The TND, a case-control study, has been commonly used in studies of the effectiveness of influenza vaccines and more recently COVID-19 vaccines. and B.F. P.R. N. Engl. J. Obstet. SGN, HHW, NA, WH, MK, PB, AZ, JLB, MC, NAA, KH, RH, AC, GD, and ST curated the data. Data requests may be sent to Kaiser Permanente Division of Research: DOR.IRB.Submissions@kp.org. 387, 109119 (2022). A study from the U.K. government, published last week, found that three doses of vaccine. 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. 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. Access your favorite topics in a personalized feed while you're on the go. 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. https://www.medrxiv.org/content/10.1101/2022.01.11.22269045v1, https://data.cdc.gov/Vaccinations/COVID-19-Vaccination-Demographics-in-the-United-St/km4m-vcsb. There was no link between risk of COVID-19 death and race, except for Indian patients, who were at slightly higher risk than their White peers. 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). Get the most important science stories of the day, free in your inbox. 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 . Med. All authors (O.Z., B.F., N.P.K., T.R., M.G., E.L., P.R., K.G., S.O., and E.L.) critically reviewed the manuscript and decided to proceed with publication. Black adults accounted for a higher percentage of hospitalizations during the Omicron-predominant period (26.7%) than during the Delta-predominant period (22.2%, p = 0.05). About half of long-COVID patients who were on sick leave at 4 months were still on sick leave at 2 years. 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. Article Kim, L. et al. As infants aged, protection provided by maternal vaccination decreased during both periods. You can review and change the way we collect information below. References to non-CDC sites on the Internet are 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. Omicron symptoms: Here's what to expect and what we know about the Thank you for visiting nature.com. The average age of participants was 60.8 years, and 92.0% were White. 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%). 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. We conducted secondary sensitivity analyses restricting the population to infants who received at least one SARS-CoV-2 PCR test. 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. Members receive almost all their medical care at KPNC-owned facilities, including clinics, hospitals, pharmacies, and laboratories. Estimated effectiveness of COVID-19 vaccines against omicron or delta symptomatic infection and severe outcomes. Slider with three articles shown per slide. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in 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. J. Med. MMWR Morb Mortal Wkly Rep 2022;71:14652. 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. Among all adults, relative to the Delta-predominant period, COVID-19related illness was the primary reason for admission for a smaller percentage of hospitalizations (87.5% versus 95.5%, p<0.01), and median length of stay was shorter (4 versus 5 days, p<0.01) during the Omicron-predominant period; during this period, the proportion of patients admitted to an intensive care unit, who received invasive mechanical ventilation, and who died in-hospital decreased significantly (all p<0.01). Ainslie, K. E. C., Shi, M., Haber, M. & Orenstein, W. A. Iowa did not provide immunization data but is included in the overall population-based hospitalization rates. 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). Persons who received no doses of any COVID-19 vaccine were considered unvaccinated. Between December 15, 2020, and May 31, 2022, we identified 62,117 infants born at Kaiser Permanente Northern California (KPNC), an integrated healthcare delivery organization. E. & Klein, N. P. Effectiveness of vaccination during pregnancy to prevent infant pertussis. Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19COVID-NET, 13 states, March 1August 22, 2020. Adults with no documented receipt of any COVID-19 vaccine dose before the test date were considered unvaccinated. 40, e137e145 (2021). COVID hospitalizations amid omicron 23 times higher among - ABC News 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. 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. Google Scholar. Table 2. The funders played no direct role in the study. 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). 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. Kharbanda, E. O. et al. Vaccinations were limited only to those received during pregnancy. During Omicron predominance, children aged <6 months accounted for 44% of hospitalizations among children ages 04 years3. 9-14 As of October 2022, 68% of the US population has completed primary series vaccination. Mortal. ; COVID-NET Surveillance Team. Among children 12 to 17, the . 387, 227236 (2022). SARS-CoV-2 variants of concern and variants under investigation in England: technical briefing 35. During the Omicron-predominant period, overall weekly adult hospitalization rates peaked at 38.4 per 100,000, exceeding the previous peak on January 9, 2021 (26.1) and the peak rate during the Delta-predominant period (15.5) (Figure 1). Pre-Omicron versions of Covid, in. and statistical significance was assessed at two-sided p0.05. The results were unchanged when no adjustments for covariates were made (Supplemental Table3). COVID-19 hospitalization rates per 100,000 population by age and vaccination status, January 05 to February 01, 2023 Age group Age-specific rate per 100,000 among unvaccinated individuals Age-specific rate per 100,000 among those who received at least one booster dose Likelihood of unvaccinated individuals being hospitalized with Implementing strategies that result in the equitable receipt of COVID-19 vaccinations among persons with disproportionately higher hospitalizations rates, including non-Hispanic Black adults, is an urgent public health priority. 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 Officials have received a growing number of reports of XDR Shigella, which is highly transmissible and resistant to commonly recommended antibiotics, in adults. 61) indicates a lower risk of hospitalisation with omicron versus delta, averaging over all age groups and vaccination strata. Without the vaccines many more people would likely be in hospital. Additional COVID-NET methods for determining vaccination status have been described previously. 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). Maternal vaccination was protective, but protection was lower during the Omicron period than during Delta. 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. Relative to the Delta-predominant period, the proportion of cases in non-Hispanic Asian or Pacific Islanders also increased, whereas the proportion in all other racial and ethnic groups decreased. Jackson, M. L. & Nelson, J. C. The test-negative design for estimating influenza vaccine effectiveness. Biomedicines | Free Full-Text | Risk Stratification Model for Severe All authors reviewed the manuscript. Vaccine 31, 21652168 (2013). As Omicron spread in the US, hospitalization rates in December were much lower for the vaccinated. Additional COVID-NET methods for determining vaccination status have been described previously. https://downloads.aap.org/AAP/PDF/AAP%20and%20CHA%20-%20Children%20and%20COVID-19%20State%20Data%20Report%209.29.22%20FINAL.pdf?_ga=2.255000394.335550773.1665001859-370326403.1636740765 (2022). TN and NMF validated the data. To account for the correlation between infants with the same mother, we fit marginal Cox proportional hazards models using robust sandwich variance estimates. 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. Buchan, S. A. et al. 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. Pregnant women were excluded because their reasons for hospital admission (4) might differ from those for nonpregnant persons. Users are referred to the electronic PDF version (https://www.cdc.gov/mmwr) Johnson AG, Amin AB, Ali AR, et al. 26K views, 1.2K likes, 65 loves, 454 comments, 23 shares, Facebook Watch Videos from Citizen TV Kenya: #FridayNight Evaluation of the relative virulence of novel SARS-CoV-2 variants: a retrospective cohort study in Ontario, Canada. Danino, D. et al. N. Engl. Mortal. Objectives To develop and implement a scoring tool to identify COVID-19 patients that are at risk for severe illness during the Omicron wave. 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, as 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). Sect. J. Med. But the average . 241(d); 5 U.S.C. 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. Ann Intern Med 2021;174:140919. 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. The cumulative monthly age-adjusted hospitalization rate during January 2022 among unvaccinated adults (528.2) was 12 times the rates among those who had received a booster or additional dose (45.0) and four times the rates among adults who received a primary series, but no booster or additional dose (133.5). JAMA Intern. 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. COVID-19 hospitalizations look different in the Omicron wave, and https://doi.org/10.1038/s41467-023-36547-4, DOI: https://doi.org/10.1038/s41467-023-36547-4.