This case-positive, control-test-negative design also referred to as the test-negative design (TND) has often been used in studies of vaccine effectiveness. Wkly. Vaccinations were limited only to those received during pregnancy. Percentages presented for demographic characteristics are weighted column percentages. Garg S, Patel K, Pham H, et al. First, COVID-19associated hospitalizations might have been missed because of hospital testing practices and test availability. A continuity correction has been applied to the denominators by capping the percent population vaccination coverage at 95% by assuming that at least 5% of each age group would always be unvaccinated in each jurisdiction. Morb. If ethnicity was unknown, non-Hispanic ethnicity was assumed. Vaccination status is based on state immunization information system data. 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. Carlsen, E. O. et al. MMWR Morb Mortal Wkly Rep 2021;70:108893. These persons are excluded from the proportions of race/ethnicity but are included in other analyses. Table 2. 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. Rates cannot be stratified by pregnancy status because the underlying population of pregnant women in the catchment area is unknown. JAMA 326, 16291631 (2021). In this large study which included >30,000 infants, we found that receipt of at least two doses of mRNA COVID-19 vaccine during pregnancy was associated with a decreased risk of infants testing SARS-CoV-2 positive during their first 6 months of life. 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. Officials have received a growing number of reports of XDR Shigella, which is highly transmissible and resistant to commonly recommended antibiotics, in adults. We take your privacy seriously. 1). Mortal. ISSN 2041-1723 (online). and statistical significance was assessed at two-sided p0.05. 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). During the first 6 months of life, 940 (3.10%) infants tested positive for SARS-CoV-2 by polymerase chain reaction (PCR) test and 10 (0.03%) infants were hospitalized with a positive SARS-CoV-2 test. supervised chart reviews. 386, 15321546 (2022). NMF, MC, GD, DDA, AMP, and ST handled project administration. Implementing strategies that result in the equitable receipt of COVID-19 vaccinations, through 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. We conducted a descriptive analysis of the study population and calculated crude rates of SARS-CoV-2 infection and hospitalization by maternal vaccination status. Initial hospital data from England and Denmark also suggest Omicron cases are less severe. Further information on research design is available in theNature Portfolio Reporting Summary linked to this article. Symptoms are abstracted from the medical chart and might not be complete. Science brief: omicron (B.1.1.529) variant. J. Med. TN, NMF, SGN, DDA, AMP, and ST wrote the original draft of the manuscript. TN, NMF, SFlax, SFunk, SA, SB, and ST did the formal analysis. DeSilva, M. et al. 40, e137e145 (2021). Baxter, R., Bartlett. Monthly incidence is based on SARS-CoV-2 positive test result date or, if not known, hospital admission date. Sarah J. The finding that maternal vaccination was less effective at protecting infants during the Omicron dominant period is also consistent with previous studies which have reported decreased effectiveness of mRNA COVID-19 vaccines during Omicron among children and adults14,20. 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 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). Data about boosters was only available for those over 50. Informed consent was waived because this was a data-only study with no direct contact with participants. Article To ensure stability and reliability of rates by vaccination status, data are presented beginning when 14 days have passed since at least 5% of the population of adults aged 18 years in the COVID-NET surveillance catchment area had received an additional or booster dose. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. The KPNC Institutional review board approved and waived consent for this study. "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. We observed that infants protection through vaccination during pregnancy decreased as they aged from 2 months to 6 months. of pages found at these sites. All authors reviewed the manuscript. Ainslie, K. E. C., Shi, M., Haber, M. & Orenstein, W. A. This analysis describes weekly hospitalization rates during Delta- and Omicron-predominant periods. Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV-2 during the first six months of life. NMF, SB, SFunk, ACG, DDA, and AMP acquired funding. Our primary cohort analysis used calendar days as the underlying scale to ensure that we compared infants of vaccinated and unvaccinated mothers on the same calendar days because vaccination status during pregnancy and risk of SARS-CoV-2 infection varied over the study period. 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. 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. https://medrxiv.org/cgi/content/short/2021.08.27.21262356v1. CIDRAP - Center for Infectious Disease Research & Policy Hospitalisation associated with SARS-CoV-2 delta variant in Denmark. Rep. 69, 10811088 (2020). The risk of hospitalisation appeared to increase when comparing delta with alpha infections. Data were available for researchers who meet the criteria for access to Kaiser Permanente Northern California confidential data. 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). Durability of anti-spike antibodies in infants after maternal COVID-19 vaccination or natural infection. J. Med. Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV-2 during the first six months of life, https://doi.org/10.1038/s41467-023-36547-4. Open 5, e2232760 (2022). If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. They help us to know which pages are the most and least popular and see how visitors move around the site. 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 TND analyses avoid this bias by limiting the analysis to infants who were tested for SARS-CoV-2. **** ICU admission and IMV are not mutually exclusive categories, and patients could have received both. NHS Test and Trace statistics (England): methodology. Omicron Is Not More Severe for Children, Despite Rising Hospitalizations More children are being treated for Covid, but a combination of factors, including low vaccination rates, most. J. Epidemiol. Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. IMV status was missing in 1.4% (weighted) of hospitalizations; these hospitalizations are otherwise included elsewhere in the analysis. Rep. 70, 895899 (2021). Additional COVID-NET methods for determining vaccination status have been described previously. Safety and efficacy of single-dose Ad26.COV2.S vaccine 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. ** Monthly incidence among adults who received booster or additional doses was calculated by summing the total number of COVID-19 patients with booster or additional doses hospitalized over all days of the month and dividing by the sum of adults with booster or additional doses in the underlying population for each day of the month. This method was also used for calculations in unvaccinated persons and those who received a primary series but not a booster or additional dose.. KPNC members are similar to the broad catchment population in Northern California in terms of sociodemographic characteristics34. * https://covid.cdc.gov/covid-data-tracker/#variant-proportions, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covid-net/purpose-methods.html. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. As infants aged, protection provided by maternal vaccination decreased during both periods. and/or the original MMWR paper copy for printable versions of official text, figures, and tables. The study provides evidence that a previous omicron infection in triple-vaccinated individuals provides high amounts of protection against BA.5 and BA.2 infections. Risk was especially high for people with severe combined immunodeficiency (HR, 6.2). 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. Several conditions, including cancer of the blood or bone marrow and dementia, were associated with HRs greater than 3. Adults who received booster doses were classified as those who completed the primary series and received an additional or booster dose on or after August 13, 2021, at any time after completion of the primary series, and 14 days before a positive test result for SARS-CoV-2, because COVID-19associated hospitalizations are a lagging indicator and time passed after receipt of a booster dose has been shown to be associated with reduced rates of COVID-19 infection (https://www.nejm.org/doi/full/10.1056/NEJMoa2114255). These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Although all data used in this analysis were anonymised, the individual-level nature of the data used risks individuals being identified, or being able to self-identify, if the data are released publicly. Lipkind, H. S. et al. https://www.cdc.gov/mmwr/volumes/70/wr/mm7050e2.htm, Adults who completed their primary COVID-19 vaccination series were defined as those who had received the second dose of a 2-dose primary vaccination series or a single dose of a 1-dose primary vaccine product 14 days before receipt of a positive SARS-CoV-2 test result associated with their hospitalization but received no additional or booster dose. ; COVID-NET Surveillance Team. Rep. 71, 429436 (2022). Accessed March 10, 2022. Rates were highest among unvaccinated adults and lowest among those who had received a booster or additional dose. This can lead to overestimates of first doses and underestimates of subsequent doses, and underestimates of hospitalization rates in persons who received additional or booster doses. Adults who received booster doses were classified as those who completed the primary series and received an additional or booster dose on or after August 13, 2021, at any time after completion of the primary series, and 14 days before a positive test result for SARS-CoV-2, as COVID-19associated hospitalizations are a lagging indicator and time passed after receipt of a booster dose has been shown to be associated with reduced rates of COVID-19 infection (https://www.nejm.org/doi/full/10.1056/NEJMoa2114255). Estimation of COVID-19 mRNA vaccine effectiveness against medically attended COVID-19 in pregnancy during periods of delta and Omicron variant predominance in the United States. Hospitalization rates and characteristics of children aged <18 years hospitalized with laboratory-confirmed COVID-19COVID-NET, 14 States, March 1-July 25, 2020. Google Scholar. Nature. Our findings that receipt of at least two doses of COVID-19 vaccine during pregnancy was effective at protecting infants during the Delta period are similar to those reported in a recent Norwegian study showing that mRNA COVID-19 vaccination during pregnancy was associated with a 71% decreased risk of testing positive for SARS-CoV-2 in infants during their first 4 months of life during the Delta period17. Article Stay up to date with your COVID-19 vaccines. Delahoy MJ, Whitaker M, OHalloran A, et al. 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. Maternal vaccination was protective, but protection was lower during the Omicron period than during Delta. JAMA Netw. 9-14 As of October 2022, 68% of the US population has completed primary series vaccination. Data among adults over 50 showed that a booster shot gave even stronger protection. Our study was strengthened both by its large sample size and our ability to follow infants through 6 months of age. 189, 13791388 (2020). O.Z., N.P.K., and B.F. conceived and designed the study. CDC graphs show in detail the protection vaccines gave from hospitalization. B., Lewis. Wkly. 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). 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. Fully-vaccinated in this chart meant one dose of the J&J vaccine or two doses of Pfizer or Moderna.
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