Dr. Klein reported receiving grants from Pfizer, Merck, GlaxoSmithKline, and Sanofi Pasteur. The results were unchanged when no adjustments for covariates were made (Supplemental Table3). Wkly. Am. Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey. Percentages presented were weighted to account for the probability of selection for sampled cases (3). CAS In this design, we used Cox proportional hazards models with calendar days as the underlying scale to estimate hazard ratios and calculated vaccine effectiveness as 1 minus the hazard ratio. T.R. "The subpopulations with the highest risk should be considered a priority for COVID-19 therapeutics and further booster doses.". Vaccination status is not available for Iowa and cases from Iowa are excluded from analyses that examined vaccination status. Rates are calculated using the CDC National Center for Health Statistics vintage 2020 bridged-race postcensal population estimates for the counties included in surveillance. 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. The rate among adults who received a primary series, but no booster or additional dose, was three times the rate among adults who received a booster or additional dose. All these results were similar to those when no adjustments for covariates are made (Supplemental Table1). SARS-CoV-2 infections can result in COVID-19associated hospitalizations, even among vaccinated persons. The efficacy of COVID 19 vaccines for reducing the risk of severe COVID-19 infection is demonstrated in real life. All other authors declare no competing interests. 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. M.G. National influenza and COVID-19 surveillance report: 27 January 2022 (week 4). Iowa does not provide data on vaccination status. 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. KPNC members are similar to the broad catchment population in Northern California in terms of sociodemographic characteristics34. A study from the U.K. government, published last week, found that three doses of vaccine. As a result, the number of total hospitalizations exceeds the sum of unvaccinated adults, adults who received a primary series without a booster or additional dose, and adults who received a primary series with a booster or additional dose. In supplemental analyses by trimester of vaccination, receipt of the second dose during the second and third trimesters reduced the risk of infants testing SARS-CoV-2 positive during the Delta dominant period by 91% (95% CI: 63, 98) and 85% (95% CI: 50, 96), respectively, during the first 2 months of life, by 59% (95% CI: 21, 79) and 67% (95% CI: 37, 83) during the first 4 months of life and by 64% (95% CI:31, 81) and 53% (95% CI: 24, 71) during the first 6 months of life. The outcomes were the infants first positive nasal/throat swab for SARS-CoV-2 by PCR, and the first COVID-19-related hospitalization, occurring during the first 6 months of life and recorded in the electronic health record. J., Fireman. O.Z., N.P.K., and B.F. conceived and designed the study. Stay up to date with what you want to know. Implementing strategies that result in the equitable receipt of COVID-19 vaccinations, though building vaccine confidence, raising awareness of the benefits of vaccination, and removing barriers to vaccination access among persons with disproportionately higher hospitalizations rates from COVID-19, including Black adults, is an urgent public health priority. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Effectiveness of BNT162b2 vaccination during pregnancy in preventing hospitalization for SARS-CoV-2 in infants. Article Google Scholar. 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? *** An additional 172 (3.4%, 95% CI = 2.7%4.2%) adults were partially vaccinated, 69 (0.9%, 95% CI=0.61.2) received a primary vaccination series <14 days before receiving a positive SARS-CoV-2 test result, and 186 (4.1%) had unknown vaccination status; these groups are not further described in this analysis. You will be subject to the destination website's privacy policy when you follow the link. Data requests may be sent to Kaiser Permanente Division of Research: DOR.IRB.Submissions@kp.org. Andrews, N. et al. Symptoms are abstracted from the medical chart and might not be complete. Wkly. We did not have genotyping data to confirm the variant that infected infants who tested positive and instead relied on state data regarding circulating strain predominance in the Northern California region. Blakeway, H. et al. These persons are excluded from the proportions of race/ethnicity but are included in other analyses. Most QCovid risk groups were tied to an increased risk of post-booster death, except congenital heart disease, asthma, and previous fracture. Publishers note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Overall, 63% of Americans are fully vaccinated. All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Preliminary findings of mRNA Covid-19 vaccine safety in pregnant persons. . and/or the original MMWR paper copy for printable versions of official text, figures, and tables. 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 B, Severe outcomes included hospitalization and death. Aircraft wastewater surveillance could be used with traveler-based surveillance to provide an early warning system for COVID-19 and other pathogens. 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 (2022). GD declares that his employer UK Health Security Agency (previously operating as Public Health England) received funding from GlaxoSmithKline for a research project related to influenza antiviral treatment. Percentages presented for demographic characteristics are weighted column percentages. SARS-CoV-2 variant data update, England: Version 21. https://doi.org/10.1038/s41467-023-36547-4, DOI: https://doi.org/10.1038/s41467-023-36547-4. During Omicron predominance, children aged <6 months accounted for 44% of hospitalizations among children ages 04 years3. Rates cannot be stratified by pregnancy status because the underlying population of pregnant women in the catchment area is unknown. Sarah J. Open 5, e2233273 (2022). https://doi.org/10.1016/j.jpeds.2022.09.059 (2022). Voysey, M., Pollard, A. J., Sadarangani, M. & Fanshawe, T. R. Prevalence and decay of maternal pneumococcal and meningococcal antibodies: a meta-analysis of type-specific decay rates. References to non-CDC sites on the Internet are The population of unvaccinated adults is determined by subtracting the number of adults who received any dose of vaccine, as previously defined, from the population. Wkly. ICU admission status was missing in 1.3% (weighted) of hospitalizations; these hospitalizations are included in other analyses. Iowa does not provide data on vaccination status. * Information on the impact that booster or additional doses of COVID-19 vaccines have on preventing hospitalizations during Omicron predominance is limited. This analysis describes weekly hospitalization rates during Delta- and Omicron-predominant periods. Female sex was a protective factor (HR, 0.52), while residence in a nursing home or low-income area was a risk factor. The results were published yesterday in JAMA Network Open. 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. Baden, L. R. et al. MMWR Morb Mortal Wkly Rep 2022;71:1328. Article 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. Carlsen, E. O. et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. Vaccine 31, 21652168 (2013). If material is not included in the articles Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Additional recommendations followed and data availability on booster-dose status varies by age because not all age groups were recommended by ACIP to receive booster doses at the same time. Waning 2-dose and 3-dose effectiveness of mRNA vaccines against COVID-19-associated emergency department and urgent care encounters and hospitalizations among adults during periods of delta and omicron variant predominanceVISION Network, 10 states, August 2021-January 2022. * https://covid.cdc.gov/covid-data-tracker/#variant-proportions, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covid-net/purpose-methods.html. A free-text field for other types of residences was examined; patients with an LTCF-type residence were also categorized as LTCF residents. But the charts are in line with data from the UK Health Safety Agency, which found that protection from a third dose of Pfizer or Moderna vaccine against hospitalization with Omicron was about 89%, waning slightly to 83% at 10 weeks, Insider's Catherine Schuster Bruce reported. J. Med. 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. If the SARS-CoV-2 test date was not available, hospital admission date was used. You can review and change the way we collect information below. Age-adjusted rates were calculated by dividing the number of hospitalized COVID-19 patients by population estimates for race/ethnicity, and vaccination status in the catchment area. Three recent epidemiological studies found that vaccination during pregnancy was associated with a reduced risk of SARS-CoV-2 infection in infants during their first 4 months of life and a reduced risk of hospitalization during the first 5 months of life17,18,19. The TND, a case-control study, has been commonly used in studies of the effectiveness of influenza vaccines and more recently COVID-19 vaccines. What are the implications for public health practice? 189, 13791388 (2020). JAMA Netw. Late last year, as Omicron was spreading fast in the US, hospitalization rates per 100,000 rose sharply among unvaccinated adults, while rates in those who were fully vaccinated remained. Background: Risk stratification models have been developed to identify patients that are at a higher risk of COVID-19 infection and severe illness. Suggested citation for this article: Taylor CA, Whitaker M, Anglin O, et al. This is a relevant consideration because vaccines can be less effective in persons with a weakened immune system. Users are referred to the electronic PDF version (https://www.cdc.gov/mmwr) 26K views, 1.2K likes, 65 loves, 454 comments, 23 shares, Facebook Watch Videos from Citizen TV Kenya: #FridayNight https://www.medrxiv.org/content/10.1101/2021.08.27.21262356v1 The group raised concerns about a small number of Guillain-Barre syndrome cases in vaccine recipients and wanted more data, especially on efficacy in those at highest risk. "The high hospitalization rates in unvaccinated compared with vaccinated persons with and without a booster dose underscores the importance of COVID-19 vaccinations in preventing hospitalizations and suggests that increasing vaccination coverage, including booster dose coverage, can prevent hospitalizations, serious illness, and death," the researchers wrote. During the Delta period, receipt of one dose during the third trimester reduced infants risk of testing positive for SARS-CoV-2 by 74% (95% CI: 19, 92) during the first 6 months of life (Table3). NMF, SB, SFunk, ACG, DDA, and AMP acquired funding. COVID-19 vaccination coverage among pregnant women during pregnancyEight Integrated Health Care Organizations, United States, December 14, 2020-May 8, 2021. Views equals page views plus PDF downloads. During the Omicron-predominant period, hospitalization rates increased among unvaccinated persons and those who completed a primary series, with and without receipt of a booster or additional dose (Figure 2). Analyses were conducted using SAS statistical software survey procedures (version 9.4; SAS Institute). The images or other third party material in this article are included in the articles Creative Commons license, unless indicated otherwise in a credit line to the material. All adults should stay up to date (1) with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. 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. 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. Atlanta, GA: US Department of Health and Human Services, CDC; 2022. 384, 21872201 (2021). New federal data shows adults who received the updated shots cut their risk of being hospitalized with . DOI: http://dx.doi.org/10.15585/mmwr.mm7112e2. This was the highest age-adjusted weekly rate observed among any racial and ethnic group during the pandemic. A recent study found that the mean titer of maternally derived antibodies in infants of vaccinated mothers were higher at age 2 months compared with antibody titers at age 6 months23. In conclusion, in this population-based cohort study, we found that infants born to mothers who received at least two doses of an mRNA COVID-19 vaccine during pregnancy were at lower risk of testing positive for SARS-CoV-2 and were at lower risk of hospitalization during the first 6 months of life compared with infants whose mothers were unvaccinated during pregnancy. Kim, L. et al. Moline HL, Whitaker M, Deng L, et al. Selected counties in California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah (https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm). Table 2. Between December 15, 2020, and May 31, 2022, we identified 62,117 infants born at Kaiser Permanente Northern California (KPNC), an integrated healthcare delivery organization. Ferdinands, J. M. et al. Methods: This is a retrospective cohort study that was conducted in Israel's second-largest . To update your cookie settings, please visit the, https://doi.org/10.1016/S0140-6736(22)00462-7, Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study, https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern, https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/scientific-brief-omicron-variant.html, https://www.mrc-bsu.cam.ac.uk/now-casting/report-on-nowcasting-and-forecasting-9th-december-2021/, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1050999/Technical-Briefing-35-28January2022.pdf, https://www.research.ed.ac.uk/en/publications/severity-of-omicron-variant-of-concern-and-vaccine-effectiveness-, https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-50-severity-omicron/, https://doi.org/10.1101/2022.01.11.22269045, https://doi.org/10.1101/2022.01.12.22269179, https://doi.org/10.1101/2022.01.20.22269406, https://doi.org/10.1101/2022.01.12.22269148, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1054071/vaccine-surveillance-report-week-6.pdf, https://www.gov.uk/government/publications/investigation-of-sars-cov-2-variants-routine-variant-data-update, https://www.gov.uk/government/publications/nhs-test-and-trace-statistics-england-methodology/nhs-test-and-trace-statistics-england-methodology, https://www.england.nhs.uk/contact-us/privacy-notice/national-flu-vaccination-programme/, https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/emergency-care-data-set-ecds, https://digital.nhs.uk/services/secondary-uses-service-sus, https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-hospital-activity/, https://doi.org/10.1101/2021.08.13.21262014, View Large Selected counties in California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah (https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm). Morb. Vaccine 35, 72977301 (2017). NMF, MC, GD, DDA, AMP, and ST supervised the work. Without the vaccines many more people would likely be in hospital. Over the entire study period, the incidence of hospitalization for COVID-19 was lower during the first 6 months of life among infants of vaccinated mothers compared with infants of unvaccinated mothers (21/100,000 person-years vs. 100/100,000 person-years). 4% of cases) without NHS numbers were excluded from our primary analysis. These trends could result in epidemic phase bias if infection severity is correlated with time from infection to test. The study had limitations worth noting. They help us to know which pages are the most and least popular and see how visitors move around the site. mmwrq@cdc.gov. Sect. Overall, the study results support recommendations for vaccination during pregnancy to protect both mothers and their infants. If SARS-CoV-2 test date was missing, hospitalization admission date was used. Schrag, S. J. et al. Risk factors for severe COVID-19 in children. Thank you for taking the time to confirm your preferences. J. Med. Foo, D., Sarna, M., Pereira, G., Moore, H. C. & Regan, A. K. Longitudinal, population-based cohort study of prenatal influenza vaccination and influenza infection in childhood. J. J. Pediatr. Age was the most important risk factor for COVID-19 death (eg, HR, 31.3 for an 80-year-old vs a 50-year-old). Third, because immunocompromise status is not always known, it is not possible to distinguish between booster and additional doses; this could have influenced observed rates. Kaiser Permanente Northern California, Vaccine Study Center, Oakland, CA, USA, Ousseny Zerbo,G. Thomas Ray,Bruce Fireman,Evan Layefsky,Kristin Goddard,Edwin Lewis,Pat Ross&Nicola P. Klein, Yale University, Institute for Global Health, New Haven, CT, USA, Department of Internal Medicine (Infectious Diseases), Yale School of Medicine, New Haven, CT, USA, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA, Obstetrics and Gynecology, Kaiser Permanente Northern California Oakland, Oakland, CA, USA, Regional Perinatal Service Center, Kaiser Permanente Northern California, Santa Clara, CA, USA, You can also search for this author in Lipkind, H. S. et al. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.. Although both approaches adjusted for the same confounding factors, the effectiveness estimates from the TND were higher than those from the cohort design, which is consistent with our previous analyses of influenza vaccine effectiveness in which we also observed that the TND tended to result in higher vaccine effectiveness estimates than did our cohort analyses30. During the proxy omicron period, we found a vaccine effectiveness of 70% (95% confidence interval . provided as a service to MMWR readers and do not constitute or imply 1.04-1.49) after adjusting for age, sex, and vaccine characteristics. Data about boosters was only available for those over 50. Stay up to date with your COVID-19 vaccines. Evaluation of the relative virulence of novel SARS-CoV-2 variants: a retrospective cohort study in Ontario, Canada. and B.F. P.R. Wkly Rep. 71, 352358 (2022). Thus, this design better adjusts for healthcare-seeking behavior31,32, but it may also introduce other biases including selection bias33. Mortal. TN, NMF, SGN, DDA, AMP, and ST wrote the original draft of the manuscript. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in During the Omicron-predominant period, overall weekly adult hospitalization rates peaked at 38.4 per 100,000, exceeding the previous peak on January 9, 2021 (26.1) and the peak rate during the Delta-predominant period (15.5) (Figure 1). All HTML versions of MMWR articles are generated from final proofs through an automated process. 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. 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. Effectiveness of COVID-19 vaccines in preventing hospitalization among adults aged 65 yearsCOVID-NET, 13 states, FebruaryApril 2021. 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. But those countries have high vaccination rates, and there, too, Omicron has spread most quickly among younger adults. Cookies used to make website functionality more relevant to you. 226, 236 e1236.e14 (2022). Our additional supplemental analysis suggests that pregnant persons who received at least one vaccine dose before pregnancy should complete their vaccination series during pregnancy to provide protection to their children during the first 6 months of life. Fully-vaccinated in this chart meant one dose of the J&J vaccine or two doses of Pfizer or Moderna. With the emergence of the SARS-CoV-2 Omicron variant in late 2021, Canadian public health case/contact testing was scaled back due to high infection rates with milder symptoms in a highly vaccinated population. It is possible that this practice may have led to some misclassification of the outcome, and we were unable to assess whether this misclassification was differential between vaccinated and unvaccinated mothers.