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Article 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. As with previous variants, being vaccinated greatly protects you from severe disease with omicron. However, vaccination during pregnancy was less effective at protecting infants against SARS-CoV-2 infection during the Omicron period. 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. 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. Users are referred to the electronic PDF version (https://www.cdc.gov/mmwr) Dis. The increase in transmissibility of the Omicron variant might have amplified these risks for hospitalization, resulting in increased hospitalization rates among Black adults compared with White adults, irrespective of vaccination status. A WHO spokesman says China informed the WHO about the case, which involves a 53-year-old woman, on Feb 24. KPNC has a comprehensive electronic health record system (Kaiser Permanente HealthConnect, a customized EPIC system), that captures detailed information on all medical services, including immunization, membership enrollment including place of residence, demographics, and pregnancy-related care from pregnancy onset to delivery, and beyond. 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. Unvaccinated Children Hospitalized at Twice the Rate During Omicron Percentages presented for the overall number are weighted row percentages. 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. 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). 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. TN and NMF were responsible for visualisation. In-hospital death status was missing in 1.4% (weighted) of hospitalizations; these hospitalizations are otherwise included elsewhere in the analysis. From Jan 1 to Mar 16, 2022, when Omicron was predominant, 4,781 (0.02%) of 19,473,570 booster recipients died of COVID-19, and 58,020 (0.3%) died of other causes. Covid's Risk to Older Adults - The New York Times 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). 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. Preliminary findings of mRNA Covid-19 vaccine safety in pregnant persons. 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. Relative to the Delta-predominant period, a larger proportion of hospitalized Black adults were unvaccinated. Estimated Effectiveness of COVID-19 Vaccines Against Omicron or Delta 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. 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. MMWR Morb Mortal Wkly Rep 2022;71:14652. 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. MMWR Morb Mortal Wkly Rep 2022;71:1328. 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. These data should be taken with a grain of salt. The study did not adjust for maternal SARS-CoV-2 infections during pregnancy due to the inability of capturing home testing results. Med. Vaccine 31, 31043109 (2013). Methods: One hundred and . https://doi.org/10.1016/j.jpeds.2022.09.059 (2022). Centers for Disease Control and Prevention. If ethnicity was unknown, non-Hispanic ethnicity was assumed. 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. Google Scholar. Risk factors for severe COVID-19 in children. Data from the COVID-19Associated Hospitalization Surveillance Network (COVID-NET) were analyzed to compare COVID-19associated hospitalization rates among adults aged 18 years during B.1.617.2 (Delta; July 1December 18, 2021) and Omicron (December 19, 2021January 31, 2022) variant predominance, overall and by race/ethnicity and vaccination status. COVID-19; IL-6 . Slider with three articles shown per slide. They, as well as vaccinated people who are immunocompromised and at higher risk of severe COVID-19, are still vulnerable to being infected by a vaccinated person. The researchers used the QCovid risk model to estimate hazard ratios (HRs) for clinical risk factors. However, we have no reason to expect a strong association between the absence of NHS number and SARS-CoV-2 variant. 1). Finally, we conducted additional supplemental analyses to estimate VE among children whose mothers received at least one vaccine dose prior to pregnancy onset and at least one dose during pregnancy. However, linking is sometimes not possible because CDC does not receive personally identifiable information about vaccine doses. Kharbanda, E. O. et al. All adjustment variables were selected a priori based on prior work36. (2021) Omicron is supercharging the COVID vaccine booster debate. Vaccines and Omicron mean Covid now less deadly than flu in England ISSN 2041-1723 (online). Pregnant women were excluded because their reasons for hospital admission (4) might differ from those for nonpregnant persons. Vaccination status is not available for Iowa and cases from Iowa are excluded from analyses that examined vaccination status. Ainslie, K. E. C., Shi, M., Haber, M. & Orenstein, W. A. Wkly. N. Engl. Starting the week ending December 4, 2021, Maryland data are not included in weekly rate calculations but are included in previous weeks. 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. Infect. CDC graphs show in detail the protection vaccines gave from hospitalization. *** 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. Analyses were conducted using SAS statistical software survey procedures (version 9.4; SAS Institute). The development of a standardized neighborhood deprivation index. 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. The average age of decedents was 83.3 years. To obtain N. Engl. Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. B., Lewis. CAS The code used to analyse the data is available on. In all models, we used calendar days as the time scale to account for changes over time in SARS-CoV-2 circulation and vaccine uptake. 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. 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. 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. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Buchan, S. A. et al. During the Delta period, we found that protection extended through the infants first 6 months of life. Delta period: July 1, 2021December 18, 2021, reflects the time when Delta was the predominant circulating variant; Omicron period: December 19, 2021January 31, 2022, reflects the time when Omicron was the predominant circulating variant. While Omicron caused a big spike in COVID-19 cases, vaccinated people continued to be less likely to be hospitalized than the unvaccinated. 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We conducted a descriptive analysis of the study population and calculated crude rates of SARS-CoV-2 infection and hospitalization by maternal vaccination status. Am. 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. The vaccines have proved highly safe and effective at reducing the risk of severe illness, hospitalization and death. Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis. Chi-square tests were used to compare differences between the Delta- and Omicron-predominant periods; p-values <0.05 were considered statistically significant. "The high hospitalization rates in unvaccinated compared with vaccinated persons with and without a booster dose underscores the importance of COVID-19 vaccinations in preventing hospitalizations and suggests that increasing vaccination coverage, including booster dose coverage, can prevent hospitalizations, serious illness, and death," the researchers wrote. CDC is not responsible for the content Correspondence to Pediatr. 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. 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. Protection during both periods decreased as infants aged from 2 months to 6 months. Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey. 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). 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. Stay up to date with your COVID-19 vaccines. 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. J. Med. Iowa does not provide data on vaccination status. 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. There were only one hospitalized case among the children of vaccinated mothers and nine hospitalized cases among the children of unvaccinated mothers (Table1). Mortal. The study was conducted among a cohort of infants born between December 15, 2020, and May 31, 2022. 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). Google Scholar. 383, 26032615 (2020). Overall, the study results support recommendations for vaccination during pregnancy to protect both mothers and their infants. Variances were estimated using Taylor series linearization method. N. Engl. Sign up for notifications from Insider! 182, 825831 (2022). Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. Schrag, S. J. et al. 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). 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. Hospitalization of Infants and Children Aged 0-4 Years with Lab 40, e137e145 (2021). 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%). By comparison, from two to 25 weeks after the second dose, protection against Omicron hospitalization was 64%, the UKHSA said. Carlsen, E. O. et al. Polack, F. P. et al. 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 . Stay up to date with what you want to know. We, therefore, were unable to assess whether maternal infection provided some protection to their infants. Wkly. 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. Article JAMA Intern. But the average . The TND is designed to better control for bias related to health care-seeking behavior31,32. endorsement of these organizations or their programs by CDC or the U.S. However, in contrast with the Norwegian study which reported that infants of mothers who were vaccinated had a 33% decreased risk of testing positive during the first 4 months of life during the Omicron period17, our study found a 13% reduced risk that was not statistically significant. TN, NMF, WH, and SA wrote the software. and/or the original MMWR paper copy for printable versions of official text, figures, and tables. 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. Article It's not clear which variant might have been associated with these hospitalizations. 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. We calculated vaccine effectiveness (VE) as 100% multiplied by 1HR. PubMed 387, 187189 (2022). 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. A study from the U.K. government, published last week, found that three doses of vaccine. Durability of anti-spike antibodies in infants after maternal COVID-19 vaccination or natural infection. 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. SARS-CoV-2 delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. All adults should stay up to date (1) with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. * 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. By clicking Sign up, you agree to receive marketing emails from Insider How Severe Are Omicron Infections? - Scientific American COVID-19 incidence and death rates among unvaccinated and fully vaccinated adults with and without booster doses during periods of Delta and Omicron variant emergence25 U.S. Jurisdictions, April 4December 25, 2021. Jackson, M. L. & Nelson, J. C. The test-negative design for estimating influenza vaccine effectiveness. Selected counties in California, Colorado, Connecticut, Georgia, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah (https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm). 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. and JavaScript. Vaccinated patients during the Delta wave were 37% (over with two doses), while during the Omicron wave they were 57%. Razzaghi, H. et al. Hospitalization Risk from Omicron 'Around a Third of Delta' - WebMD Several conditions, including cancer of the blood or bone marrow and dementia, were associated with HRs greater than 3. Pre-Omicron versions of Covid, in. . Models were adjusted for the covariates listed above. J. Med. What are the implications for public health practice? Beginning the week of December 1925, 2021, the B.1.1.529 (Omicron) variant of SARS-CoV-2 (the virus that causes COVID-19) became the predominant circulating variant in the United States (i.e., accounted for >50% of sequenced isolates). NMF, MC, GD, DDA, AMP, and ST handled project administration. NHS Test and Trace statistics (England): methodology. Defined as one or more of the following: chronic lung disease including asthma, chronic metabolic disease including diabetes mellitus, blood disorder/hemoglobinopathy, cardiovascular disease, neurologic disorder, immunocompromising condition, renal disease, gastrointestinal/liver disease, rheumatologic/autoimmune/inflammatory condition, obesity, feeding tube dependency, and wheelchair dependency. Dis. Mortal. Percentages presented for demographic characteristics are weighted column percentages. CDC twenty four seven. Google Scholar. Google Scholar. provided as a service to MMWR readers and do not constitute or imply 45 C.F.R. Rates are calculated using the CDC National Center for Health Statistics vintage 2020 bridged-race postcensal population estimates for the counties included in surveillance. Maternal vaccination was protective, but protection was lower during the Omicron period than during Delta. 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. Among nonpregnant and pregnant adults aged 18 years, hospitalization rates were calculated overall, and by race/ethnicity and COVID-19 vaccination status. 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. Delahoy MJ, Whitaker M, OHalloran A, et al. Ann Intern Med 2021;174:140919. 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. Sect. Nature Communications (Nat Commun) Klein, N. P. et al. Morb. During the Omicron dominant period, maternal vaccination with at least two doses reduced the infants risk of testing SARS-CoV-2 positive by 43% (95% CI: 4, 69) during the first 2 months of life, 36% (95% CI:11, 55) during the first 4 months of life, and 41% (95% CI: 25, 53) during the first 6 months of life (Supplemental Table2). 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. TN, NMF, SFlax, SFunk, SA, SB, and ST did the formal analysis. All authors reviewed the manuscript. 387, 109119 (2022). 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 . J. Epidemiol. COVID-19 vaccination coverage among pregnant women during pregnancyEight Integrated Health Care Organizations, United States, December 14, 2020-May 8, 2021. 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. As Omicron spread in the US, hospitalization rates in December were much lower for the vaccinated. TN, NMF, SFlax, MC, DDA, AMP, and ST conceptualised the work. Without the vaccines many more people would likely be in hospital. Hospitalization rates among non-Hispanic Black adults increased more than rates in other racial/ethnic groups. Risk was especially high for people with severe combined immunodeficiency (HR, 6.2). Klein, N. P. 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. This is a relevant consideration because vaccines can be less effective in persons with a weakened immune system. Mortal. J. Pediatr. Rates cannot be stratified by pregnancy status because the underlying population of pregnant women in the catchment area is unknown. Children and COVID-19: state data report. Foppa, I. M., Haber, M., Ferdinands, J. M. & Shay, D. K. The case test-negative design for studies of the effectiveness of influenza vaccine. Furthermore, it was reassuring that both the cohort and the secondary TND yielded vaccine effectiveness estimates in the same direction. 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,. 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. IMV status was missing in 1.4% (weighted) of hospitalizations; these hospitalizations are otherwise included elsewhere in the analysis. 384, 22732282 (2021). Among 829 adults hospitalized during the Omicron-predominant period, 49.4% were unvaccinated, compared with 69.5% during the Delta-predominant period (p<0.01). 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. Article **** ICU admission and IMV are not mutually exclusive categories, and patients could have received both. of Omicron-infected patients with a high rate of vaccination in China. 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. Effectiveness of Covid-19 vaccines in ambulatory and inpatient care settings. Department of Health and Human Services. This was the highest age-adjusted weekly rate observed among any racial and ethnic group during the pandemic. M.G. Initial hospital data from England and Denmark also suggest Omicron cases are less severe. Zerbo, O. et al. 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? Protection during both periods decreased as infants aged. Like all observational studies, our study results are susceptible to residual confounding. PLoS ONE 15, e0229279 (2020). On the bias of estimates of influenza vaccine effectiveness from test-negative studies. The mean age at pregnancy onset was 31.62 years (standard deviation of 4.66 years). 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). 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.