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). Article But the average . If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Google Scholar. BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting. Mortal. Cookies used to make website functionality more relevant to you. Baden, L. R. et al. Taken together, these findings suggest that the increased risk for hospitalization among Black adults during the Omicron-predominant period might also be due, in part, to lower proportions of Black adults receiving both the primary vaccination series and booster doses. 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. ** 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.. 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. wrote the initial manuscript. SARS-CoV-2 variant data update, England: Version 21. Persons who received no doses of any COVID-19 vaccine were considered unvaccinated. Members receive almost all their medical care at KPNC-owned facilities, including clinics, hospitals, pharmacies, and laboratories. However, a milder virus could still put pressure . Get the most important science stories of the day, free in your inbox. The second study, led by Office for National Statistics researchers in Wales, involved death rates and risk factors in adults in England who had received an mRNA booster at least 14 days before Dec 31, 2021. The group raised concerns about a small number of Guillain-Barre syndrome cases in vaccine recipients and wanted more data, especially on efficacy in those at highest risk. Libby Reeg reports grants from the Michigan Department of Health and Human Services during the conduct of the study. Slider with three articles shown per slide. 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%). Pediatrics. PLoS ONE 15, e0229279 (2020). 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. Among children 12 to 17, the . The researchers used the QCovid risk model to estimate hazard ratios (HRs) for clinical risk factors. and statistical significance was assessed at two-sided p0.05. 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. Hospitalization of infants and children aged 0-4 years with laboratory-confirmed COVID-19COVID-NET, 14 states, March 2020-February 2022. 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. Structural changes in the brain may explain the persistent fatigue and neuropsychiatric complications tied to long COVID. Clinical trends among U.S. adults hospitalized with COVID-19, March to December 2020: a cross-sectional study. Symptoms are abstracted from the medical chart and might not be complete. Vaccine 31, 31043109 (2013). Requests for access to the underlying source data should be directed to UKHSA. It is possible that our exclusion criteria may have resulted in a final sample that may not be reflective of all KPNC infants. and B.F. P.R. The study had limitations worth noting. Evan J. Anderson reports grants from Pfizer, Merck, PaxVax, Micron, Sanofi-Pasteur, Janssen, MedImmune, and GlaxoSmithKline; personal fees from Pfizer, Medscape, Kentucky Bioprocessing, Inc., Sanofi-Pasteur, and Janssen, outside the submitted work; and institutional funding from the National Institutes of Health to conduct clinical trials of Moderna and Janssen COVID-19 vaccines. Relative to the Delta-predominant period, a larger proportion of hospitalized Black adults were unvaccinated. Iuliano AD, Brunkard JM, Boehmer TK, et al. Infect. 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). As Omicron spread in the US, hospitalization rates in December were much lower for the vaccinated. Protection during both periods decreased as infants aged from 2 months to 6 months. The results were published yesterday in JAMA Network Open. 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). Finally, the COVID-NET catchment areas include approximately 10% of the U.S. population; thus, these findings might not be nationally generalizable. 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. JAMA Netw. 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. T.R. * https://covid.cdc.gov/covid-data-tracker/#variant-proportions, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covid-net/purpose-methods.html. Using previously described methods (3), investigators collected clinical data on a representative sample of adult patients (7.9%) hospitalized during July 1, 2021January 31, 2022, stratified by age and COVID-NET site. Stay up to date with your COVID-19 vaccines. 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. 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. Iowa does not provide data on vaccination status. It showed that boosters further reduced the risk of hospitalization. Carlsen, E. O. et al. MMWR Morb Mortal Wkly Rep 2022;71:466473. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. 384, 21872201 (2021). We also conducted analyses based on the trimester during which the vaccine was received during pregnancy (first, second, or third trimester). All analyses were conducted using SAS software, v9.4. What are the implications for public health practice? Several conditions, including cancer of the blood or bone marrow and dementia, were associated with HRs greater than 3. 384, 403416 (2021). Google Scholar. The development of a standardized neighborhood deprivation index. Adults with no documented receipt of any COVID-19 vaccine dose before the test date were considered unvaccinated. 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. Kharbanda, E. O. et al. TN and NMF were responsible for visualisation. Nature. Maternal vaccination was protective, but protection was lower during Omicron than during Delta. Morb. Johnson AG, Amin AB, Ali AR, et al. 20, 15225 (2016). Vaccine 31, 21652168 (2013). Experts say they. In January 2022, unvaccinated adults and those vaccinated with a primary series, but no booster or additional dose, were 12 and three times as likely to be hospitalized, respectively, as were adults who received booster or additional doses. Surveillance officers abstracted data on sampled patients from medical charts. JAMA Netw Open 2021;4:e2130479. Article Rep. 71, 429436 (2022). In the present study, the mothers of only 32% of infants in the cohort received at least 2 doses during pregnancy. You can review and change the way we collect information below. 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. Without the vaccines many more people would likely be in hospital. provided as a service to MMWR readers and do not constitute or imply 182, 825831 (2022). 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. N. Engl. J. Med. We thank staff at UKHSA and members of the UK Government SPI-M committee and the UKHSA Variant Technical Group for valuable discussions. Our additional supplemental analysis suggests that pregnant persons who received at least one vaccine dose before pregnancy should complete their vaccination series during pregnancy to provide protection to their children during the first 6 months of life. Most mothers (1032 of 1138) who received only one dose received the vaccine during the third trimester. 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). Other studies found similarly decreased proportions of severe outcomes among hospitalized patients with COVID-19 during this period (6).. Waning 2-dose and 3-dose effectiveness of mRNA vaccines against COVID-19-associated emergency department and urgent care encounters and hospitalizations among adults during periods of delta and omicron variant predominanceVISION Network, 10 states, August 2021-January 2022. *** 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. Moline HL, Whitaker M, Deng L, et al. Jackson, M. L. & Nelson, J. C. The test-negative design for estimating influenza vaccine effectiveness. Marks, K. J. et al. We take your privacy seriously. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. Initial hospital data from England and Denmark also suggest Omicron cases are less severe. 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. Corresponding author: Christopher A. Taylor, iyq3@cdc.gov. These findings are consistent with estimates of booster effectiveness against symptomatic Omicron infection using healthcare ascertainment. N. Engl. CIDRAP - Center for Infectious Disease Research & Policy 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). By comparison, from two to 25 weeks after the second dose, protection against Omicron hospitalization was 64%, the UKHSA said. 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. Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis. 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. All adults should stay up to date with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. part 56; 42 U.S.C. 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. volume14, Articlenumber:894 (2023) Data were available for researchers who meet the criteria for access to Kaiser Permanente Northern California confidential data. https://doi.org . as well as other partner offers and accept our. Third, because immunocompromise status is not always known, it is not possible to distinguish between booster and additional doses; this could have influenced observed rates. The study was funded by the National Institute of Allergy and Infectious Disease grant # 1R01AI168373-01 to O.Z. 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). Dagan, N. et al. Abbreviations: COVID-NET = COVID-19Associated Hospitalization Surveillance Network; ICU=intensive care unit; IMV=invasive mechanical ventilation; LTCF=long-term care facility; NA = not applicable. These cookies may also be used for advertising purposes by these third parties. Image, Download Hi-res 189, 13791388 (2020). 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). The company also said full results of its 2,250-person study confirmed the pill's promising early results against the virus: The drug reduced combined hospitalizations and deaths by about 89. Second, vaccination status is subject to misclassification; this might affect estimation of rates by vaccination status. Questions or messages regarding errors in formatting should be addressed to Risk factors for severe COVID-19 in children. J. Med. By the end of December, Omicron made up 58% of all cases in the US, per Our World in Data, but Delta is thought to cause more severe disease and more hospitalizations than Omicron on average. Additional COVID-NET methods for determining vaccination status have been described previously. In conclusion, in this population-based cohort study, we found that infants born to mothers who received at least two doses of an mRNA COVID-19 vaccine during pregnancy were at lower risk of testing positive for SARS-CoV-2 and were at lower risk of hospitalization during the first 6 months of life compared with infants whose mothers were unvaccinated during pregnancy. KPNC members are similar to the broad catchment population in Northern California in terms of sociodemographic characteristics34. MMWR Morb Mortal Wkly Rep 2022;71:1328. 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. 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 Among the infants in the cohort, 19,418 (64.06%) of the mothers were unvaccinated during pregnancy, 1138 (3.75%) of the mothers received one dose of an mRNA COVID-19 vaccine and 9755 (32.18%) received 2 doses during pregnancy (Table1). J. Med. Because the immune status of all patients is not known, an additional dose (recommended for persons with a weakened immune system) cannot be distinguished from a booster dose. Percentages presented were weighted to account for the probability of selection for sampled cases (3). Children born at Kaiser Permanente Northern California from December 15, 2020, through May 31, 2022. 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). 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. The stats are for COVID-associated hospitalizations, which may include people for whom COVID-19 was not the primary reason for admission. We, therefore, were unable to assess whether maternal infection provided some protection to their infants. Aircraft wastewater surveillance could be used with traveler-based surveillance to provide an early warning system for COVID-19 and other pathogens. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. 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. J. Med. All adjustment variables were selected a priori based on prior work36. part 46, 21 C.F.R. Effectiveness of Covid-19 vaccines in ambulatory and inpatient care settings. Klein, N. P. et al. The objective of this study was to further evaluate the effectiveness of at least two doses of mRNA COVID-19 vaccination during pregnancy for preventing SARS-CoV-2 infection in infants during the first 2, 4, and 6 months of life during the Delta and Omicron variant periods. The proportion of hospitalized adults who received booster or additional doses increased from 1.3% during the Delta-predominant period to 13.4% during the Omicron-predominant period (p<0.01)***; among these, 10.7% were long-term care facility residents and 69.5% had an immunosuppressive condition. Black adults accounted for 25.2% of all unvaccinated persons hospitalized during the Delta-predominant period; that proportion increased by 23%, to 31.0% during the Omicron-predominant period. While Omicron caused a big spike in COVID-19 cases, vaccinated people continued to be less likely to be hospitalized than the unvaccinated. 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.

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