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. Informed consent was waived because this was a data-only study with no direct contact with participants. Science brief: omicron (B.1.1.529) variant. Google Scholar. * Overall rates are unadjusted; rates presented by racial and ethnic group are age-adjusted. N. Engl. Cite this article. However, linking is sometimes not possible because CDC does not receive personally identifiable information about vaccine doses. Most mothers (66.14%) were between ages 25 and <35 years, and more than a quarter (27.27%) were of Asian race, 5.16% were Black, 24.44% were of Hispanic ethnicity and 37.57% were White. There were only one hospitalized case among the children of vaccinated mothers and nine hospitalized cases among the children of unvaccinated mothers (Table1). J., Fireman. To update your cookie settings, please visit the, https://doi.org/10.1016/S0140-6736(22)00462-7, Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study, https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern, https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/scientific-brief-omicron-variant.html, https://www.mrc-bsu.cam.ac.uk/now-casting/report-on-nowcasting-and-forecasting-9th-december-2021/, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1050999/Technical-Briefing-35-28January2022.pdf, https://www.research.ed.ac.uk/en/publications/severity-of-omicron-variant-of-concern-and-vaccine-effectiveness-, https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-50-severity-omicron/, https://doi.org/10.1101/2022.01.11.22269045, https://doi.org/10.1101/2022.01.12.22269179, https://doi.org/10.1101/2022.01.20.22269406, https://doi.org/10.1101/2022.01.12.22269148, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1054071/vaccine-surveillance-report-week-6.pdf, https://www.gov.uk/government/publications/investigation-of-sars-cov-2-variants-routine-variant-data-update, https://www.gov.uk/government/publications/nhs-test-and-trace-statistics-england-methodology/nhs-test-and-trace-statistics-england-methodology, https://www.england.nhs.uk/contact-us/privacy-notice/national-flu-vaccination-programme/, https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/emergency-care-data-set-ecds, https://digital.nhs.uk/services/secondary-uses-service-sus, https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-hospital-activity/, https://doi.org/10.1101/2021.08.13.21262014, View Large Just 28% of children in the age group - around 8 million . 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. For infants, we included age, as a categorical time-changing variable in 30-day increments. "The subpopulations with the highest risk should be considered a priority for COVID-19 therapeutics and further booster doses.". The TND is designed to better control for bias related to health care-seeking behavior31,32. 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). Acosta AM, Garg S, Pham H, et al. SARS-CoV-2 variant data update, England: Version 21. N. Engl. BNT162b2 vaccine effectiveness against omicron in children 5 to 11 years of age. 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. 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. Other studies found similarly decreased proportions of severe outcomes among hospitalized patients with COVID-19 during this period (6).. Individual and neighborhood factors associated with failure to vaccinate against influenza during pregnancy. All these results were similar to those when no adjustments for covariates are made (Supplemental Table1). SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland, Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy, Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel, Covid-19 vaccination programme effectiveness against SARS-CoV-2 related infections, hospital admissions and deaths in the Apulia region of Italy: a one-year retrospective cohort study, Post-vaccination outcomes in association with four COVID-19 vaccines in the Kingdom of Bahrain, Effectiveness and protection duration of Covid-19 vaccines and previous infection against any SARS-CoV-2 infection in young adults, The indirect effect of mRNA-based COVID-19 vaccination on healthcare workers unvaccinated household members, SARS-CoV-2 infection and COVID-19 vaccination in pregnancy, Duration of mRNA vaccine protection against SARS-CoV-2 Omicron BA.1 and BA.2 subvariants in Qatar, 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, https://doi.org/10.1016/j.jpeds.2022.09.059, http://creativecommons.org/licenses/by/4.0/. Effectiveness of COVID-19 Pfizer-BioNTech BNT162b2 mRNA vaccination in preventing COVID-19-associated emergency department and urgent care encounters and hospitalizations among nonimmunocompromised children and adolescents aged 5-17 yearsVISION Network, 10 states, April 2021-January 2022. J. But the average . 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. 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. The University of Minnesota is an equal opportunity educator and employer, Office of the Vice President for Research | Contact U of M | Privacy Policy, Mary Van Beusekom | News Writer | CIDRAP News, Two recent papers claim there are no differences between surgical masks and respirators for preventing the spread of respiratory diseases like COVID-19 and flu, but the articles. Preliminary findings of mRNA Covid-19 vaccine safety in pregnant persons. The TND, a case-control study, has been commonly used in studies of the effectiveness of influenza vaccines and more recently COVID-19 vaccines. 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. Risk was especially high for people with severe combined immunodeficiency (HR, 6.2). Mountain lions, a bobcat, red foxes, black bears, and skunks represent the latest avian flu cases in mammals. 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. Despite several studies showing that vaccination during pregnancy is safe for pregnant people24,25,26,27,28, vaccine uptake has been suboptimal in this group29. Methods: One hundred and . 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. 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. Pediatrics. Protection during both periods decreased as infants aged from 2 months to 6 months. JAMA Netw. We excluded these infants because we were primarily interested in estimating the effectiveness of mRNA vaccines received during pregnancy; (7) mothers who received adenovirus vector vaccines or any non-mRNA platform vaccines during pregnancy; (8) mothers who did not receive their mRNA vaccinations in accordance with CDC recommendationse.g., the timing between dose 1 and dose 2 was not within the recommended intervals; and (9) infants who did not become KPNC members within two calendar months of their birth. Overall, the study results support recommendations for vaccination during pregnancy to protect both mothers and their infants. 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. Razzaghi, H. et al. https://www.medrxiv.org/content/10.1101/2021.08.27.21262356v1 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. 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. 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 this primary design, all eligible infants meeting inclusion criteria were included without sampling which improved power and minimized bias related to selection. Zerbo, O., Ray, G.T., Fireman, B. et al. 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). Health and Human Services. However, vaccination during pregnancy was less effective at protecting infants against SARS-CoV-2 infection during the Omicron period. We observed a similar pattern in vaccine effectiveness by trimester during the Omicron dominant period, however, estimates of vaccine effectiveness by trimester were imprecise and much lower than during the Delta period (Table3). TN and NMF were responsible for visualisation. Evaluation of the relative virulence of novel SARS-CoV-2 variants: a retrospective cohort study in Ontario, Canada. DOI: http://dx.doi.org/10.15585/mmwr.mm7112e2. JAMA Netw Open 2021;4:e2130479. Members receive almost all their medical care at KPNC-owned facilities, including clinics, hospitals, pharmacies, and laboratories. Google Scholar. Vaccine effectiveness for 1 dose during the first 6 months of life was 68% (95% CI: 12, 88) (Table2). Article The funders played no direct role in the study. According to the CDC, hospitalization rates among the unvaccinated were 16 times higher in December overall. Relative to the Delta-predominant period, a larger proportion of hospitalized Black adults were unvaccinated. MB), Help with This conversion might result in character translation or format errors in the HTML version. Blakeway, H. et al. But those countries have high vaccination rates, and there, too, Omicron has spread most quickly among younger adults. TN, NMF, SB, EV, SRS, DDA, and AMP developed the methodology. N. Engl. The average age of decedents was 83.3 years. 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. Sect. Wkly. China informed the WHO about the case, which involves a 53-year-old woman, on Feb 24. Adults with no documented receipt of any COVID-19 vaccine dose before the test date were considered unvaccinated. 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. Vaccinations were limited only to those received during pregnancy. Secondarily, we used a Test-Negative Design (TND), which is a case-control study, to compare the odds of vaccination among mothers of infants who tested positive vs. the odds of vaccination among mothers of infants who tested negative. Morb. 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. Am. If SARS-CoV-2 test date was missing, hospitalization admission date was used. 20, 15225 (2016). wrote the initial manuscript. Maternal vaccination was protective, but protection was lower during the Omicron period than during Delta. ISSN 2041-1723 (online). KPNC members are similar to the broad catchment population in Northern California in terms of sociodemographic characteristics34. The KPNC Institutional review board approved and waived consent for this study. 1.04-1.49) after adjusting for age, sex, and vaccine characteristics. 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 Maryland did not contribute data after December 4, 2021, but did contribute data for previous weeks. N. Engl. CDC graphs show in detail the protection vaccines gave from hospitalization. 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. Stay up to date with your COVID-19 vaccines. U.S. regulators had authorized the Pfizer/BioNTech COVID-19 vaccine for children aged 5 to 11 years in October, prior to the Omicron surge. First, COVID-19associated hospitalizations might have been missed because of hospital testing practices and test availability. A and B, Markers indicate estimates, with vertical lines indicating 95% CIs. 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 . J. Obstet. Infections are rare and can be severe or fatal, but so far scientists don't see genetic changes that pose an increased threat to people. Age-adjusted hospitalization rates among Black adults peaked at 94.7 (January 8, 2022), higher than that among all other racial and ethnic groups, 3.8 times the rate among White adults (24.8) for the same week, and 2.5 times the previous peak (January 16, 2021) among Black adults (37.2). 40, e137e145 (2021). It is not inevitable that viral evolution leads to lower severity. Infect. Children and COVID-19: state data report. SGN, HHW, NA, WH, MK, PB, AZ, JLB, MC, NAA, KH, RH, AC, GD, and ST curated the data. 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. Corresponding author: Christopher A. Taylor, iyq3@cdc.gov. Mortal. The images or other third party material in this article are included in the articles Creative Commons license, unless indicated otherwise in a credit line to the material. E. & Klein, N. P. Effectiveness of vaccination during pregnancy to prevent infant pertussis. 386, 15321546 (2022). MMWR Morb Mortal Wkly Rep 2022;71:466473. Vaccination offers the best way to protect against COVID-19 and its complications. 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. The Lancet Regional Health Southeast Asia, The Lancet Regional Health Western Pacific, 36-fold higher estimate of deaths attributable to red meat intake in GBD 2019: is this reliable? 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. Views equals page views plus PDF downloads. 9-14 As of October 2022, 68% of the US population has completed primary series vaccination. B, Severe outcomes included hospitalization and death. The study did not adjust for maternal SARS-CoV-2 infections during pregnancy due to the inability of capturing home testing results. Nat Commun 14, 894 (2023). During the Omicron-predominant period, peak hospitalization rates among non-Hispanic Black (Black) adults were nearly four times the rate of non-Hispanic White (White) adults and was the highest rate observed among any racial and ethnic group during the pandemic. part 46, 21 C.F.R. All HTML versions of MMWR articles are generated from final proofs through an automated process. 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. The average death rate among Americans over age 65 who contract the flu has ranged between 1 in 75 and 1 in 160 in recent years, according to the C.D.C. Estimated effectiveness of COVID-19 vaccines against omicron or delta symptomatic infection and severe outcomes. Persons who received only 1 vaccine dose of a 2-dose series 14 days before the SARS-CoV-2 test date or had received a single dose of either a 1- or 2-dose vaccination series <14 days before the positive SARS-CoV-2 test result were considered partially vaccinated and were not included in rates by vaccination status.
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