Kharbanda, E. O. et al. 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. 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. China informed the WHO about the case, which involves a 53-year-old woman, on Feb 24. Methods: This is a retrospective cohort study that was conducted in Israel's second-largest . Wkly. 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. First, COVID-19associated hospitalizations might have been missed because of hospital testing practices and test availability. 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. Risk was especially high for people with severe combined immunodeficiency (HR, 6.2). Dis. 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. 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). 3501 et seq. All HTML versions of MMWR articles are generated from final proofs through an automated process. Estimated effectiveness of COVID-19 vaccines against omicron or delta symptomatic infection and severe outcomes. Danino, D. et al. Other studies found similarly decreased proportions of severe outcomes among hospitalized patients with COVID-19 during this period (6).. 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. of pages found at these sites. Urban Health 83, 10411062 (2006). O.Z. Furthermore, it was reassuring that both the cohort and the secondary TND yielded vaccine effectiveness estimates in the same direction. 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. JAMA 327, 10871089 (2022). 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. pdf files, Omicron: fewer adverse outcomes come with new dangers, Statement on offensive historical content, Redistribute or republish the final article, Reuse portions or extracts from the article in other works. CAS A WHO spokesman says China informed the WHO about the case, which involves a 53-year-old woman, on Feb 24. 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). 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. 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. ** Total hospitalizations include data from selected counties in 14 COVID-NET states irrespective of vaccination status and includes adults with partial or unknown vaccination status. the date of publication. All adjustment variables were selected a priori based on prior work36. In this analysis, we estimated the odds ratio (OR) of vaccination of mothers of infants who tested positive for SARS-CoV-2 versus infants who tested negative using logistic regression models conditioned (stratified) on the calendar date of the test so that infants testing positive on a certain day were compared to infants testing negative on that same day. Rates were highest among unvaccinated adults and lowest among those who had received a booster or additional dose. What are the implications for public health practice? But those countries have high vaccination rates, and there, too, Omicron has spread most quickly among younger adults. 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. Monthly incidence is based on SARS-CoV-2 positive test result date or, if not known, hospital admission date. By clicking Sign up, you agree to receive marketing emails from Insider 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. https://doi.org/10.1038/s41467-023-36547-4, DOI: https://doi.org/10.1038/s41467-023-36547-4. 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. By comparison, from two to 25 weeks after the second dose, protection against Omicron hospitalization was 64%, the UKHSA said. Annually, approximately 40,000 births occur at KPNC facilities. Perm. 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. Baden, L. R. et al. Pre-Omicron versions of Covid, in. CDC. The average age of decedents was 83.3 years. Hospitalization rates during peak Omicron circulation (January 2022) among unvaccinated adults remained 12 times the rates among vaccinated adults who received booster or additional doses and four times the rates among adults who received a primary series, but no booster or additional dose. * Information on the impact that booster or additional doses of COVID-19 vaccines have on preventing hospitalizations during Omicron predominance is limited. 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 adults should stay up to date with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. J. Med. Among nonpregnant and pregnant adults aged 18 years, hospitalization rates were calculated overall, and by race/ethnicity and COVID-19 vaccination status. 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. Shimabukuro, T. T. et al. SARS-CoV-2 infection can lead to severe illnesses and hospitalizations in children and infants2,3,4,5. Am. The researchers used the QCovid risk model to estimate hazard ratios (HRs) for clinical risk factors. NMF, SB, SFunk, ACG, DDA, and AMP acquired funding. ** 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.. 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 meantime, to ensure continued support, we are displaying the site without styles We used two different study designs: a primary design using a cohort analysis in which infants of vaccinated pregnant persons were compared with infants of unvaccinated pregnant persons. These data should be taken with a grain of salt. Most mothers (1032 of 1138) who received only one dose received the vaccine during the third trimester. As Omicron spread in the US, hospitalization rates in December were much lower for the vaccinated. 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. 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. 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. The findings in this report are subject to at least four limitations. N. Engl. You will be subject to the destination website's privacy policy when you follow the link. Effectiveness of BNT162b2 vaccination during pregnancy in preventing hospitalization for SARS-CoV-2 in infants. Hospitalization rates among non-Hispanic Black adults increased more than rates in other racial/ethnic groups. VE against hospitalization was not estimated because of the very small number of hospitalized cases. 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. Children born at Kaiser Permanente Northern California from December 15, 2020, through May 31, 2022. Weekly COVID-19-associated hospitalization rates among U.S. infants and children aged 0-4 years have declined since the peak of January 8, 2022; however, peak rates during Omicron predominance were approximately five times those of the peak during Delta predominance. 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. 385, 13551371 (2021). Several conditions, including cancer of the blood or bone marrow and dementia, were associated with HRs greater than 3. Effectiveness of Covid-19 vaccines in ambulatory and inpatient care settings. Mortal. 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. The study was funded by the National Institute of Allergy and Infectious Disease grant # 1R01AI168373-01 to O.Z. 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. Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. These results suggest that in addition to providing protection against testing positive, vaccination during pregnancy also provides protection against hospitalization (severe disease) in infants during their first 6 months of life as previously reported recently18,19. 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. ISSN 2041-1723 (online). TN and NMF validated the data. MMWR and Morbidity and Mortality Weekly Report are service marks of the U.S. Department of Health and Human Services. National influenza and COVID-19 surveillance report: 27 January 2022 (week 4). You are using a browser version with limited support for CSS. In the TND, we estimated that during the Delta predominant period, maternal vaccination with at least doses reduced the infants risk of testing SARS-CoV-2 positive by 95% (95% CI:76, 99) during the first 2 months of life, 70% (95% CI: 52, 82) during the first 4 months of life, and 61% (95% CI: 42, 74) during the first 6 months of life (Supplemental Table2). Author's reply, Efficacy, safety, and immunogenicity of the DNA SARS-CoV-2 vaccine (ZyCoV-D): the interim efficacy results of a phase 3, randomised, double-blind, placebo-controlled study in India, Centers for Disease Control and Prevention, MRC Biostatistics Unit COVID-19 Working Group, Cases, hospital admissions, and hospital attendances in those with delta and omicron SARS-CoV-2 variants, between Nov 29, 2021, and Jan 9, 2022, Risk of hospitalisation and mortality for COVID-19 cases with omicron compared with delta, overall and by age group, Estimated HRs for vaccination categories, secondary analysis. Mortal. You can review and change the way we collect information below. Hospitalization of infants and children aged 0-4 years with laboratory-confirmed COVID-19COVID-NET, 14 states, March 2020-February 2022. and JavaScript. Vaccine 35, 72977301 (2017). 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. Buchan, S. A. et al. They help us to know which pages are the most and least popular and see how visitors move around the site. J. Pediatr. O.Z., N.P.K., and B.F. conceived and designed the study. provided as a service to MMWR readers and do not constitute or imply Ann Intern Med 2021;174:140919. Article Carlsen, E. O. et al. New charts from the Centers for Disease Control and Prevention (CDC) showed that hospitalization rates were much lower among those who were vaccinated even as Omicron was sweeping the nation. 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). 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. "The subpopulations with the highest risk should be considered a priority for COVID-19 therapeutics and further booster doses.". Mortal. B, Severe outcomes included hospitalization and death. 386, 15321546 (2022). of Omicron-infected patients with a high rate of vaccination in China. part 56; 42 U.S.C. Safety and efficacy of the BNT162b2 mRNA covid-19 vaccine. Risk of hospitalisation associated with infection with SARS-CoV-2 lineage B.1.1.7 in Denmark: an observational cohort study. The difference between the two studies might be due to population characteristics and the timing of follow-up as ours went through May 31, 2022, while the Norwegian study ended in April 2022. 1.04-1.49) after adjusting for age, sex, and vaccine characteristics. *** 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. In this primary design, all eligible infants meeting inclusion criteria were included without sampling which improved power and minimized bias related to selection. Mortal. 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Still, even with a smaller percentage of people getting severely ill during the Omicron wave, a large number of cases over a short time can lead to a spike in people being hospitalized or admitted . Rep. 70, 895899 (2021). 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,. After the emergence of the Omicron variant, the rate of COVID-19 hospitalizations in the United States was 10.5 times higher in unvaccinated adults and 2.5 times higher in those who were vaccinated but received no booster than in booster recipients, according to a new study. Sect. Marks, K. J. et al. J. Med. 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. NMF, MC, GD, DDA, AMP, and ST handled project administration. Requests for access to the underlying source data should be directed to UKHSA. wrote the initial manuscript. Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey. 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. Gretchen Rothrock, California Emerging Infections Program; Millen Tsegaye, Colorado Department of Public Health and Environment; Julie Plano, Connecticut Emerging Infections Program, Yale School of Public Health; Kyle Openo, Georgia Emerging Infections Program, Georgia Department of Public Health Division of Infectious Diseases, School of Medicine, Emory University; Andy Weigel, Iowa Department of Health; Chloe Brown, Michigan Department of Health and Human Services; Erica Bye, Minnesota Department of Health; Wickliffe Omondi, New Mexico Emerging Infections Program, University of New Mexico; Alison Muse, New York State Department of Health; Christina Felsen, University of Rochester School of Medicine and Dentistry; Eli Shiltz, Ohio Department of Health; Nasreen Abdullah, Public Health Division, Oregon Health Authority; William Schaffner, Vanderbilt University Medical Center; Melanie Crossland, Salt Lake County Health Department. MMWR Morb Mortal Wkly Rep 2022;71:14652. Thank you for visiting nature.com. Rates cannot be stratified by pregnancy status because the underlying population of pregnant women in the catchment area is unknown. Initial hospital data from England and Denmark also suggest Omicron cases are less severe. In the Omicron variant period, the effectiveness of maternal vaccination in these three age intervals was 21% (CI: 21,48), 14% (CI: 9,32) and 13% (CI: 3,26), respectively. Surveillance officers abstracted data on sampled patients from medical charts. The infection fatality rate from Covid-19 fell more than 10-fold from a little more than 1 per cent in January 2021 to 0.1 per cent in July as the UK's vaccination campaign was rolled out, and . Article Clinical trends among U.S. adults hospitalized with COVID-19, March to December 2020: a cross-sectional study. Mothers were classified as either having had 2 doses or one dose of mRNA COVID-19 vaccines during pregnancy (and completed more than 14 days prior to delivery) or not having had any COVID-19 vaccines prior to delivery. Delahoy MJ, Whitaker M, OHalloran A, et al. 384, 403416 (2021). The proportion of hospitalized Black adults who received a primary COVID-19 vaccination series with or without a booster or additional dose increased from 4.7% and 14.9%, respectively, during the Delta-predominant period to 14.8% and 25.5%, respectively, during the Omicron-predominant period; Hispanic adults experienced smaller increases. 384, 22732282 (2021). 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). Google Scholar. 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. Additional COVID-NET methods for determining vaccination status have been described previously.