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We also conducted analyses based on the trimester during which the vaccine was received during pregnancy (first, second, or third trimester). Models in this analysis were adjusted for the same covariates included in the primary analysis. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Among these infants, for our main analysis, we excluded 21,891 (35.2%) based on maternal exclusion criteria and 10,412 (16.8%) after applying infant exclusion criteria (Fig. Kim, L. et al. Children and COVID-19: state data report. Infect. Background: Risk stratification models have been developed to identify patients that are at a higher risk of COVID-19 infection and severe illness. 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. Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey. O.Z. Another explanation is the presence of a high COVID-19 vaccination rate among studied individuals (more than two-thirds), which is supported by the finding that the majority of patients had been infected with SARS-CoV-2 prior to undergoing vaccination. 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. Mountain lions, a bobcat, red foxes, black bears, and skunks represent the latest avian flu cases in mammals. M.G. J. Relative to unvaccinated hospitalized patients, hospitalized vaccinees were more likely to be older (median age, 70 vs 58 years) and to have at least three underlying conditions (77.8% vs 51.6%). The study setting was Kaiser Permanente Northern California (KPNC), an integrated healthcare delivery organization that provides comprehensive healthcare to ~4.4 million members as of 2019. 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. Individual and neighborhood factors associated with failure to vaccinate against influenza during pregnancy. Data were available for researchers who meet the criteria for access to Kaiser Permanente Northern California confidential data. Data among adults over 50 showed that a booster shot gave even stronger protection. Trends in disease severity and health care utilization during the early Omicron variant period compared with previous SARS-CoV-2 high transmission periodsUnited States, December 2020January 2022. 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. Relative to the Delta-predominant period, a larger proportion of hospitalized Black adults were unvaccinated. CIDRAP - Center for Infectious Disease Research & Policy Requests for access to the underlying source data should be directed to UKHSA. 3501 et seq. Abbreviations: COVID-NET = COVID-19Associated Hospitalization Surveillance Network; ICU=intensive care unit; IMV=invasive mechanical ventilation; LTCF=long-term care facility; NA = not applicable. TN, NMF, WH, and SA wrote the software. NMF, MC, GD, DDA, AMP, and ST supervised the work. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Graff, K. et al. The research was published yesterday in JAMA Internal Medicine. Correspondence to 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. Nature Communications thanks Annette Regan, Olof Stephansson and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. 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. 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. During the Delta dominant period, the crude incidences of testing positive for SARS-CoV-2 during the first 2, 4, and 6 months of life were lower among infants whose mothers received at least two doses of mRNA COVID-19 vaccines during pregnancy (0.75, 1.43, and 1.56 infants per 100 person-years [PY], respectively) than those whose mothers were not vaccinated during pregnancy (5.47, 5.10, and 4.78 infants per 100 PYs, respectively). Vaccination status is not available for Iowa and cases from Iowa are excluded from analyses that examined vaccination status. The aim of the secondary design was to compare the results of the cohort with TND. 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. And in a second large study during the Omicron period, older people, men, and residents of nursing homes or in low-income areas were most at risk for post-booster COVID-19 death in England, but the risk was very low. 387, 187189 (2022). The KPNC Institutional review board approved and waived consent for this study. The study was conducted among a cohort of infants born between December 15, 2020, and May 31, 2022. PLoS ONE 15, e0229279 (2020). Vaccine 35, 72977301 (2017). Nursing home residents have been disproportionately affected by COVID-19; older age, comorbidities, and the congregate nature of nursing homes place residents at higher risk for infection and severe COVID-19-associated outcomes . Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19COVID-NET, 13 states, March 1August 22, 2020. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.. 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. All other authors declare no competing interests. It is possible that our exclusion criteria may have resulted in a final sample that may not be reflective of all KPNC infants. Statistical codes are not publicly available but are available from the corresponding author. 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. J. Med. You will be subject to the destination website's privacy policy when you follow the link. part 46, 21 C.F.R. CDC. CAS "People who get vaccinated may be more cautious about COVID in general, or perhaps getting vaccinated makes them less cautious, or they may live in states with more/less COVID risk, etc," Jit said. Nat Commun 14, 894 (2023). Morb. Further information on research design is available in theNature Portfolio Reporting Summary linked to this article. Article ** 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.. T.R. Am. Includes current treatment or recent diagnosis within the previous 12 months of an immunosuppressive condition or use of an immunosuppressive therapy. All adults should stay up to date (1) with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. The results were published yesterday in JAMA Network Open. 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. Mortal. 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 Rates are calculated using the CDC National Center for Health Statistics vintage 2020 bridged-race postcensal population estimates for the counties included in surveillance. Although hospitalization rates increased for all adults, rates were highest among unvaccinated adults and lowest among adults who had received a primary series and a booster or additional dose. 1). Vaccine 35, 58505857 (2017). The report shows people catching Omicron are: 31% to 45% less likely to go to A&E. 50% to 70% less likely to be admitted to hospital for treatment. of Omicron-infected patients with a high rate of vaccination in China. 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. 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. Internet Explorer). Klein, N. P. et al. The development of a standardized neighborhood deprivation index. Among fully vaccinated people without a booster, rates were lower at 3,355.5 per 100,000 for COVID-19 cases and 35.4 per 100,000 for hospitalizations. After adjusting for covariates, vaccination during pregnancy significantly reduced the risk of the infant testing SARS-CoV-2 positive by 84% (95% confidence interval [CI]: 66, 93) during the first 2 months of life, 62% (95% CI: 39, 77) during the first 4 months of life and 56% (95% CI: 34,71) during the first 6 months of life. **** ICU admission and IMV are not mutually exclusive categories, and patients could have received both. Starting the week ending December 4, 2021, Maryland data are not included in weekly rate calculations but are included in previous weeks. volume14, Articlenumber:894 (2023) JAMA 326, 16291631 (2021). It's not clear which variant might have been associated with these hospitalizations. During the Delta period, we found that protection extended through the infants first 6 months of life. The average age of decedents was 83.3 years. J. Med. Maternal vaccination was protective, but protection was lower during Omicron than during Delta. PubMedGoogle Scholar. In January 2022, unvaccinated adults and those vaccinated with a primary series, but no booster or additional dose, were 12 and three times as likely to be hospitalized, respectively, as were adults who received booster or additional doses. According to the Ontario Science Table's online dashboard, the hospital occupancy rate for the unvaccinated was 611 per million unvaccinated people in the province's population as of Jan. 7,. The state has administered 3.2 million vaccine doses since Dec. 1 alone, but lagging rates between full vaccination and first doses for adults especially (82.6% vs. 95%) are becoming a point of . This preceded and had no relation to COVID-19, and GD had no role in and received no funding from the project. All rights Reserved. part 56; 42 U.S.C. This conversion might result in character translation or format errors in the HTML version. 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). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. 384, 403416 (2021). 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. Slider with three articles shown per slide. However, a milder virus could still put pressure . Adults with a positive result whose SARS-CoV-2 test date was 14 days after the first dose of a 2-dose series but <14 days after receipt of the second dose were considered partially vaccinated. Get the most important science stories of the day, free in your inbox. 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. * 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. 386, 15321546 (2022). 1.04-1.49) after adjusting for age, sex, and vaccine characteristics. Additional COVID-NET methods for determining vaccination status have been described previously. JAMA Netw. Percentages presented for demographic characteristics are weighted column percentages. The second study, led by Office for National Statistics researchers in Wales, involved death rates and risk factors in adults in England who had received an mRNA booster at least 14 days before Dec 31, 2021. The vaccines have proved highly safe and effective at reducing the risk of severe illness, hospitalization and death. Adults with no documented receipt of any COVID-19 vaccine dose before the test date were considered unvaccinated. 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. There were only one hospitalized case among the children of vaccinated mothers and nine hospitalized cases among the children of unvaccinated mothers (Table1). New federal data shows adults who received the updated shots cut their risk of being hospitalized with . From this cohort, the study excluded the following infants born to (1) mothers who were not between ages 16 and 50 years at pregnancy onset; (2) mothers who did not have a primary KPNC facility assignment; (3) mothers who were not continuous KPNC members from December 15, 2020 until delivery; (4) mothers who had a positive nasal/throat swab for SARS-CoV-2 by polymerase chain reaction (PCR) prior to pregnancy onset; (5) mothers who had a positive SARS-CoV-2 antibody test documented by KPNC prior to the onset of pregnancy; (6) mothers who received one or more doses of COVID-19 vaccine prior to pregnancy onset. In the first study, a team led by US Centers for Disease Control and Prevention (CDC) researchers analyzed data on 192,509 hospitalizations from more than 250 hospitals in 13 states participating in the COVID-19Associated Hospitalization Surveillance Network from Jan 1, 2021, to Apr 30, 2022. J. Med. 139, e20164091 (2017). 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. Hospitalisation associated with SARS-CoV-2 delta variant in Denmark. Effectiveness of Two Doses of BNT162b2 Vaccine before and during Proxy Omicron Period. As Omicron spread in the US, hospitalization rates in December were much lower for the vaccinated. Buchan, S. A. et al. 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. Durability of anti-spike antibodies in infants after maternal COVID-19 vaccination or natural infection. Vaccination offers the best way to protect against COVID-19 and its complications. Sect. Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis. We conducted a descriptive analysis of the study population and calculated crude rates of SARS-CoV-2 infection and hospitalization by maternal vaccination status. 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. 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. Zerbo, O. et al. N. Engl. Additional limitations include the inability to estimate the effectiveness of vaccines received prior to pregnancy onset. If the SARS-CoV-2 test date was not available, hospital admission date was used. Perm. MMWR Morb Mortal Wkly Rep 2020;69:134754. CDC is not responsible for the content 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. Publishers note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Nature Communications (Nat Commun) Arthur Reingold, Jeremy Roland, Ashley Coates, California Emerging Infections Program, Oakland, California; Breanna Kawasaki, Rachel Herlihy, Isaac Armistead, Madelyn Lensing, Jordan Surgnier, Sarah McLafferty, Colorado Department of Public Health & Environment; Ann Basting, Tessa Carter, Maria Correa, Daewi Kim, Carol Lyons, Hazhia Sorosindi, Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut; Emily Fawcett, Katelyn Ward, Jana Manning, Asmith Joseph, Allison Roebling, Chandler Surell, Stephanie Lehman, Taylor Eisenstein, Suzanne Segler, Grayson Kallas, Marina Bruck, Rayna Ceaser, Annabel Patterson, Sabrina Hendrick, Johanna Hernandez, Hope Wilson, School of Medicine, Emory University, Georgia Emerging Infections Program, Georgia Department of Public Health, Veterans Affairs Medical Center, Foundation for Atlanta Veterans Education and Research, Atlanta, Georgia; Jim Collins, Shannon Johnson, Justin Henderson, Sue Kim, Alexander Kohrman, Lauren Leegwater, Val Tellez Nunez, Sierra Peguies-Khan, Michigan Department of Health and Human Services; Kayla Bilski, Kristen Ehresmann, Richard Danila, Jake Garfin, Grace Hernandez, Kieu My Phi, Ruth Lynfield, Sara Vetter, Xiong Wang, Minnesota Department of Health; Daniel M. Sosin, Susan L. Ropp, Sunshine Martinez, Jasmyn Sanchez, Cory Cline, Melissa Judson, Florent Nkouaga, Mark Montoya, New Mexico Department of Health; Sarah Lathrop, Kathy M. Angeles, Yadira Salazar-Sanchez, Sarah A. Khanlian, Nancy Eisenberg, Dominic Rudin, Sarah Shrum Davis, Mayvilynne Poblete, Emily B. Hancock, Francesca Pacheco, New Mexico Emerging Infections Program; Yassir Talha, Celina Chavez, Jennifer Akpo, Alesia Reed, Murtada Khalifa, CDC Foundation, New Mexico Department of Health; Suzanne McGuire, Kerianne Engesser, Nancy Spina, Adam Rowe, New York State Department of Health; Sophrena Bushey, Virginia Cafferky, Maria Gaitan, Christine Long, Thomas Peer, Kevin Popham, University of Rochester School of Medicine and Dentistry, Rochester, New York; Julie Freshwater, Denise Ingabire-Smith, Ann Salvator, Rebekah Sutter, Ohio Department of Health; Sam Hawkins, Public Health Division, Oregon Health Authority; Tiffanie Markus, Katie Dyer, Karen Leib, Terri McMinn, Danielle Ndi, Gail Hughett, Emmanuel Sackey, Kathy Billings, Anise Elie, Manideepthi Pemmaraju, Vanderbilt University Medical Center, Nashville, Tennessee; Amanda Carter, Andrea George, Andrew Haraghey, Ashley Swain, Caitlin Shaw, Laine McCullough, Mary Hill, Ryan Chatelain, Salt Lake County Health Department, Salt Lake City, Utah; Alvin Shultz, Robert W. Pinner, Rainy Henry, Sonja Mali Nti-Berko, CDC; Elizabeth Daly, Council of State and Territorial Epidemiologists. 189, 13791388 (2020). Stock, Jade Carruthers, Rachael Wood, Joshua Guedalia, Michal Lipschuetz, Ofer Beharier, Tobias Homan, Sara Mazzilli, Domenico Martinelli, Manaf AlQahtani, Xing Du, Siddhartha Mukherjee, Jussipekka Salo, Milla Hgg, Lauri Sksvuori, Hiam Chemaitelly, Houssein H. Ayoub, Laith J. Abu-Raddad, Nature Communications As of December 25, the rate among unvaccinated people was 78 per 100,000, compared to 4 per 100,000 among fully vaccinated people, the CDC reported. Office of the Vice President for Research. URL addresses listed in MMWR were current as of Shimabukuro, T. T. et al. The TND analyses avoid this bias by limiting the analysis to infants who were tested for SARS-CoV-2. Rates cannot be stratified by pregnancy status because the underlying population of pregnant women in the catchment area is unknown. 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. It showed that boosters further reduced the risk of hospitalization. We take your privacy seriously. Libby Reeg reports grants from the Michigan Department of Health and Human Services during the conduct of the study.