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. You will be subject to the destination website's privacy policy when you follow the link. Surveillance officers abstracted data on sampled patients from medical charts. However, data currently available on the persistence of immunity after vaccination on the one hand and the emergence of viral variants with reduced sensibility to vaccine immunity on the other, raise the need to administer boosters to maintain the protection and to compare . 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). State data show the average age for COVID deaths was about 80 in late 2020, but dropped in spring 2021 to as low as 69 after most older adults received their first COVID vaccines. Introduction: A rapid increase in COVID-19 cases due to the spread of the Delta and Omicron variants in vaccinated populations has raised concerns about the hospitalization risk associated with, and the effectiveness of, COVID-19 vaccines. Rep. 71, 429436 (2022). Klein, N. P. et al. In this analysis, vaccine effectiveness was evaluated as 1 minus the odds ratio. *** 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. The KPNC Institutional review board approved and waived consent for this study. However, linking is sometimes not possible because CDC does not receive personally identifiable information about vaccine doses. CAS Iowa did not provide immunization data but is included in the overall population-based hospitalization rates. 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. Preliminary findings of mRNA Covid-19 vaccine safety in pregnant persons. However, infants aged <6 months are not currently eligible for any currently available COVID-19 vaccines and must rely on placentally acquired immunity from their mothers. It's not clear which variant might have been associated with these hospitalizations. BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting. During the Delta period, we found that protection extended through the infants first 6 months of life. https://doi.org/10.1038/s41467-023-36547-4, DOI: https://doi.org/10.1038/s41467-023-36547-4. It showed that boosters further reduced the risk of hospitalization. We also conducted analyses based on the trimester during which the vaccine was received during pregnancy (first, second, or third trimester). 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. 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). Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. Data among adults over 50 showed that a booster shot gave even stronger protection. Dis. Methods: One hundred and . BNT162b2 vaccine effectiveness against omicron in children 5 to 11 years of age. Stay up to date with your COVID-19 vaccines. Percentages presented were weighted to account for the probability of selection for sampled cases (3). Mortal. During the Omicron dominant period, receipt of 2 doses during pregnancy reduced the risk of the infant testing SARS-CoV-2 positive by 21% (95% CI: 21, 48) during the first 2 months of life, 14% (95% CI: 8, 32) during the first 4 months of life, and 13% (95% CI: 3, 26) during the first 6 months of life (Table2). J. Med. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. 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. Hospitalization rates were 10.5 times higher in the unvaccinated and 2.5 times higher in vaccinated patients with no booster than in booster recipients. Two to 4 weeks after a booster dose, vaccine effectiveness ranged from around 65-75%, dropped to 55-70% at 5 to 9 weeks, and 40-50% from 10 weeks or more after a booster dose. Infect. Sadoff, J. et al. 383, 26032615 (2020). Razzaghi, H. et al. Method: This case-control study aims to determine the hospitalization risk associated with the inactivated BBIBP-CorV (Sinopharm) and mRNA BNT162b2 (Pfizer . Vaccination status is based on state immunization information system data. 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. J. Med. While this proportion might not be representative of the proportion of vaccinated pregnant women within KPNC because of our exclusion criteria, more efforts are needed to promote COVID-19 vaccines for pregnant persons because vaccination provides protection to mothers and their infants until they are old enough to receive their own COVID-19 vaccines. 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. 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., Fireman. JAMA Intern. J. Med. endorsement of these organizations or their programs by CDC or the U.S. Publishers note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The efficacy of COVID 19 vaccines for reducing the risk of severe COVID-19 infection is demonstrated in real life. Objectives To develop and implement a scoring tool to identify COVID-19 patients that are at risk for severe illness during the Omicron wave. 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). On the bias of estimates of influenza vaccine effectiveness from test-negative studies. 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. The TND is designed to better control for bias related to health care-seeking behavior31,32. wrote the initial manuscript. New federal data shows adults who received the updated shots cut their risk of being hospitalized with . Children currently account for about 18.5% of reported COVID-19 cases in the United States1. 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. 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. Association of COVID-19 vaccination during pregnancy with incidence of SARS-CoV-2 infection in infants. Durability of anti-spike antibodies in infants after maternal COVID-19 vaccination or natural infection. No other potential conflicts of interest were disclosed. CDC. Zerbo, O., Ray, G.T., Fireman, B. et al. 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. MMWR Morb Mortal Wkly Rep 2022;71:466473. There were only one hospitalized case among the children of vaccinated mothers and nine hospitalized cases among the children of unvaccinated mothers (Table1). In this primary design, all eligible infants meeting inclusion criteria were included without sampling which improved power and minimized bias related to selection. 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. M.G. Wkly. Maternal vaccination and risk of hospitalization for Covid-19 among infants. 384, 21872201 (2021). The study was conducted among a cohort of infants born between December 15, 2020, and May 31, 2022. Christopher A. Taylor, PhD1; Michael Whitaker, MPH1; Onika Anglin, MPH1,2; Jennifer Milucky, MSPH1; Kadam Patel, MPH1,2; Huong Pham, MPH1; Shua J. Chai, MD3,4; Nisha B. Alden, MPH5; Kimberly Yousey-Hindes, MPH6; Evan J. Anderson, MD7,8,9; Kenzie Teno, MPH10; Libby Reeg, MPH11; Kathryn Como-Sabetti, MPH12; Molly Bleecker, MA13; Grant Barney, MPH14; Nancy M. Bennett, MD15; Laurie M. Billing, MPH16; Melissa Sutton, MD17; H. Keipp Talbot, MD18; Keegan McCaffrey19; Fiona P. Havers, MD1; COVID-NET Surveillance Team (View author affiliations). American Academy of Pediatrics. Percentages presented for demographic characteristics are weighted column percentages. COVID-19 vaccine surveillance report: week 6. Messer, L. C. et al. TN, NMF, WH, and SA wrote the software. You are using a browser version with limited support for CSS. MMWR Morb Mortal Wkly Rep 2022;71:14652. This is consistent with data showing the incidence of positive SARS-CoV-2 test results or death from COVID-19 is higher among unvaccinated adults and adults who have not received a booster than among those who have received a booster or additional dose (5). Among all adults, relative to the Delta-predominant period, COVID-19related illness was the primary reason for admission for a smaller percentage of hospitalizations (87.5% versus 95.5%, p<0.01), and median length of stay was shorter (4 versus 5 days, p<0.01) during the Omicron-predominant period; during this period, the proportion of patients admitted to an intensive care unit, who received invasive mechanical ventilation, and who died in-hospital decreased significantly (all p<0.01). 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). However, these Omicron impacts have been mostly observed in countries with high vaccination rates in the Region: the comparatively lower rate of hospitalizations and deaths so far is in large part thanks to vaccination, particularly of vulnerable groups. CDC twenty four seven. COVID-19; IL-6 . SGN, HHW, NA, WH, MK, PB, AZ, JLB, MC, NAA, KH, RH, AC, GD, and ST curated the data. 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. 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). 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 Informed consent was waived because this was a data-only study with no direct contact with participants. The findings in this report are subject to at least four limitations. Questions or messages regarding errors in formatting should be addressed to Relative to the Delta-predominant period, the proportion of cases in non-Hispanic Asian or Pacific Islanders also increased, whereas the proportion in all other racial and ethnic groups decreased. Racial and ethnic disparities in rates of COVID-19associated hospitalization, intensive care unit admission, and in-hospital death in the United States from March 2020 to February 2021. Risk was especially high for people with severe combined immunodeficiency (HR, 6.2). 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). Rep. 7, 255263 (2022). Annually, approximately 40,000 births occur at KPNC facilities. 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). All adults should stay up to date with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. Lipkind, H. S. et al. These trends could result in epidemic phase bias if infection severity is correlated with time from infection to test. Vaccination offers the best way to protect against COVID-19 and its complications. First, COVID-19associated hospitalizations might have been missed because of hospital testing practices and test availability. Halasa, N. B. et al. 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. ** 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. N. Engl. According to the CDC, hospitalization rates among the unvaccinated were 16 times higher in December overall. Vaccination status (unvaccinated, receipt of a primary series only, or receipt of a primary series plus a booster or additional dose) was determined for individual hospitalized patients and for the catchment population using state immunization information systems data (2). Vaccination status is not available for Iowa and cases from Iowa are excluded from analyses that examined vaccination status. About half of long-COVID patients who were on sick leave at 4 months were still on sick leave at 2 years. Members receive almost all their medical care at KPNC-owned facilities, including clinics, hospitals, pharmacies, and laboratories. 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. JAMA Netw. 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 SARS-CoV-2 variants of concern and variants under investigation in England: technical briefing 35. Estimated effectiveness of COVID-19 vaccines against omicron or delta symptomatic infection and severe outcomes. SARS-CoV-2 infection can lead to severe illnesses and hospitalizations in children and infants2,3,4,5. 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. During the Omicron period, among children whose mothers received 1 dose before pregnancy and 1 dose during pregnancy, VE against infection was 46% (95% CI: 23, 77) during the first 2 months of life, 16% (95% CI: 28, 50) during the first 4 months of life and 3% (95% CI: 32, 36) during the first 6 months of life compared with children whose mothers were unvaccinated (Supplemental Table4). Adults who completed a primary vaccination series were persons who had received the second dose of a 2-dose COVID-19 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 or additional dose. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Laurie M. Billing and Kenzie Teno report grants from the Council of State and Territorial Epidemiologists during the conduct of the study. 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. During the period of Omicron predominance, hospitalization rates increased most sharply among Black adults in the United States relative to all other racial and ethnic groups examined and reached the highest rate observed among all racial and ethnic groups since the beginning of the pandemic. Correspondence to COVID-19Associated Hospitalizations Among Adults During SARS-CoV-2 Delta and Omicron Variant Predominance, by Race/Ethnicity and Vaccination Status COVID-NET, 14 States, July 2021January 2022. Thompson, M. G. et al. To obtain The report found that, during the omicron wave 6,743.5 per 100,000 unvaccinated people were contracting COVID-19 and 187.8 per 100,000 were hospitalized. COVID-19associated signs and symptoms included respiratory symptoms (congestion or runny nose, cough, hemoptysis or bloody sputum, shortness of breath or respiratory distress, sore throat, upper respiratory infection, influenza-like illness, and wheezing) and non-respiratory symptoms (abdominal pain, altered mental status or confusion, anosmia or decreased smell, chest pain, conjunctivitis, diarrhea, dysgeusia or decreased taste, fatigue, fever or chills, headache, muscle aches or myalgias, nausea or vomiting, rash, and seizures). 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. In the present study, the mothers of only 32% of infants in the cohort received at least 2 doses during pregnancy. We examined the effectiveness of maternal vaccination against SARS-CoV-2 infection in 30,311 infants born at Kaiser Permanente Northern California from December 15, 2020, to May 31, 2022. 26 Among those fully vaccinated individuals 5 years of age who are booster eligible, only 49% have received a . 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. NMF, SB, SFunk, ACG, DDA, and AMP acquired funding. J. Med. 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. 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 . 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). 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). 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 . Persons who received no doses of any COVID-19 vaccine were considered unvaccinated. 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. Children and COVID-19: state data report. Relative to the Delta-predominant period, a larger proportion of hospitalized Black adults were unvaccinated. 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. Further information on research design is available in theNature Portfolio Reporting Summary linked to this article. Adults with no documented receipt of any COVID-19 vaccine dose before the test date were considered unvaccinated. Graff, K. et al. N. Engl. Schrag, S. J. et al. Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey. 9-14 As of October 2022, 68% of the US population has completed primary series vaccination.