Association between maternal COVID-19 vaccination and infant hospitalization

In a recent study published in New England Journal of MedicineResearchers evaluated Effectiveness of Pregnant maternal messenger ribonucleic acid (mRNA) vaccination against hospitalization for 2019 coronavirus disease (COVID-19) in infants <6 months.

Background

Infants under 6 months are at increased risk of complications with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and are not eligible for the COVID-19 vaccine. Transplacental transfer of the mother’s anti-SARS-CoV-2 antibody after SARS-CoV-2 vaccination to the mother may provide infant immune protection against SARS-CoV-2.

The authors of this study found that COVID-19-related infants <6 months old from mothers who received double (mRNA) vaccination during pregnancy with SARS-CoV-2 delta (SARS-CoV-2 delta). I have previously reported that the risk of hospitalization is 61% lower. B.1.617.2) The variant was dominant.

About research

In a current case control study, researchers previously investigated the protective role of mRNA vaccination in pregnant women against COVID-19-related hospitalization in infants <6 months dominated by SARS-CoV-2 omicrons. Extends the analysis of (B .1.1.259) variant. Compared to their previous study, this study included a much larger sample size, namely 361 and 309 case infants and control infants, respectively.

The study was conducted from July 1, 2021 to March 8, 2022, with 30 pediatric hospitals in 22 states for infants with COVID-19-related hospitalization (case infants) and COVID-19-related hospitalizations. It consisted of unaccompanied infants (control infants). The infant in the case Center For Disease control When Prevention (CDC)-Overcoming the COVID-19 network with funding.

Data were obtained via electronic medical records and by interviewing infant parents (or guardians) about demographic parameters, previous history of COVID-19, and clinical findings of existing illnesses. .. Get information about your mother’s vaccination, including date of vaccination, dose received, whether the mother was vaccinated during pregnancy, where the mother was vaccinated, the vaccine manufacturer, and availability of the COVID-19 vaccination card. Was vaccinated.

Data were also obtained for critical COVID-19 cases requiring COVID-19-related hospitalization, intensive care unit (ICU) admission, and life-sustaining intervention or even death. Life-sustaining interventions include non-invasive ventilation (continuous or biphasic positive airway pressure), invasive ventilation, vasoactive infusion, and extracorporeal membrane oxygenation.

Infants in all cases were diagnosed as SARS-CoV-2 positive by antigen Testing or reverse transcription-polymerase chain reaction (RT-PCR) within 10 days of onset of symptoms or within 3 days of admission. Mothers were considered fully vaccinated if they were vaccinated twice with the mRNA-1273 or BNT162b2 mRNA vaccine.

Women who received the first vaccination before pregnancy and the second vaccination after pregnancy were included in the analysis. Infants born to mothers vaccinated within 14 days of delivery were excluded from the analysis because protective immunity was established approximately 2 weeks after vaccination.

In addition, babies born to triple mRNA vaccinated mothers (n = 29 babies) or babies vaccinated with Ad26.COV2.S non-mRNA vaccine (n = 13 babies) are these. Both categories. Vaccine efficacy is Delta dominant (July 1, 2021 to December 18, 2021) and Omicron dominant (December 19, 2021 to March 8, 2022).

result

The analysis was performed on 537 and 512 babies and control babies, respectively. Of the infants in the case, 181 were hospitalized for delta infection and 356 infants were hospitalized for omicron infection. The average age of study participants was 2 months. Approximately 16% and 29% of case infants and control infants were born to women who were fully vaccinated during pregnancy, respectively.

Infants born to women who were fully vaccinated during pregnancy (n = 87 babies) compared to babies born to mothers who were not completely vaccinated during pregnancy (n = 450 babies). The ICU admission rate was low (23% vs. 13%). In addition, the infants in the cases had lower serious SARS-CoV-2 infections (12% vs. 9%), invasive ventilation requirements (7% vs. 3%), and non-invasive ventilation requirements (8% vs. 6%). ), And infusion requirements compared to control infants (3% vs. 1%) that showed vasoactive properties.

Of the infants in the case, 21% (n = 113) were admitted to the ICU, of which 12% (n = 64) received vasoactive infusion or mechanical ventilation. Two infant deaths were reported due to COVID-19, two infants required extracorporeal membrane oxygenation replacement, but none of the mothers received two mRNA vaccinations during pregnancy. ..

Complete maternal mRNA vaccination for infants with COVID-19-related hospitalization has been reported to be 52% effective, with Delta predominance at 80% and Omicron predominance at 38%. Efficacy was 70% for COVID-19-related ICU admissions and 47% for admissions that did not require ICU admission. In addition, if the mother was vaccinated during the first 20 weeks of gestation and 20 weeks after gestation, the efficacy was 38% and 69%, respectively.

Overall, the study results showed that complete (double dose) maternal mRNA vaccination reduced the risk of COVID-19-related hospitalization for infants <6 months old.