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Grand Rounds

More Data: Does Maternal COVID-19 Vaccination Protect Infants Against Hospitalization for COVID?

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BACKGROUND AND PURPOSE:

  • Infants born to mothers vaccinated against COVID-19 may have protection conferred via transplacental transfer of antibodies
  • Halasa et al. (NEJM, 2022) assessed the effectiveness of maternal vaccination during pregnancy against hospitalization for Covid-19 among infants <6 months

METHODS:

  • Case–control test-negative study
  • Participants
    • Infants <6 months who were hospitalized between July 2021 and March 2022 across 22 U.S. states
      • Cases: Hospitalized for COVID-19
      • Controls: Hospitalized without COVID-19
  • Exposures
    • Maternal COVID-19 vaccination
  • Study design
    • Full maternal vaccination was defined as two doses of mRNA vaccine
    • The primary variants in circulation were
      • Delta: July 2021 to December 2021
      • Omicron: December 2021 to March 2022
  • Primary outcome
    • Vaccine effectiveness in infants

RESULTS:

  • Case infants: 537 | Control infants: 512
    • Cases: Hospital admission occurred during
      • Delta: 181 infants
      • Omicron: 356 infants
    • Median infant age: 2 months
  • Maternal vaccination among cases and controls
    • Cases: 16% born to vaccinated mothers
    • Controls: 29% born to vaccinated mothers
  • Case infant outcomes
    • Received intensive care: 21%
      • Received mechanical ventilation or vasoactive infusions: 12%
    • Deaths: 2 cases (neither mother was vaccinated)
  • Effectiveness of maternal vaccination against infant hospitalization for COVID-19
    • Overall: 52% (95% CI, 33 to 65)
    • During Delta: 80% (95% CI, 60 to 90)
    • During Omicron: 38% (95% CI, 8 to 58)
  • Effectiveness by vaccination timing
    • Vaccination >20 weeks: 69% (95% CI, 50 to 80)
    • Vaccination <20 weeks: 38% (95% CI, 3 to 60)

CONCLUSION:

  • Maternal vaccination against COVID-19 was associated with a reduced risk of infant (<6 months of age) hospitalization due to COVID-19
  • The authors state

In this real-world evaluation, maternal vaccination with mRNA vaccines was associated with a substantial reduction in the risk of Covid-19–related hospitalization and critical illness among young infants, although reductions were less pronounced when the omicron variant was predominant

These findings provide additional support for the current recommendations regarding Covid-19 vaccination during pregnancy

Learn More – Primary Sources:

Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants

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Related ObG Topics:

Does Maternal COVID-19 Vaccination Protect Against Infant Hospitalization Due to COVID?
Latest Data on Transplacental Antibody Transfer Following COVID-19 Vaccination
Vaccines in Pregnant and Lactating Women: Is Immune Response Similar to that of Non-Pregnant Patients?

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