccine in pregnancy for the best neonatal protection? Do the various types of vaccines have different effectiveness or immunogenicity? How long does immune protection last?
“Although the sample size doesn’t allow us to make broad statements about efficacy and safety, it does show that the vaccine works just as well from an immune standpoint in pregnant people as in the non-pregnant.”
We know that pregnancy is a risk factor for worse COVID-19 outcomes, so we’re encouraging people to remember to include them when designing clinical trials for treatments or vaccines. We need more data. It’s a big step that pregnant women will be included in the COVID-19 booster vaccine trial that we’re participating in at Beth Israel Deaconess Medical Center.
Have you returned to your other line of research?
Yes, I’m also back to my original passion, which is to understand the mechanisms of immune tolerance and how loss of tolerance can lead to pregnancy-related diseases like preeclampsia or fetal growth restriction. I’d like to identify new pathways to better treat or prevent these serious complications. I’m now able to continue enrolling participants with preeclampsia and/or fetal growth restriction and collect blood samples from them on our Labor and Delivery unit. We are also collecting samples from the first trimester.
Personally, have there been any silver linings to the pandemic?
Everyone now knows how to use video conferencing, which has helped us more easily communicate and arrange meetings across time zones, both professionally and personally. My three sisters, parents, and I are scattered—east coast, west coast, and Arizona—but we now routinely get together virtually. We do cocktail hours and exercise as a group. I’ve been in more frequent contact with them this past year than ever before, when we relied on in-person visits.