Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants.
COVID-19
/ epidemiology
COVID-19 Vaccines
/ adverse effects
Female
Hospitalization
/ statistics & numerical data
Humans
Infant
Mothers
Pregnancy
Pregnancy Complications, Infectious
/ epidemiology
SARS-CoV-2
Vaccination
/ statistics & numerical data
Vaccines, Synthetic
mRNA Vaccines
/ adverse effects
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
14 07 2022
14 07 2022
Historique:
pubmed:
23
6
2022
medline:
16
7
2022
entrez:
22
6
2022
Statut:
ppublish
Résumé
Infants younger than 6 months of age are at high risk for complications of coronavirus disease 2019 (Covid-19) and are not eligible for vaccination. Transplacental transfer of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after maternal Covid-19 vaccination may confer protection against Covid-19 in infants. We used a case-control test-negative design to assess the effectiveness of maternal vaccination during pregnancy against hospitalization for Covid-19 among infants younger than 6 months of age. Between July 1, 2021, and March 8, 2022, we enrolled infants hospitalized for Covid-19 (case infants) and infants hospitalized without Covid-19 (control infants) at 30 hospitals in 22 states. We estimated vaccine effectiveness by comparing the odds of full maternal vaccination (two doses of mRNA vaccine) among case infants and control infants during circulation of the B.1.617.2 (delta) variant (July 1, 2021, to December 18, 2021) and the B.1.1.259 (omicron) variant (December 19, 2021, to March 8, 2022). A total of 537 case infants (181 of whom had been admitted to a hospital during the delta period and 356 during the omicron period; median age, 2 months) and 512 control infants were enrolled and included in the analyses; 16% of the case infants and 29% of the control infants had been born to mothers who had been fully vaccinated against Covid-19 during pregnancy. Among the case infants, 113 (21%) received intensive care (64 [12%] received mechanical ventilation or vasoactive infusions). Two case infants died from Covid-19; neither infant's mother had been vaccinated during pregnancy. The effectiveness of maternal vaccination against hospitalization for Covid-19 among infants was 52% (95% confidence interval [CI], 33 to 65) overall, 80% (95% CI, 60 to 90) during the delta period, and 38% (95% CI, 8 to 58) during the omicron period. Effectiveness was 69% (95% CI, 50 to 80) when maternal vaccination occurred after 20 weeks of pregnancy and 38% (95% CI, 3 to 60) during the first 20 weeks of pregnancy. Maternal vaccination with two doses of mRNA vaccine was associated with a reduced risk of hospitalization for Covid-19, including for critical illness, among infants younger than 6 months of age. (Funded by the Centers for Disease Control and Prevention.).
Sections du résumé
BACKGROUND
Infants younger than 6 months of age are at high risk for complications of coronavirus disease 2019 (Covid-19) and are not eligible for vaccination. Transplacental transfer of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after maternal Covid-19 vaccination may confer protection against Covid-19 in infants.
METHODS
We used a case-control test-negative design to assess the effectiveness of maternal vaccination during pregnancy against hospitalization for Covid-19 among infants younger than 6 months of age. Between July 1, 2021, and March 8, 2022, we enrolled infants hospitalized for Covid-19 (case infants) and infants hospitalized without Covid-19 (control infants) at 30 hospitals in 22 states. We estimated vaccine effectiveness by comparing the odds of full maternal vaccination (two doses of mRNA vaccine) among case infants and control infants during circulation of the B.1.617.2 (delta) variant (July 1, 2021, to December 18, 2021) and the B.1.1.259 (omicron) variant (December 19, 2021, to March 8, 2022).
RESULTS
A total of 537 case infants (181 of whom had been admitted to a hospital during the delta period and 356 during the omicron period; median age, 2 months) and 512 control infants were enrolled and included in the analyses; 16% of the case infants and 29% of the control infants had been born to mothers who had been fully vaccinated against Covid-19 during pregnancy. Among the case infants, 113 (21%) received intensive care (64 [12%] received mechanical ventilation or vasoactive infusions). Two case infants died from Covid-19; neither infant's mother had been vaccinated during pregnancy. The effectiveness of maternal vaccination against hospitalization for Covid-19 among infants was 52% (95% confidence interval [CI], 33 to 65) overall, 80% (95% CI, 60 to 90) during the delta period, and 38% (95% CI, 8 to 58) during the omicron period. Effectiveness was 69% (95% CI, 50 to 80) when maternal vaccination occurred after 20 weeks of pregnancy and 38% (95% CI, 3 to 60) during the first 20 weeks of pregnancy.
CONCLUSIONS
Maternal vaccination with two doses of mRNA vaccine was associated with a reduced risk of hospitalization for Covid-19, including for critical illness, among infants younger than 6 months of age. (Funded by the Centers for Disease Control and Prevention.).
Identifiants
pubmed: 35731908
doi: 10.1056/NEJMoa2204399
pmc: PMC9342588
doi:
Substances chimiques
COVID-19 Vaccines
0
Vaccines, Synthetic
0
mRNA Vaccines
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
109-119Subventions
Organisme : NCIRD CDC HHS
ID : 75D30121C10297
Pays : United States
Organisme : NCIRD CDC HHS
ID : 75D30121C10297
Pays : United States
Investigateurs
Michele Kong
(M)
Meghan Murdock
(M)
Katherine Irby
(K)
Ronald C Sanders
(RC)
Masson Yates
(M)
Chelsea Smith
(C)
Melissa A Cameron
(MA)
Katheryn Crane
(K)
Natalie Z Cvijanovich
(NZ)
Geraldina Lionetti
(G)
Juliana Murcia-Montoya
(J)
Matt S Zinter
(MS)
Denise Villarreal-Chico
(D)
Pia S Pannaraj
(PS)
Adam L Skura
(AL)
Daniel Hakimi
(D)
Harvey Peralta
(H)
Yea Ji Sea
(YJ)
Kennis-Grace Mrotek
(KG)
Aline B Maddux
(AB)
Justin M Lockwood
(JM)
Emily Port
(E)
Imogene Carson
(I)
Satoshi Kamidani
(S)
Keiko M Tarquinio
(KM)
Laila Hussaini
(L)
Nadine Baida
(N)
Kelly N Michelson
(KN)
Bria M Coates
(BM)
Simone T Rhodes
(ST)
Hassan A Khan
(HA)
Samina S Bhumbra
(SS)
Courtney M Rowan
(CM)
Mary Stumpf
(M)
Tamara T Bradford
(TT)
Marla S Johnston
(MS)
Adrienne G Randolph
(AG)
Margaret M Newhams
(MM)
Suden Kucukak
(S)
Amber O Orzel
(AO)
Sabrina R Chen
(SR)
Benjamin J Boutselis
(BJ)
Timothy P McCadden
(TP)
Edie Weller
(E)
Laura Berbert
(L)
Jie He
(J)
Sabrina M Heidemann
(SM)
Heidi R Flori
(HR)
Patrick Moran
(P)
Janet R Hume
(JR)
Ellen R Bruno
(ER)
Lexie A Goertzen
(LA)
Emily R Levy
(ER)
Supriya Behl
(S)
Noelle M Drapeau
(NM)
Charlotte V Hobbs
(CV)
Lora Martin
(L)
Lacy Malloch
(L)
Virginia Austin Harrison
(VA)
Cameron Sanders
(C)
Kayla Patterson
(K)
Chidinma A Chikere
(CA)
Jennifer E Schuster
(JE)
Shannon M Hill
(SM)
Melissa Sullivan
(M)
Melissa L Cullimore
(ML)
Valerie H Rinehart
(VH)
Lauren A Hoody
(LA)
Shira J Gertz
(SJ)
Stephanie P Schwartz
(SP)
Tracie C Walker
(TC)
Paris C Bennett
(PC)
Ryan A Nofziger
(RA)
Nicole A Twinem
(NA)
Merry L Tomcany
(ML)
Mary Allen Staat
(MA)
Chelsea C Rohlfs
(CC)
Katherine Bline
(K)
Amber Wolfe
(A)
Kathleen Chiotos
(K)
Rebecca L Douglas
(RL)
Kathlyn Phengchomphet
(K)
Elizabeth H Mack
(EH)
Megan M Bickford
(MM)
Lauren E Wakefield
(LE)
Laura Smallcomb
(L)
Natasha B Halasa
(NB)
Haya Hayek
(H)
Yesenia Romero
(Y)
Julie A Boom
(JA)
Leila C Sahni
(LC)
Jennifer N Oates
(JN)
Mia Maamari
(M)
Cindy Bowens
(C)
Hillary Crandall
(H)
Samantha M Olson
(SM)
Ashley M Price
(AM)
Suzanne M Gilboa
(SM)
Kara N Polen
(KN)
Laura D Zambrano
(LD)
Angela P Campbell
(AP)
Manish M Patel
(MM)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 Massachusetts Medical Society.
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