Ann Intern Med 2021;174:140919. 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. Risk of hospitalisation associated with infection with SARS-CoV-2 lineage B.1.1.7 in Denmark: an observational cohort study. CAS Access your favorite topics in a personalized feed while you're on the go. Article 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). Risk of hospitalization and vaccine effectiveness among COVID-19 But those countries have high vaccination rates, and there, too, Omicron has spread most quickly among younger adults. Accessed March 10, 2022. However, linking is sometimes not possible because CDC does not receive personally identifiable information about vaccine doses. 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. Data among adults over 50 showed that a booster shot gave even stronger protection. J. Med. adjudicated chart reviews. Chi-square tests were used to compare differences between the Delta- and Omicron-predominant periods; p-values <0.05 were considered statistically significant. 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. Maternal vaccination was protective, but protection was lower during Omicron than during Delta. We conducted a descriptive analysis of the study population and calculated crude rates of SARS-CoV-2 infection and hospitalization by maternal vaccination status. 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. Publishers note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Includes current treatment or recent diagnosis of an immunosuppressive condition or use of an immunosuppressive therapy during the preceding 12 months. N. Engl. About half of long-COVID patients who were on sick leave at 4 months were still on sick leave at 2 years. All other authors declare no competing interests. Objectives To develop and implement a scoring tool to identify COVID-19 patients that are at risk for severe illness during the Omicron wave. COVID hospitalizations amid omicron 23 times higher among - ABC News Mortal. The KPNC Institutional review board approved and waived consent for this study. Association of COVID-19 vaccination during pregnancy with incidence of SARS-CoV-2 infection in infants. Maternal vaccination and risk of hospitalization for Covid-19 among infants. Effectiveness of Covid-19 vaccines in ambulatory and inpatient care settings. Article J. Med. Adults who received booster doses were classified as those who completed their primary vaccination series and received an additional or booster dose of vaccine on or after August 13, 2021, at any time after the completion of their 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). Mortal. 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. 383, 26032615 (2020). 241(d); 5 U.S.C. "The subpopulations with the highest risk should be considered a priority for COVID-19 therapeutics and further booster doses.". IMV status was missing in 1.4% (weighted) of hospitalizations; these hospitalizations are otherwise included elsewhere in the analysis. Relative to the Delta-predominant period, a larger proportion of hospitalized Black adults were unvaccinated. By clicking Sign up, you agree to receive marketing emails from Insider Zerbo, O. et al. Second, vaccination status is subject to misclassification; this might affect estimation of rates by vaccination status. By submitting a comment you agree to abide by our Terms and Community Guidelines. Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey. If the SARS-CoV-2 test date was not available, hospital admission date was used. Infect. J. Med. Finally, the COVID-NET catchment areas include approximately 10% of the U.S. population; thus, these findings might not be nationally generalizable. 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. Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19COVID-NET, 13 states, March 1August 22, 2020. Evaluation of acute adverse events after Covid-19 vaccination during pregnancy. The images or other third party material in this article are included in the articles Creative Commons license, unless indicated otherwise in a credit line to the material. 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. The rate among adults who received a primary series, but no booster or additional dose (133.5), was three times the rate among adults who received a booster or additional dose (45.0). Trends in disease severity and health care utilization during the early Omicron variant period compared with previous SARS-CoV-2 high transmission periodsUnited States, December 2020January 2022. Estimation of COVID-19 mRNA vaccine effectiveness against medically attended COVID-19 in pregnancy during periods of delta and Omicron variant predominance in the United States. Risk was especially high for people with severe combined immunodeficiency (HR, 6.2). You will be subject to the destination website's privacy policy when you follow the link. J. Pediatr. Data analysis shows omicron variant less severe, better at evading vaccines and/or the original MMWR paper copy for printable versions of official text, figures, and tables. Persons who received only 1 vaccine dose of a 2-dose series 14 days before the SARS-CoV-2 test date or had received a single dose of either a 1- or 2-dose vaccination series <14 days before the positive SARS-CoV-2 test result were considered partially vaccinated and were not included in rates by vaccination status. Google Scholar. 387, 187189 (2022). Requests for access to the underlying source data should be directed to UKHSA. In the meantime, to ensure continued support, we are displaying the site without styles 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). Pediatr. 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. J. Med. Furthermore, it was reassuring that both the cohort and the secondary TND yielded vaccine effectiveness estimates in the same direction. What are the implications for public health practice? Selected counties in California, Colorado, Connecticut, Georgia, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah (https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm). Recently another study reported that the effectiveness of mRNA COVID-19 vaccines against infections and hospitalizations among pregnant people was higher during the Delta period than during the Omicron period21. Hospitalization rates among non-Hispanic Black adults increased more than rates in other racial/ethnic groups. The findings in this report are subject to at least four limitations. O.Z., N.P.K., and B.F. conceived and designed the study. Sarah J. #FridayNight | #FridayNight | By Citizen TV Kenya | Facebook | Good PubMed 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). Moline HL, Whitaker M, Deng L, et al. In this design, we used Cox proportional hazards models with calendar days as the underlying scale to estimate hazard ratios and calculated vaccine effectiveness as 1 minus the hazard ratio. Hospitalisation associated with SARS-CoV-2 delta variant in Denmark. https://doi.org/10.1016/j.jpeds.2022.09.059 (2022). Using Cox regression, the effectiveness of 2 doses of COVID-19 vaccine received during pregnancy was 84% (95% confidence interval [CI]: 66, 93), 62% (CI: 39, 77) and 56% (CI: 34,71) during months 02, 04 and 0- 6 of a childs life, respectively, in the Delta variant period. 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. In this analysis, we estimated the odds ratio (OR) of vaccination of mothers of infants who tested positive for SARS-CoV-2 versus infants who tested negative using logistic regression models conditioned (stratified) on the calendar date of the test so that infants testing positive on a certain day were compared to infants testing negative on that same day. SGN, HHW, NA, WH, MK, PB, AZ, JLB, MC, NAA, KH, RH, AC, GD, and ST curated the data. The company also said full results of its 2,250-person study confirmed the pill's promising early results against the virus: The drug reduced combined hospitalizations and deaths by about 89. Stock, Jade Carruthers, Rachael Wood, Joshua Guedalia, Michal Lipschuetz, Ofer Beharier, Tobias Homan, Sara Mazzilli, Domenico Martinelli, Manaf AlQahtani, Xing Du, Siddhartha Mukherjee, Jussipekka Salo, Milla Hgg, Lauri Sksvuori, Hiam Chemaitelly, Houssein H. Ayoub, Laith J. Abu-Raddad, Nature Communications We take your privacy seriously. Omicron cases are exploding. Scientists still don't know how bad the During the study period, home testing became more prevalent. 61) indicates a lower risk of hospitalisation with omicron versus delta, averaging over all age groups and vaccination strata. Over the entire study period, the crude rate of hospitalization with a SARS-CoV-2 positive test was lower during the first 6 months of life among infants whose mothers received at least two doses of mRNA COVID-19 vaccines during pregnancy compared with infants whose mothers were unvaccinated during pregnancy (21/100,000 PY vs. 100/100,000 PY). Kharbanda, E. O. et al. 26 Among those fully vaccinated individuals 5 years of age who are booster eligible, only 49% have received a . TN, NMF, SFlax, MC, DDA, AMP, and ST conceptualised the work. During Omicron predominance, children aged <6 months accounted for 44% of hospitalizations among children ages 04 years3. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. Hospitalizations of Children Aged 5-11 Years with Laboratory Severe cases may increase in the wake of holiday parties where people of all ages mixed. 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. 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. We also conducted analyses based on the trimester during which the vaccine was received during pregnancy (first, second, or third trimester). 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. . These data should be taken with a grain of salt. Urban Health 83, 10411062 (2006). Another explanation is the presence of a high COVID-19 vaccination rate among studied individuals (more than two-thirds), which is supported by the finding that the majority of patients had been infected with SARS-CoV-2 prior to undergoing vaccination. Nature Communications thanks Annette Regan, Olof Stephansson and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. To obtain 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. The infection fatality rate from Covid-19 fell more than 10-fold from a little more than 1 per cent in January 2021 to 0.1 per cent in July as the UK's vaccination campaign was rolled out, and . 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. Get the most important science stories of the day, free in your inbox. Atlanta, GA: US Department of Health and Human Services, CDC; 2022. 2022 The Authors. Experts say they. Our analysis . Acosta AM, Garg S, Pham H, et al. 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. Correspondence to Over the entire study period, the crude rate of hospitalization with a SARS-CoV-2 positive test was lower during the first 6 months of life among infants whose mothers received at least two doses . Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. These results suggest that in addition to providing protection against testing positive, vaccination during pregnancy also provides protection against hospitalization (severe disease) in infants during their first 6 months of life as previously reported recently18,19. COVID-19-Associated Hospitalizations Among Adults During SARS-CoV-2 Centers for Disease Control and Prevention. Percentages presented for demographic characteristics are weighted column percentages. This preceded and had no relation to COVID-19, and GD had no role in and received no funding from the project. Data requests may be sent to Kaiser Permanente Division of Research: DOR.IRB.Submissions@kp.org. J., Fireman. 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%. Sadoff, J. et al. Effectiveness of Two Doses of BNT162b2 Vaccine before and during Proxy Omicron Period. COVID-19 vaccine surveillance report: week 6. Hospitalization of infants and children aged 0-4 years with laboratory-confirmed COVID-19COVID-NET, 14 states, March 2020-February 2022. 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. A previous study conducted before the Omicron-predominant period that showed increased risk for COVID-19associated hospitalization among certain racial and ethnic groups, including Black adults, and suggested the increased hospitalization rates were likely multifactorial and could include increased prevalence of underlying medical conditions, increased community-level exposure to and incidence of COVID-19, and poor access to health care in these groups (7). Andrews, N. et al. Office of the Vice President for Research. J. Med. Ainslie, K. E. C., Shi, M., Haber, M. & Orenstein, W. A. Methods: This is a retrospective cohort study that was conducted in Israel's second-largest . 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. However, a milder virus could still put pressure . Jackson, M. L. & Nelson, J. C. The test-negative design for estimating influenza vaccine effectiveness. No other exclusion criteria were applied. Kids' low COVID-19 vaccination rates called a 'gut punch' How likely is COVID-19 hospitalization for vaccinated Americans? - USAFacts The objective of this study was to further evaluate the effectiveness of at least two doses of mRNA COVID-19 vaccination during pregnancy for preventing SARS-CoV-2 infection in infants during the first 2, 4, and 6 months of life during the Delta and Omicron variant periods. As Omicron spread in the US, hospitalization rates in December were much lower for the vaccinated. Symptoms are abstracted from the medical chart and might not be complete. Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis. 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. Hospitalization rates and characteristics of children aged <18 years hospitalized with laboratory-confirmed COVID-19COVID-NET, 14 States, March 1-July 25, 2020. 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 All adults should stay up to date (1) with COVID-19 vaccination to reduce their risk for COVID-19associated hospitalization. 226, 236 e1236.e14 (2022). We, therefore, were unable to assess whether maternal infection provided some protection to their infants. TN, NMF, SB, EV, SRS, DDA, and AMP developed the methodology. Sign up for the Nature Briefing newsletter what matters in science, free to your inbox daily. 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 "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. Children born at Kaiser Permanente Northern California from December 15, 2020, through May 31, 2022. Morb. Additional COVID-NET methods for determining vaccination status have been described previously. All rights Reserved. Wkly. 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. Background: Risk stratification models have been developed to identify patients that are at a higher risk of COVID-19 infection and severe illness. The data cannot be shared publicly because the data contain potentially identifying or sensitive patient information and is legally restricted by Kaiser Permanente Northern California. 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. We excluded these infants because we were primarily interested in estimating the effectiveness of mRNA vaccines received during pregnancy; (7) mothers who received adenovirus vector vaccines or any non-mRNA platform vaccines during pregnancy; (8) mothers who did not receive their mRNA vaccinations in accordance with CDC recommendationse.g., the timing between dose 1 and dose 2 was not within the recommended intervals; and (9) infants who did not become KPNC members within two calendar months of their birth. These proportions are lower compared with 47.3% of White persons who received a primary series and 54.5% of eligible adults who received a booster dose. Relative to the Delta-predominant period, Black adults accounted for a larger proportion of unvaccinated adults during the Omicron-predominant period, and age-adjusted hospitalization rates for Black adults increased to the highest rate among all racial and ethnic groups for any week during the pandemic.