In this primary design, all eligible infants meeting inclusion criteria were included without sampling which improved power and minimized bias related to selection. This is in keeping with the age profile. From Jan 1 to Mar 16, 2022, when Omicron was predominant, 4,781 (0.02%) of 19,473,570 booster recipients died of COVID-19, and 58,020 (0.3%) died of other causes. NMF, MC, GD, DDA, AMP, and ST supervised the work. Vaccine 40, 656665 (2022). J. Obstet. We observed a similar pattern in vaccine effectiveness by trimester during the Omicron dominant period, however, estimates of vaccine effectiveness by trimester were imprecise and much lower than during the Delta period (Table3). Maternal vaccination with at least two doses reduced the infants risk of testing SARS-CoV-2 positive initially by 84% which decreased to 56% by 6 months of life in the Delta dominant period. Individual and neighborhood factors associated with failure to vaccinate against influenza during pregnancy. However, protection estimates greater than 90% might be too high if individuals with a previous infection were more likely than those without one to come forward for a test for reasons other than suspicion of COVID-19. Evaluation of acute adverse events after Covid-19 vaccination during pregnancy. U.S. regulators had authorized the Pfizer/BioNTech COVID-19 vaccine for children aged 5 to 11 years in October, prior to the Omicron surge. SGN, HHW, NA, WH, MK, PB, AZ, JLB, MC, NAA, KH, RH, AC, GD, and ST curated the data. Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV-2 during the first six months of life. You will be subject to the destination website's privacy policy when you follow the link. Mortal. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Persons who received only 1 vaccine dose of a 2-dose series 14 days before the SARS-CoV-2 test date or had received a single dose of either a 1- or 2-dose vaccination series <14 days before the positive SARS-CoV-2 test result were considered partially vaccinated and were not included in rates by vaccination status. However, we have no reason to expect a strong association between the absence of NHS number and SARS-CoV-2 variant. VE against hospitalization was not estimated because of the very small number of hospitalized cases. M.G. Nature. With wave after wave of SARS-CoV-2 variants, COVID-19 patients filled the worlds' hospitals and morgues because not everybody had access to vaccines or were willing to be vaccinated. A WHO spokesman says China informed the WHO about the case, which involves a 53-year-old woman, on Feb 24. The final study population included 30311 (48.8%) infants who were KPNC members at least 2 months after birth. We calculated vaccine effectiveness (VE) as 100% multiplied by 1HR. Racial and ethnic disparities in rates of COVID-19associated hospitalization, intensive care unit admission, and in-hospital death in the United States from March 2020 to February 2021. The objective of this study was to further evaluate the effectiveness of at least two doses of mRNA COVID-19 vaccination during pregnancy for preventing SARS-CoV-2 infection in infants during the first 2, 4, and 6 months of life during the Delta and Omicron variant periods. B., Lewis. The TND, a case-control study, has been commonly used in studies of the effectiveness of influenza vaccines and more recently COVID-19 vaccines. Most mothers (1032 of 1138) who received only one dose received the vaccine during the third trimester. Clinical information was abstracted for 5,681 adults with COVID-19associated hospitalization during July 1, 2021January 31, 2022 (Table). Vaccine 35, 58505857 (2017). Recently another study reported that the effectiveness of mRNA COVID-19 vaccines against infections and hospitalizations among pregnant people was higher during the Delta period than during the Omicron period21. J. Med. J. Med. MMWR Morb Mortal Wkly Rep 2022;71:466473. Second, vaccination status is subject to misclassification; this might affect estimation of rates by vaccination status. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of part 46, 21 C.F.R. Most QCovid risk groups were tied to an increased risk of post-booster death, except congenital heart disease, asthma, and previous fracture. There were only one hospitalized case among the children of vaccinated mothers and nine hospitalized cases among the children of unvaccinated mothers (Table1). Objectives To develop and implement a scoring tool to identify COVID-19 patients that are at risk for severe illness during the Omicron wave. Using Cox regression, the effectiveness of 2 doses of COVID-19 vaccine received during pregnancy was 84% (95% confidence interval [CI]: 66, 93), 62% (CI: 39, 77) and 56% (CI: 34,71) during months 02, 04 and 0- 6 of a childs life, respectively, in the Delta variant period. RESP-NET: COVID-19 Associated Hospitalization Rates among Adults Ages 65 Years and Older CDC's Respiratory Virus Hospitalization Surveillance Network (RESP-NET) shows that overall weekly rates of COVID-19-associated hospitalizations have declined for all age groups from a peak in December 2022. The Lancet Regional Health Southeast Asia, The Lancet Regional Health Western Pacific, 36-fold higher estimate of deaths attributable to red meat intake in GBD 2019: is this reliable? Coinciding with Omicron variant predominance, COVID-19associated hospitalization rates among adults increased in late December 2021 and peaked in January 2022; rates increased more among Black adults relative to rates among adults of other racial and ethnic groups. Effectiveness of COVID-19 vaccines in preventing hospitalization among adults aged 65 yearsCOVID-NET, 13 states, FebruaryApril 2021. Omicron vaccine effectiveness estimates for 7 to 59 days, 60 to 119 days, and 240 days or more after the second dose are not presented owing to imprecision in the estimates and wide 95% CIs (ie, 100 percentage points). Google Scholar. In all models, we used calendar days as the time scale to account for changes over time in SARS-CoV-2 circulation and vaccine uptake. Thompson, M. G. et al. Safety and efficacy of single-dose Ad26.COV2.S vaccine against Covid-19. Klein, N. P. et al. Covid-19 vaccine effectiveness against the Omicron (B.1.1.529) variant. Vaccination status is not available for Iowa and cases from Iowa are excluded from analyses that examined vaccination status. Maternal vaccination and risk of hospitalization for Covid-19 among infants. The KPNC Institutional review board approved and waived consent for this study. Like influenza and Tdap vaccines15,16, data suggest that vaccination during pregnancy may protect infants who are not old enough to be vaccinated against COVID-19. COVID-19 vaccines have demonstrated both high efficacy in clinical trials and high real-world effectiveness, especially against the original and Delta variant of the virus6,7,8,9,10. These findings are consistent with the diminishing of pregnancy-derived antibodies in infants over time22. Relative to the Delta-predominant period, the proportion of cases in non-Hispanic Asian or Pacific Islanders also increased, whereas the proportion in all other racial and ethnic groups decreased. All other authors declare no competing interests. However, linking is sometimes not possible because CDC does not receive personally identifiable information about vaccine doses. Implementing strategies that result in the equitable receipt of COVID-19 vaccinations among persons with disproportionately higher hospitalizations rates, including non-Hispanic Black adults, is an urgent public health priority. O.Z. mmwrq@cdc.gov. MB), Help with A and B, Markers indicate estimates, with vertical lines indicating 95% CIs. By the end of December, Omicron made up 58% of all cases in the US, per Our World in Data, but Delta is thought to cause more severe disease and more hospitalizations than Omicron on average. Percentages presented were weighted to account for the probability of selection for sampled cases (3). Statistical codes are not publicly available but are available from the corresponding author. Initial hospital data from England and Denmark also suggest Omicron cases are less severe. However, in contrast with the Norwegian study which reported that infants of mothers who were vaccinated had a 33% decreased risk of testing positive during the first 4 months of life during the Omicron period17, our study found a 13% reduced risk that was not statistically significant. KPNC has a comprehensive electronic health record system (Kaiser Permanente HealthConnect, a customized EPIC system), that captures detailed information on all medical services, including immunization, membership enrollment including place of residence, demographics, and pregnancy-related care from pregnancy onset to delivery, and beyond. 384, 403416 (2021). Shimabukuro, T. T. et al. Starting the week ending December 4, 2021, Maryland data are not included in calculations but are included in previous weeks. The study was funded by the National Institute of Allergy and Infectious Disease grant # 1R01AI168373-01 to O.Z. Christopher A. Taylor, PhD1; Michael Whitaker, MPH1; Onika Anglin, MPH1,2; Jennifer Milucky, MSPH1; Kadam Patel, MPH1,2; Huong Pham, MPH1; Shua J. Chai, MD3,4; Nisha B. Alden, MPH5; Kimberly Yousey-Hindes, MPH6; Evan J. Anderson, MD7,8,9; Kenzie Teno, MPH10; Libby Reeg, MPH11; Kathryn Como-Sabetti, MPH12; Molly Bleecker, MA13; Grant Barney, MPH14; Nancy M. Bennett, MD15; Laurie M. Billing, MPH16; Melissa Sutton, MD17; H. Keipp Talbot, MD18; Keegan McCaffrey19; Fiona P. Havers, MD1; COVID-NET Surveillance Team (View author affiliations). 41, e81e86 (2022). Cite this article. Vaccination status (unvaccinated, receipt of a primary series only, or receipt of a primary series plus a booster or additional dose) was determined for individual hospitalized patients and for the catchment population using state immunization information systems data (2). The TND is designed to better control for bias related to health care-seeking behavior31,32. Selected counties in California, Colorado, Connecticut, Georgia, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah (https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm). In addition, our study period included two different SARV-CoV-2 variants, which allowed estimation of the effectiveness of vaccination during pregnancy in infants during both the Delta and Omicron variant periods. Corresponding author: Christopher A. Taylor, iyq3@cdc.gov. . This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.. SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland, Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy, Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel, Covid-19 vaccination programme effectiveness against SARS-CoV-2 related infections, hospital admissions and deaths in the Apulia region of Italy: a one-year retrospective cohort study, Post-vaccination outcomes in association with four COVID-19 vaccines in the Kingdom of Bahrain, Effectiveness and protection duration of Covid-19 vaccines and previous infection against any SARS-CoV-2 infection in young adults, The indirect effect of mRNA-based COVID-19 vaccination on healthcare workers unvaccinated household members, SARS-CoV-2 infection and COVID-19 vaccination in pregnancy, Duration of mRNA vaccine protection against SARS-CoV-2 Omicron BA.1 and BA.2 subvariants in Qatar, https://downloads.aap.org/AAP/PDF/AAP%20and%20CHA%20-%20Children%20and%20COVID-19%20State%20Data%20Report%209.29.22%20FINAL.pdf?_ga=2.255000394.335550773.1665001859-370326403.1636740765, https://doi.org/10.1016/j.jpeds.2022.09.059, http://creativecommons.org/licenses/by/4.0/. BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting. TN, NMF, SFlax, MC, DDA, AMP, and ST conceptualised the work. This was the highest age-adjusted weekly rate observed among any racial and ethnic group during the pandemic. Finally, the COVID-NET catchment areas include approximately 10% of the U.S. population; thus, these findings might not be nationally generalizable. Vaccinations were limited only to those received during pregnancy. Open 5, e2232760 (2022). COVID-19 hospitalization rates per 100,000 population by age and vaccination status, January 05 to February 01, 2023 Age group Age-specific rate per 100,000 among unvaccinated individuals Age-specific rate per 100,000 among those who received at least one booster dose Likelihood of unvaccinated individuals being hospitalized with TN, NMF, SGN, DDA, AMP, and ST wrote the original draft of the manuscript. The U.K. Health. New charts from the Centers for Disease Control and Prevention (CDC), more severe disease and more hospitalizations, Insider's Catherine Schuster Bruce reported. J. Epidemiol. JAMA Netw. We thank staff at UKHSA and members of the UK Government SPI-M committee and the UKHSA Variant Technical Group for valuable discussions. Two recent papers claim there are no differences between surgical masks and respirators for preventing the spread of respiratory diseases like COVID-19 and flu, but the articles are deeply flawed. JAMA 327, 10871089 (2022). endorsement of these organizations or their programs by CDC or the U.S. Age-adjusted hospitalization rates among Black adults peaked at 94.7 (January 8, 2022), higher than that among all other racial and ethnic groups, 3.8 times the rate among White adults (24.8) for the same week, and 2.5 times the previous peak (January 16, 2021) among Black adults (37.2). Over the entire study period, the crude rate of hospitalization with a SARS-CoV-2 positive test was lower during the first 6 months of life among infants whose mothers received at least two doses of mRNA COVID-19 vaccines during pregnancy compared with infants whose mothers were unvaccinated during pregnancy (21/100,000 PY vs. 100/100,000 PY). image, https://doi.org/10.1038/s41586-022-04474-x, https://doi.org/10.1038/s41586-022-04479-6, https://doi.org/10.1101/2022.01.18.22269082, https://www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2021-to-2022-season, Download .pdf (.95 Vaccine effectiveness of cell-culture relative to egg-based inactivated influenza vaccine during the 2017-18 influenza season. . Department of Health and Human Services. PLoS ONE 15, e0229279 (2020). We conducted secondary sensitivity analyses restricting the population to infants who received at least one SARS-CoV-2 PCR test. Carlsen, E. O. et al. All adults should stay up to date (1) with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. The average death rate among Americans over age 65 who contract the flu has ranged between 1 in 75 and 1 in 160 in recent years, according to the C.D.C. All authors (O.Z., B.F., N.P.K., T.R., M.G., E.L., P.R., K.G., S.O., and E.L.) critically reviewed the manuscript and decided to proceed with publication. Weekly rates among unvaccinated adults and adults who received a primary COVID-19 vaccination series with a booster or additional dose peaked at 149.8 (January 8, 2022) and 11.7 (January 22, 2022), respectively. Buchan, S. A. et al. 241(d); 5 U.S.C. part 56; 42 U.S.C. Includes current treatment or recent diagnosis of an immunosuppressive condition or use of an immunosuppressive therapy during the preceding 12 months. Pregnant women were excluded because their reasons for hospital admission (4) might differ from those for nonpregnant persons. Mortal. CDC. However, data currently available on the persistence of immunity after vaccination on the one hand and the emergence of viral variants with reduced sensibility to vaccine immunity on the other, raise the need to administer boosters to maintain the protection and to compare . The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Fully-vaccinated in this chart meant one dose of the J&J vaccine or two doses of Pfizer or Moderna. Experts say they. Beginning the week of December 1925, 2021, the B.1.1.529 (Omicron) variant of SARS-CoV-2 (the virus that causes COVID-19) became the predominant circulating variant in the United States (i.e., accounted for >50% of sequenced isolates). There was no link between risk of COVID-19 death and race, except for Indian patients, who were at slightly higher risk than their White peers. Data were available for researchers who meet the criteria for access to Kaiser Permanente Northern California confidential data. Additional COVID-NET methods for determining vaccination status have been described previously. J. Overall, the study results support recommendations for vaccination during pregnancy to protect both mothers and their infants. Article The rates don't account for non-vaccine-related risks, Mark Jit, professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine told Insider in an email. and statistical significance was assessed at two-sided p0.05. Adults who completed a primary vaccination series were persons who had received the second dose of a 2-dose COVID-19 vaccination series or a single dose of a 1-dose product 14 days before a positive SARS-CoV-2 test associated with their hospitalization but received no booster or additional dose. and/or the original MMWR paper copy for printable versions of official text, figures, and tables. The risk of hospitalisation appeared to increase when comparing delta with alpha infections. Suggested citation for this article: Taylor CA, Whitaker M, Anglin O, et al. Over the entire study period, the crude rate of hospitalization with a SARS-CoV-2 positive test was lower during the first 6 months of life among infants whose mothers received at least two doses . You are using a browser version with limited support for CSS. 61) indicates a lower risk of hospitalisation with omicron versus delta, averaging over all age groups and vaccination strata. Zerbo, O., Ray, G.T., Fireman, B. et al. They help us to know which pages are the most and least popular and see how visitors move around the site. Table 2. * Data are from a weighted sample of hospitalized nonpregnant adults with completed medical record abstractions and a discharge disposition. COVID-NET conducts population-based surveillance for laboratory-confirmed COVID-19associated hospitalizations in 99 counties across 14 states. COVID-19associated hospitalizations are those occurring among residents of a predefined surveillance catchment area who have a positive real-time reverse transcriptionpolymerase chain reaction (RT-PCR) or rapid antigen detection test result for SARS-CoV-2 during hospitalization or the 14 days preceding admission. The data cannot be shared publicly because the data contain potentially identifying or sensitive patient information and is legally restricted by Kaiser Permanente Northern California. During the study period, the omicron variant experienced a rapidly increasing incidence, whereas the delta variant was experiencing a decreasing or less rapidly increasing incidence. The code used to analyse the data is available on. Provided by the Springer Nature SharedIt content-sharing initiative. Saving Lives, Protecting People, https://covid.cdc.gov/covid-data-tracker/#variant-proportions, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covid-net/purpose-methods.html, https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm, https://www.cdc.gov/nchs/nvss/bridged_race.htm, https://www.medrxiv.org/content/10.1101/2021.08.27.21262356v1, https://www.cdc.gov/mmwr/volumes/70/wr/mm7050e2.htm, https://www.nejm.org/doi/full/10.1056/NEJMoa2114255, https://medrxiv.org/cgi/content/short/2021.08.27.21262356v1, https://www.medrxiv.org/content/10.1101/2022.01.11.22269045v1, https://data.cdc.gov/Vaccinations/COVID-19-Vaccination-Demographics-in-the-United-St/km4m-vcsb, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html, https://doi.org/10.1001/jamanetworkopen.2021.30479, Centers for Disease Control and Prevention, U.S. Department of Health & Human Services, American Indian or Alaska Native, non-Hispanic, Psychiatric admission requiring medical care. On 13 December, Denmark released data showing that hospitalization rates for people infected with Omicron seemed to be on a par with those for people infected with other variants. Rep. 71, 429436 (2022). Finally, we conducted additional supplemental analyses to estimate VE among children whose mothers received at least one vaccine dose prior to pregnancy onset and at least one dose during pregnancy. Vaccinated patients were older (68 vs. 57 years), and 62% had at least one comorbidity Admission to the ICU was 20%, and the mortality rate at 30 days was 14%. **** ICU admission and IMV are not mutually exclusive categories, and patients could have received both. Omicron data in UK is 'enormously worrying,' immunologist says "In the last two weeks, no fewer than 80% of admissions were below the age of 50 years. Graff, K. et al. Because the immune status of all patients is not known, an additional dose (recommended for persons with a weakened immune system) cannot be distinguished from a booster dose. Among children 12 to 17, the . Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birtheight integrated Health Care Organizations, United States, December 15, 2020-July 22, 2021. About half of long-COVID patients who were on sick leave at 4 months were still on sick leave at 2 years. Variances were estimated using Taylor series linearization method. During the Omicron-predominant period, peak hospitalization rates among non-Hispanic Black (Black) adults were nearly four times the rate of non-Hispanic White (White) adults and was the highest rate observed among any racial and ethnic group during the pandemic. N. Engl. Our analysis . TN, NMF, SB, EV, SRS, DDA, and AMP developed the methodology. Sample sizes presented are unweighted with weighted percentages. As infants aged, protection provided by maternal vaccination decreased during both periods. CAS The vaccines have proved highly safe and effective at reducing the risk of severe illness, hospitalization and death. During Omicron predominance, shortly after the Food and Drug Administration authorized COVID-19 vaccination for this age group, population-based hospitalization rates among unvaccinated children were twice as high as were those among vaccinated children. Protection during both periods decreased as infants aged. CAS All HTML versions of MMWR articles are generated from final proofs through an automated process. In the US, as of the end of September 2022, almost 15 million children ages <18 years have tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Coronavirus Disease 2019 (COVID-19). Am. Monthly COVID-19 hospitalization rates were 3.5 to 17.7 times higher in unvaccinated patients than in their vaccinated counterparts, regardless of whether they had received a booster. Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. Rep. 70, 895899 (2021). CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Two to 4 weeks after a booster dose, vaccine effectiveness ranged from around 65-75%, dropped to 55-70% at 5 to 9 weeks, and 40-50% from 10 weeks or more after a booster dose. Pediatrics. For mothers of infants in the cohort, we extracted from the electronic health record data: age at pregnancy onset, self-reported race/ethnicity (Asian, Black, Hispanic, Pacific Islander, Multiracial, Native American, Other, White), the primary KPNC facility at which the woman received most of their health care, insurance payor (dichotomized as Medicare/Medicaid/other subsidized insurance and Other), neighborhood deprivation index [NDI]35 categorized into quartiles with higher values representing greater deprivation), pre-pregnancy body mass index (BMI=kg/m2; underweight <18.5, normal 18.524.9, overweight 25.029.9, obese 30.0), pre-pregnancy diabetes status, pre-pregnancy hypertension, and parity (0, 1, 2, 3, 4).
March 11, 2023