Google Scholar. Additional COVID-NET methods for determining vaccination status have been described previously. A and B, Markers indicate estimates, with vertical lines indicating 95% CIs. Hobbs, C. V. et al. . During the Delta period, we found that protection extended through the infants first 6 months of life. Vaccine 35, 58505857 (2017). Covid-19 vaccine effectiveness against the Omicron (B.1.1.529) variant. These cookies may also be used for advertising purposes by these third parties. 41, e81e86 (2022). Although all data used in this analysis were anonymised, the individual-level nature of the data used risks individuals being identified, or being able to self-identify, if the data are released publicly. The KPNC Institutional review board approved and waived consent for this study. New charts from the Centers for Disease Control and Prevention (CDC) showed that hospitalization rates were much lower among those who were vaccinated even as Omicron was sweeping the nation. Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV-2 during the first six months of life. Razzaghi, H. et al. TN, NMF, SFlax, MC, DDA, AMP, and ST conceptualised the work. MB), Help with If SARS-CoV-2 test date was missing, hospitalization admission date was used. Nursing home residents have been disproportionately affected by COVID-19; older age, comorbidities, and the congregate nature of nursing homes place residents at higher risk for infection and severe COVID-19-associated outcomes . Stay up to date with what you want to know. To ensure stability and reliability of rates by vaccination status, data are presented beginning 14 days after at least 5% of the age group-specific population of the COVID-NET surveillance catchment area has received an additional or booster dose. Finally, the COVID-NET catchment areas include approximately 10% of the U.S. population; thus, these findings might not be nationally generalizable. As with previous variants, being vaccinated greatly protects you from severe disease with omicron. J. Obstet. 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. Officials have received a growing number of reports of XDR Shigella, which is highly transmissible and resistant to commonly recommended antibiotics, in adults. 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. TN and NMF were responsible for visualisation. 26 Among those fully vaccinated individuals 5 years of age who are booster eligible, only 49% have received a . 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. For children whose mothers received one dose before pregnancy and two doses during pregnancy, VE against infection was 89% during the first 2 months of life, 73% during the first 4 months of life, and 48% up to 6 months of life. We take your privacy seriously. 241(d); 5 U.S.C. For mothers of infants in the cohort, we extracted from the electronic health record data: age at pregnancy onset, self-reported race/ethnicity (Asian, Black, Hispanic, Pacific Islander, Multiracial, Native American, Other, White), the primary KPNC facility at which the woman received most of their health care, insurance payor (dichotomized as Medicare/Medicaid/other subsidized insurance and Other), neighborhood deprivation index [NDI]35 categorized into quartiles with higher values representing greater deprivation), pre-pregnancy body mass index (BMI=kg/m2; underweight <18.5, normal 18.524.9, overweight 25.029.9, obese 30.0), pre-pregnancy diabetes status, pre-pregnancy hypertension, and parity (0, 1, 2, 3, 4). Additional limitations include the inability to estimate the effectiveness of vaccines received prior to pregnancy onset. It is possible that this practice may have led to some misclassification of the outcome, and we were unable to assess whether this misclassification was differential between vaccinated and unvaccinated mothers. 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 . 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. 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). Wkly. Med. 3501 et seq. 385, 13551371 (2021). Morb. 226, 236 e1236.e14 (2022). If the SARS-CoV-2 test date was not available, hospital admission date was used. *** An additional 172 (3.4%, 95% CI = 2.7%4.2%) adults were partially vaccinated, 69 (0.9%, 95% CI=0.61.2) received a primary vaccination series <14 days before receiving a positive SARS-CoV-2 test result, and 186 (4.1%) had unknown vaccination status; these groups are not further described in this analysis. In this analysis, vaccine effectiveness was evaluated as 1 minus the odds ratio. and JavaScript. Monthly COVID-19 hospitalization rates were 3.5 to 17.7 times higher in unvaccinated patients than in their vaccinated counterparts, regardless of whether they had received a booster. CDC. Risk factors for severe COVID-19 in children. All HTML versions of MMWR articles are generated from final proofs through an automated process. According to the CDC, hospitalization rates among the unvaccinated were 16 times higher in December overall. It is not inevitable that viral evolution leads to lower severity. Data requests may be sent to Kaiser Permanente Division of Research: [email protected]. "The association between the QCovid risk groups and the risk of death were stronger in people who had received a booster and were infected by the Omicron variant compared with evidence from the Alpha and Delta period in doubly vaccinated individuals," the authors wrote. The results were published yesterday in JAMA Network Open. 61) indicates a lower risk of hospitalisation with omicron versus delta, averaging over all age groups and vaccination strata. SARS-CoV-2 infections can result in COVID-19associated hospitalizations, even among vaccinated persons. J. Pediatr. 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). MMWR and Morbidity and Mortality Weekly Report are service marks of the U.S. Department of Health and Human Services. * https://covid.cdc.gov/covid-data-tracker/#variant-proportions, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covid-net/purpose-methods.html. Vaccination offers the best way to protect against COVID-19 and its complications. Models in this analysis were adjusted for the same covariates included in the primary analysis. In the Omicron variant period, the effectiveness of maternal vaccination in these three age intervals was 21% (CI: 21,48), 14% (CI: 9,32) and 13% (CI: 3,26), respectively. Jackson, M. L. & Nelson, J. C. The test-negative design for estimating influenza vaccine effectiveness. Slider with three articles shown per slide. 384, 21872201 (2021). This preceded and had no relation to COVID-19, and GD had no role in and received no funding from the project. Clinical information was abstracted for 5,681 adults with COVID-19associated hospitalization during July 1, 2021January 31, 2022 (Table). Most mothers (1032 of 1138) who received only one dose received the vaccine during the third trimester. 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-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. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 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. Several conditions, including cancer of the blood or bone marrow and dementia, were associated with HRs greater than 3. supervised chart reviews. 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. By comparison, from two to 25 weeks after the second dose, protection against Omicron hospitalization was 64%, the UKHSA said. Experts say they. 139, e20164091 (2017). Morb. We conducted a descriptive analysis of the study population and calculated crude rates of SARS-CoV-2 infection and hospitalization by maternal vaccination status. N. Engl. 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. During the first 6 months of life, 940 (3.10%) infants tested positive for SARS-CoV-2 by polymerase chain reaction (PCR) test and 10 (0.03%) infants were hospitalized with a positive SARS-CoV-2 test. Mortal. This conversion might result in character translation or format errors in the HTML version. J. TN and NMF validated the data. 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. 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. 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). This work was supported by grants from the UK Research and Innovation (UKRI) Medical Research Council (NMF, WH, SB, EV, ACG [Centre for Global Infectious Disease Analysis; MR/R015600/1], DDA, AMP [MC/UU/00002/11], and SRS [MC/UU/00002/10]); Medical Research Council UKRIDepartment of Health and Social Care National Institute for Health Research (NIHR) COVID-19 rapid response call (NMF, SB [MR/V038109/1], TN, AC, DDA, and AMP [MC/PC/19074]); the NIHR Health Protection Units in: Modelling and Health Economics (NMF, WH, SB, EV, AC, and ACG [NIHR200908]), Behavioural Science and Evaluation (AC and DDA), and Respiratory Infections (JLB); Wellcome Trust (SFunk and SA [210758/Z/18/Z]); philanthropic funding from Community Jameel (NMF, WH, SB, and EV); and the UKRI Engineering and Physical Sciences Research Council (SFlax [EP/V002910/2]). NMF, SB, SFunk, ACG, DDA, and AMP acquired funding. Adults with no documented receipt of any COVID-19 vaccine dose before the test date were considered unvaccinated. Dagan, N. et al. On the bias of estimates of influenza vaccine effectiveness from test-negative studies. N. Engl. If ethnicity was unknown, non-Hispanic ethnicity was assumed. The Spanish Health Ministry also publishes hospitalization data throughout Spain broken down by vaccination status, although in this case it is based on estimates: to calculate the number of unvaccinated in each age group, they subtract the number of vaccinated from the population in 2020.However, the target population will have grown since then, so it is possible that the ministry's . Two new observational studies suggest that COVID-19 vaccination lowers long-COVID incidence and severity. Baxter, R., Bartlett. . VE against hospitalization was not estimated because of the very small number of hospitalized cases. Persons with multiple, unknown, or missing race accounted for 6.9% (weighted) of all cases. During the Omicron-predominant period, weekly COVID-19associated hospitalization rates (hospitalizations per 100,000 adults) peaked at 38.4, compared with 15.5 during Delta predominance. 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%). 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). Hospitalisation associated with SARS-CoV-2 delta variant in Denmark. COVID-19; IL-6 . Spontaneous abortion following COVID-19 vaccination during pregnancy. Nature Communications thanks Annette Regan, Olof Stephansson and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. TN, NMF, SFlax, SFunk, SA, SB, and ST did the formal analysis. 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. Chi-square tests were used to compare differences between the Delta- and Omicron-predominant periods; p-values <0.05 were considered statistically significant. Google Scholar. We calculated vaccine effectiveness (VE) as 100% multiplied by 1HR. Schrag, S. J. et al. New federal data shows adults who received the updated shots cut their risk of being hospitalized with . 387, 227236 (2022). Rates were highest among unvaccinated adults and lowest among those who had received a booster or additional dose. 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. 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. A study from the U.K. government, published last week, found that three doses of vaccine. 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. 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). It is possible that our exclusion criteria may have resulted in a final sample that may not be reflective of all KPNC infants. They help us to know which pages are the most and least popular and see how visitors move around the site. Vaccination status is based on state immunization information system data. 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 MMWR Morb Mortal Wkly Rep 2022;71:466473. We use cookies to help provide and enhance our service and tailor content and ads. Adults whose vaccination status had not yet been verified using the immunization information system data were considered to have unknown vaccination status and were included in total proportions but not stratified by vaccination status. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. DeSilva, M. et al. Rep. 69, 10811088 (2020). SARS-CoV-2 variants of concern and variants under investigation in England: technical briefing 35. Infect. 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. 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? 1). Thus, this design better adjusts for healthcare-seeking behavior31,32, but it may also introduce other biases including selection bias33. Morb. B, Severe outcomes included hospitalization and death. 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. Monthly incidence is based on SARS-CoV-2 positive test result date or, if not known, hospital admission date. Pediatrics. *** LTCF residents include hospitalized adults who were identified as residents of a nursing home/skilled nursing facility, rehabilitation facility, assisted living/residential care, long-term acute care hospital, group/retirement home, or other LTCF upon hospital admission. J. Med. 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. We thank staff at UKHSA and members of the UK Government SPI-M committee and the UKHSA Variant Technical Group for valuable discussions. Compared with the Delta-predominant period, the proportion of unvaccinated hospitalized Black adults increased during the Omicron-predominant period. 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. Ferdinands, J. M. et al. * Overall rates are unadjusted; rates presented by racial and ethnic group are age-adjusted. 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 are deeply flawed. Among fully vaccinated people without a booster, rates were lower at 3,355.5 per 100,000 for COVID-19 cases and 35.4 per 100,000 for hospitalizations. endorsement of these organizations or their programs by CDC or the U.S. Libby Reeg reports grants from the Michigan Department of Health and Human Services during the conduct of the study. Views equals page views plus PDF downloads. J. Med. JAMA 327, 10871089 (2022). The development of a standardized neighborhood deprivation index. First, COVID-19associated hospitalizations might have been missed because of hospital testing practices and test availability. The findings in this report are subject to at least four limitations. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. In the US, as of the end of September 2022, almost 15 million children ages <18 years have tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Coronavirus Disease 2019 (COVID-19). To obtain 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. The code used to analyse the data is available on. To ensure stability and reliability of rates by vaccination status, data are presented beginning when 14 days have passed since at least 5% of the population of adults aged 18 years in the COVID-NET surveillance catchment area had received an additional or booster dose. 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. Author's reply, Efficacy, safety, and immunogenicity of the DNA SARS-CoV-2 vaccine (ZyCoV-D): the interim efficacy results of a phase 3, randomised, double-blind, placebo-controlled study in India, Centers for Disease Control and Prevention, MRC Biostatistics Unit COVID-19 Working Group, Cases, hospital admissions, and hospital attendances in those with delta and omicron SARS-CoV-2 variants, between Nov 29, 2021, and Jan 9, 2022, Risk of hospitalisation and mortality for COVID-19 cases with omicron compared with delta, overall and by age group, Estimated HRs for vaccination categories, secondary analysis. Sign up for notifications from Insider! JAMA Netw. 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. Weekly / March 25, 2022 / 71(12);466473. Vaccinated patients during the Delta wave were 37% (over with two doses), while during the Omicron wave they were 57%. Article Pediatr. 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. All adults should stay up to date (1) with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. This analysis describes weekly hospitalization rates during Delta- and Omicron-predominant periods. Correspondence to [email protected]. 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. 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. Mortal. Safety and efficacy of the BNT162b2 mRNA covid-19 vaccine. Further information on research design is available in theNature Portfolio Reporting Summary linked to this article. Methods: One hundred and . All authors reviewed the manuscript. 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). "People who get vaccinated may be more cautious about COVID in general, or perhaps getting vaccinated makes them less cautious, or they may live in states with more/less COVID risk, etc," Jit said. JAMA Netw. Annually, approximately 40,000 births occur at KPNC facilities. Google Scholar. Delahoy MJ, Whitaker M, OHalloran A, et al. Relative to the Delta-predominant period, a larger proportion of hospitalized Black adults were unvaccinated. 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). 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. Sect. https://www.cdc.gov/nchs/nvss/bridged_race.htm, ** https://www.medrxiv.org/content/10.1101/2021.08.27.21262356v1, On August 13, 2021, CDCs Advisory Committee on Immunization Practices (ACIP) issued the first of several recommendations for additional or booster doses of COVID-19 vaccine. 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. The final study population included 30311 (48.8%) infants who were KPNC members at least 2 months after birth. RESP-NET: COVID-19 Associated Hospitalization Rates among Adults Ages 65 Years and Older CDC's Respiratory Virus Hospitalization Surveillance Network (RESP-NET) shows that overall weekly rates of COVID-19-associated hospitalizations have declined for all age groups from a peak in December 2022. Late last year, as Omicron was spreading fast in the US, hospitalization rates per 100,000 rose sharply among unvaccinated adults, while rates in those who were fully vaccinated remained. Google Scholar. wrote the initial manuscript. Frequency, characteristics and complications of COVID-19 in hospitalized infants. Mortal. The efficacy of COVID 19 vaccines for reducing the risk of severe COVID-19 infection is demonstrated in real life. It's not clear which variant might have been associated with these hospitalizations. Durability of anti-spike antibodies in infants after maternal COVID-19 vaccination or natural infection. Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey.