Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey. The results were published yesterday in JAMA Network Open. https://www.cdc.gov/nchs/nvss/bridged_race.htm, ** https://www.medrxiv.org/content/10.1101/2021.08.27.21262356v1, On August 13, 2021, CDCs Advisory Committee on Immunization Practices (ACIP) issued the first of several recommendations for additional or booster doses of COVID-19 vaccine. Am. Persons with multiple, unknown, or missing race accounted for 6.9% (weighted) of all cases. 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. 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. 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. Children and COVID-19: state data report. 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. In-hospital death status was missing in 1.4% (weighted) of hospitalizations; these hospitalizations are otherwise included elsewhere in the analysis. It showed that boosters further reduced the risk of hospitalization. Shimabukuro, T. T. et al. Morb. Jackson, M. L. & Nelson, J. C. The test-negative design for estimating influenza vaccine effectiveness. N. Engl. This conversion might result in character translation or format errors in the HTML version. NMF, MC, GD, DDA, AMP, and ST supervised the work. Article 41, e81e86 (2022). 241(d); 5 U.S.C. The exposure of interest was mRNA COVID-19 vaccination status during pregnancy in the electronic health record. The TND is designed to better control for bias related to health care-seeking behavior31,32. Gynecol. Additional limitations include the inability to estimate the effectiveness of vaccines received prior to pregnancy onset. Children born at Kaiser Permanente Northern California from December 15, 2020, through May 31, 2022. Health and Human Services. Other studies found similarly decreased proportions of severe outcomes among hospitalized patients with COVID-19 during this period (6).. * Data are from a weighted sample of hospitalized nonpregnant adults with completed medical record abstractions and a discharge disposition. We use cookies to help provide and enhance our service and tailor content and ads. Percentages presented for demographic characteristics are weighted column percentages. On March 18, 2022, this report was posted online as an MMWR Early Release. It is possible that our exclusion criteria may have resulted in a final sample that may not be reflective of all KPNC infants. Vaccine 35, 58505857 (2017). We thank staff at UKHSA and members of the UK Government SPI-M committee and the UKHSA Variant Technical Group for valuable discussions. Relative to the Delta-predominant period, a significantly shorter median length of hospital stay was observed during the Omicron-predominant period and smaller proportions of hospitalizations with intensive care unit admission, receipt of invasive mechanical ventilation, or in-hospital death. 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. Mortal. Proportions between the pre-Delta and Delta period were compared using chi-square tests; p-values <0.05 were considered statistically significant, adjusted for multiple comparisons using the Bonferroni correction method. ; COVID-NET Surveillance Team. 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. Moline HL, Whitaker M, Deng L, et al. 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. It is not inevitable that viral evolution leads to lower severity. We ran separate models on the time periods associated with the Delta (7/01/2021 to 12/20/2021) and Omicron variants (12/21/2021 to 5/31/2022). We further classified vaccination status by the trimester within which the second dose or the unique dose (for those who received only one dose) was received. We did not assess whether vaccines received before pregnancy or immediately after pregnancy were associated with a reduced risk of testing positive for SARS-CoV-2 in infants. Infants were followed from birth until the first positive SARS-CoV-2 test by PCR at age 2, 4, or 6 months, with censoring due to death, health plan disenrollment, or end of follow-up (May 31, 2022). 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. Pediatr. Polack, F. P. et al. Adults whose vaccination status had not yet been verified using the immunization information system data were considered to have unknown vaccination status and were included in total proportions but not stratified by vaccination status. NEW YORK and MAINZ, GERMANY, March 1, 2023 Pfizer Inc. (NYSE: PFE) and BioNTech SE (Nasdaq: BNTX) today submitted an application to the U.S. Food and Drug Administration (FDA) for Emergency Use Authorization (EUA) of a booster (fourth) dose of the companies' Omicron BA.4/BA.5-adapted bivalent COVID-19 vaccine in children 6 months through 4 years of age (also referred to as under 5 years). But the average . 383, 26032615 (2020). Sect. Sadoff, J. et al. Receipt of one dose especially during the third trimester was also associated with a reduced risk of infants testing positive for SARS-CoV-2 during the first 6 months of life during the Delta dominant period. Perm. 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. E.L. coordinated administrative tasks. 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. 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. 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). All authors reviewed the manuscript. Although the study was unable to directly estimate VE against hospitalization due to the small number of hospitalized cases, it found that over the entire study period, the incidence rate of hospitalization during the first 6 months of life was much lower among the infants whose mothers were vaccinated during pregnancy compared with those whose mothers were not vaccinated. Thank you for visiting nature.com. Effectiveness of BNT162b2 vaccination during pregnancy in preventing hospitalization for SARS-CoV-2 in infants. N. Engl. Among nonpregnant and pregnant adults aged 18 years, hospitalization rates were calculated overall, and by race/ethnicity and COVID-19 vaccination status. Internet Explorer). J. Med. PubMed 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). adjudicated chart reviews. Using previously described methods (3), investigators collected clinical data on a representative sample of adult patients (7.9%) hospitalized during July 1, 2021January 31, 2022, stratified by age and COVID-NET site. ISSN 2041-1723 (online). * Information on the impact that booster or additional doses of COVID-19 vaccines have on preventing hospitalizations during Omicron predominance is limited. 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 Finally, the COVID-NET catchment areas include approximately 10% of the U.S. population; thus, these findings might not be nationally generalizable. The cumulative monthly age-adjusted hospitalization rate during January 2022 among unvaccinated adults (528.2) was 12 times the rates among those who had received a booster or additional dose (45.0) and four times the rates among adults who received a primary series, but no booster or additional dose (133.5). Vaccine 31, 31043109 (2013). 384, 14121423 (2021). They help us to know which pages are the most and least popular and see how visitors move around the site. PubMed Evaluation of the relative virulence of novel SARS-CoV-2 variants: a retrospective cohort study in Ontario, Canada. In our primary analysis, we implemented a cohort study design where we used Cox proportional hazards models that allow for time-varying covariates to estimate the SARS-CoV-2 infection hazard ratio (HR) in infants of mothers vaccinated with at least 2 doses of mRNA COVID-19 vaccines during pregnancy and 1 dose only versus mothers who were unvaccinated during pregnancy. The TND analyses avoid this bias by limiting the analysis to infants who were tested for SARS-CoV-2. The final study population included 30311 (48.8%) infants who were KPNC members at least 2 months after birth. However, a milder virus could still put pressure . "The association between the QCovid risk groups and the risk of death were stronger in people who had received a booster and were infected by the Omicron variant compared with evidence from the Alpha and Delta period in doubly vaccinated individuals," the authors wrote. Relative to the Delta-predominant period, a larger proportion of hospitalized Black adults were unvaccinated. To account for the correlation between infants with the same mother, we fit marginal Cox proportional hazards models using robust sandwich variance estimates. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Severe cases may increase in the wake of holiday parties where people of all ages mixed. Thank you for taking the time to confirm your preferences. This preceded and had no relation to COVID-19, and GD had no role in and received no funding from the project. 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. Mountain lions, a bobcat, red foxes, black bears, and skunks represent the latest avian flu cases in mammals. part 46, 21 C.F.R. 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. 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. 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. All adjustment variables were selected a priori based on prior work36. First, COVID-19associated hospitalizations might have been missed because of hospital testing practices and test availability. Includes current treatment or recent diagnosis within the previous 12 months of an immunosuppressive condition or use of an immunosuppressive therapy. Dagan, N. et al. SARS-CoV-2 delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. During the study period, home testing became more prevalent. Zerbo, O., Ray, G.T., Fireman, B. et al. N. Engl. Pregnant women were excluded because their reasons for hospital admission (4) might differ from those for nonpregnant persons. The rate among adults who received a primary series, but no booster or additional dose (133.5), was three times the rate among adults who received a booster or additional dose (45.0). During the Omicron-predominant period, weekly COVID-19associated hospitalization rates (hospitalizations per 100,000 adults) peaked at 38.4, compared with 15.5 during Delta predominance. Rates cannot be stratified by pregnancy status because the underlying population of pregnant women in the catchment area is unknown. * Adults who completed a primary 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 product 14 days before a positive SARS-CoV-2 test associated with their hospitalization but received no booster dose.
