Percentages presented for the overall number are weighted row percentages. 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. 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). Ferdinands, J. M. et al. Models in this analysis were adjusted for the same covariates included in the primary analysis. 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. We conducted a descriptive analysis of the study population and calculated crude rates of SARS-CoV-2 infection and hospitalization by maternal vaccination status. We take your privacy seriously. N. Engl. Surveillance officers abstracted data on sampled patients from medical charts. After the emergence of the Omicron variant, the rate of COVID-19 hospitalizations in the United States was 10.5 times higher in unvaccinated adults and 2.5 times higher in those who were vaccinated but received no booster than in booster recipients, according to a new study. As of December 25, the rate among unvaccinated people was 78 per 100,000, compared to 4 per 100,000 among fully vaccinated people, the CDC reported. O.Z. Overall, the study results support recommendations for vaccination during pregnancy to protect both mothers and their infants. 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. 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. 1). Protection during both periods decreased as infants aged. Mortal. The U.K. Health. 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. 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 . During the Delta dominant period, the crude incidences of testing positive for SARS-CoV-2 during the first 2, 4, and 6 months of life were lower among infants whose mothers received at least two doses of mRNA COVID-19 vaccines during pregnancy (0.75, 1.43, and 1.56 infants per 100 person-years [PY], respectively) than those whose mothers were not vaccinated during pregnancy (5.47, 5.10, and 4.78 infants per 100 PYs, respectively). 387, 187189 (2022). Annually, approximately 40,000 births occur at KPNC facilities. If material is not included in the articles Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. 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. Morb. Classification of omicron (B.1.1.529): SARS-CoV-2 variant of concern. Kharbanda, E. O. et al. PubMed COVID-19 vaccines have demonstrated both high efficacy in clinical trials and high real-world effectiveness, especially against the original and Delta variant of the virus6,7,8,9,10. 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. J. Med. Starting the week ending December 4, 2021, Maryland data are not included in weekly rate calculations but are included in previous weeks. * Information on the impact that booster or additional doses of COVID-19 vaccines have on preventing hospitalizations during Omicron predominance is limited. You will be subject to the destination website's privacy policy when you follow the link. Maternal vaccination was protective, but protection was lower during the Omicron period than during Delta. 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. Office of the Vice President for Research. CDC graphs show in detail the protection vaccines gave from hospitalization. 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 . Corresponding author: Christopher A. Taylor, iyq3@cdc.gov. 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). of pages found at these sites. * Overall rates are unadjusted; rates presented by racial and ethnic group are age-adjusted. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.. Vaccine 35, 72977301 (2017). All authors reviewed the manuscript. 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. Two new observational studies suggest that COVID-19 vaccination lowers long-COVID incidence and severity. SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland, Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy, Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel, Covid-19 vaccination programme effectiveness against SARS-CoV-2 related infections, hospital admissions and deaths in the Apulia region of Italy: a one-year retrospective cohort study, Post-vaccination outcomes in association with four COVID-19 vaccines in the Kingdom of Bahrain, Effectiveness and protection duration of Covid-19 vaccines and previous infection against any SARS-CoV-2 infection in young adults, The indirect effect of mRNA-based COVID-19 vaccination on healthcare workers unvaccinated household members, SARS-CoV-2 infection and COVID-19 vaccination in pregnancy, Duration of mRNA vaccine protection against SARS-CoV-2 Omicron BA.1 and BA.2 subvariants in Qatar, 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, https://doi.org/10.1016/j.jpeds.2022.09.059, http://creativecommons.org/licenses/by/4.0/. Cookies used to make website functionality more relevant to you. Sample sizes presented are unweighted with weighted percentages. 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. Vaccination status is based on state immunization information system data. In the first study, a team led by US Centers for Disease Control and Prevention (CDC) researchers analyzed data on 192,509 hospitalizations from more than 250 hospitals in 13 states participating in the COVID-19Associated Hospitalization Surveillance Network from Jan 1, 2021, to Apr 30, 2022. The proportion of hospitalized Black adults who received a primary COVID-19 vaccination series with or without a booster or additional dose increased from 4.7% and 14.9%, respectively, during the Delta-predominant period to 14.8% and 25.5%, respectively, during the Omicron-predominant period; Hispanic adults experienced smaller increases. If the SARS-CoV-2 test date was not available, hospital admission date was used. 384, 403416 (2021). Wkly Rep. 71, 352358 (2022). Access your favorite topics in a personalized feed while you're on the go. Overall, 63% of Americans are fully vaccinated. Internet Explorer). 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 Structural changes in the brain may explain the persistent fatigue and neuropsychiatric complications tied to long COVID. Hobbs, C. V. et al. The TND is designed to better control for bias related to health care-seeking behavior31,32. 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%). Our study was strengthened both by its large sample size and our ability to follow infants through 6 months of age. Messer, L. C. et al. CDC twenty four seven. PubMed 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). According to the CDC, hospitalization rates among the unvaccinated were 16 times higher in December overall. 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. Frequency, characteristics and complications of COVID-19 in hospitalized infants. 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). Article We use cookies to help provide and enhance our service and tailor content and ads. Stay up to date with your COVID-19 vaccines. ISSN 2041-1723 (online). References to non-CDC sites on the Internet are N. Engl. the date of publication. During the Omicron-predominant period, hospitalization rates increased among unvaccinated persons and those who completed a primary series, with and without receipt of a booster or additional dose (Figure 2). Association of COVID-19 vaccination during pregnancy with incidence of SARS-CoV-2 infection in infants. 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. MMWR Morb Mortal Wkly Rep 2022;71:14652. Article Analyses were conducted using SAS statistical software survey procedures (version 9.4; SAS Institute). Receipt of one dose especially during the third trimester was also associated with a reduced risk of infants testing positive for SARS-CoV-2 during the first 6 months of life during the Delta dominant period. Danino, D. et al. Among children 12 to 17, the . This was the highest age-adjusted weekly rate observed among any racial and ethnic group during the pandemic. mmwrq@cdc.gov. Secondarily, we used a Test-Negative Design (TND), which is a case-control study, to compare the odds of vaccination among mothers of infants who tested positive vs. the odds of vaccination among mothers of infants who tested negative. Aircraft wastewater surveillance could be used with traveler-based surveillance to provide an early warning system for COVID-19 and other pathogens. Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. This can lead to overestimates of first doses and underestimates of subsequent doses, and underestimates of hospitalization rates in persons who received additional or booster doses. 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). 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). 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. 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. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. 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. N. Engl. Background: Risk stratification models have been developed to identify patients that are at a higher risk of COVID-19 infection and severe illness. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Sect. 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). SGN, HHW, NA, WH, MK, PB, AZ, JLB, MC, NAA, KH, RH, AC, GD, and ST curated 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. 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. Statistical codes are not publicly available but are available from the corresponding author. Abbreviations: COVID-NET = COVID-19Associated Hospitalization Surveillance Network; ICU=intensive care unit; IMV=invasive mechanical ventilation; LTCF=long-term care facility; NA = not applicable. Methods: This is a retrospective cohort study that was conducted in Israel's second-largest . Adults with no documented receipt of any COVID-19 vaccine dose before the test date were considered unvaccinated. The KPNC Institutional review board approved and waived consent for this study. The funders played no direct role in the study. as well as other partner offers and accept our. Morb. Vaccination offers the best way to protect against COVID-19 and its complications. and B.F. P.R. Children born at Kaiser Permanente Northern California from December 15, 2020, through May 31, 2022. Children currently account for about 18.5% of reported COVID-19 cases in the United States1. GD declares that his employer UK Health Security Agency (previously operating as Public Health England) received funding from GlaxoSmithKline for a research project related to influenza antiviral treatment. 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. 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). This case-positive, control-test-negative design also referred to as the test-negative design (TND) has often been used in studies of vaccine effectiveness. Monthly incidence is based on SARS-CoV-2 positive test result date or, if not known, hospital admission date. The researchers used the QCovid risk model to estimate hazard ratios (HRs) for clinical risk factors. Open 5, e2233273 (2022). 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. 384, 21872201 (2021). J. Med. 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). https://doi.org/10.1038/s41467-023-36547-4, DOI: https://doi.org/10.1038/s41467-023-36547-4. Foppa, I. M., Haber, M., Ferdinands, J. M. & Shay, D. K. The case test-negative design for studies of the effectiveness of influenza vaccine. ; COVID-NET Surveillance Team. Vaccinated patients were older (68 vs. 57 years), and 62% had at least one comorbidity Admission to the ICU was 20%, and the mortality rate at 30 days was 14%. It is not inevitable that viral evolution leads to lower severity. Buchan, S. A. et al. 384, 14121423 (2021). The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Rep. 70, 895899 (2021). Mountain lions, a bobcat, red foxes, black bears, and skunks represent the latest avian flu cases in mammals. 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. This preceded and had no relation to COVID-19, and GD had no role in and received no funding from the project. All adults should stay up to date (1) with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. In-hospital death status was missing in 1.4% (weighted) of hospitalizations; these hospitalizations are otherwise included elsewhere in the analysis. Jackson, M. L. & Nelson, J. C. The test-negative design for estimating influenza vaccine effectiveness. 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. Urban Health 83, 10411062 (2006). 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). and JavaScript. B, Severe outcomes included hospitalization and death. Rep. 71, 429436 (2022). During Omicron predominance, children aged <6 months accounted for 44% of hospitalizations among children ages 04 years3. All HTML versions of MMWR articles are generated from final proofs through an automated process. Includes current treatment or recent diagnosis of an immunosuppressive condition or use of an immunosuppressive therapy during the preceding 12 months. Additional COVID-NET methods for determining vaccination status have been described previously. Vaccine 31, 21652168 (2013). 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. Covid-19 vaccine effectiveness against the Omicron (B.1.1.529) variant. PubMed Publishers note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Nature Communications thanks Annette Regan, Olof Stephansson and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Views equals page views plus PDF downloads. 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. We observed that infants protection through vaccination during pregnancy decreased as they aged from 2 months to 6 months. All other authors declare no competing interests. Google Scholar. By clicking Sign up, you agree to receive marketing emails from Insider JAMA Intern. 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). 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). Omicron is super infectious, and about 20% of people in the United States over the age of 5 as well as all children under 5 remain unvaccinated. volume14, Articlenumber:894 (2023) Variances were estimated using Taylor series linearization method. TN and NMF were responsible for visualisation. ** 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.. 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). Rep. 71, 2630 (2022). Morb. This analysis describes weekly hospitalization rates during Delta- and Omicron-predominant periods.