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

被引：161

作者：

Halasa, Natasha B. ^{[1
]}

Olson, Samantha M. ^{[2
]}

Staat, Mary A. ^{[6
]}

Newhams, Margaret M. ^{[9
]}

Price, Ashley M. ^{[2
]}

Pannaraj, Pia S. ^{[11
,12
]}

Boom, Julie A. ^{[16
]}

Sahni, Leila C. ^{[16
]}

Chiotos, Kathleen ^{[17
]}

Cameron, Melissa A. ^{[13
]}

Bline, Katherine E. ^{[7
]}

Hobbs, Charlotte V. ^{[18
,36
]}

Maddux, Aline B. ^{[19
,20
]}

Coates, Bria M. ^{[21
,22
]}

Michelson, Kelly N. ^{[21
,22
]}

Heidemann, Sabrina M. ^{[23
]}

Irby, Katherine ^{[26
]}

Nofziger, Ryan A. ^{[8
]}

Mack, Elizabeth H. ^{[27
]}

Smallcomb, Laura ^{[28
]}

Schwartz, Stephanie P. ^{[29
]}

Walker, Tracie C. ^{[29
]}

Gertz, Shira J. ^{[30
]}

Schuster, Jennifer E. ^{[31
]}

Kamidani, Satoshi ^{[3
,4
]}

Tarquinio, Keiko M. ^{[5
]}

Bhumbra, Samina S. ^{[32
]}

Maamari, Mia ^{[33
]}

Hume, Janet R. ^{[34
]}

Crandall, Hillary

Levy, Emily R. ^{[35
]}

Zinter, Matt S. ^{[14
]}

Bradford, Tamara T. ^{[37
]}

Flori, Heidi R. ^{[24
,25
]}

Cullimore, Melissa L. ^{[38
]}

Kong, Michele ^{[39
]}

Cvijanovich, Natalie Z. ^{[15
]}

Gilboa, Suzanne M. ^{[2
]}

Polen, Kara N. ^{[2
]}

Campbell, Angela P. ^{[2
]}

Randolph, Adrienne G. ^{[9
,10
]}

Patel, Manish M. ^{[2
]}

机构：

[1] Vanderbilt Univ, Div Pediat Infect Dis, Dept Pediat, Med Ctr, Nashville, TN USA

[2] Emory Univ, Sch Med, Covid19 Response Team Ctrs Dis Control & Prevent, Atlanta, GA USA

[3] Emory Univ, Ctr Childhood Infect & Vaccines Childrens Healthc, Atlanta, GA USA

[4] Emory Univ, Dept Pediat, Sch Med, Atlanta, GA USA

[5] Emory Univ, Div Crit Care Med, Dept Pediat, Childrens Healthcare Atlanta,Sch Med, Atlanta, GA USA

[6] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Coll Med, Cincinnati, OH USA

[7] Nationwide Childrens Hosp, Div Pediat Crit Care Med, Columbus, OH USA

[8] Akron Childrens Hosp, Div Crit Care Med, Dept Pediat, Akron, OH USA

[9] Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA USA

[10] Harvard Med Sch, Dept Anaesthesia & Pediat, Boston, MA 02115 USA

[11] Childrens Hosp Los Angeles, Div Infect Dis, Los Angeles, CA USA

[12] Univ Southern Calif, Dept Pediat & Molr Microbiol & Immunol, Los Angeles, CA 90007 USA

[13] Univ Calif San Diego, Div Pediat Hosp Med, Rady Childrens Hosp, San Diego, CA USA

[14] Univ Calif San Francisco, Div Crit Care Med & Allergy Immunol & Bone Marrow, Dept Pediat, San Francisco, CA USA

[15] UCSF Benioff Childrens Hosp, Div Crit Care Med, Oakland, CA USA

[16] Texas Childrens Hosp, Dept Pediat, Baylor Coll Med, Immunizat Project, Houston, TX USA

[17] Childrens Hosp Philadelphia, Div Crit Care Med, Dept Anesthesiol & Crit Care, Philadelphia, PA USA

[18] Univ Mississippi, Div Infect Dis, Dept Pediat, Med Ctr, Jackson, MS USA

[19] Univ Colorado, Sect Crit Care Med, Dept Pediat, Sch Med, Aurora, CO USA

[20] Univ Colorado, Hosp Colorado, Sch Med, Aurora, CO USA

[21] Northwestern Univ, Div Crit Care Med, Dept Pediat, Feinberg Sch Med, Chicago, IL USA

[22] Robert H Lurie Childrens Hosp Chicago, Chicago, IL USA

[23] Cent Michigan Univ, Childrens Hosp Michigan, Div Pediat Crit Care Med, Detroit, MI USA

[24] Mott Childrens Hosp, Dept Pediat, Div Pediat Crit Care Med, Ann Arbor, MI USA

[25] Univ Michigan, Ann Arbor, MI USA

[26] Arkansas Childrens Hosp, Pediat Crit Care Sect, Dept Pediat, Little Rock, AR USA

[27] Med Univ South Carolina, Div Pediat Crit Care Med, Charleston, SC USA

[28] Med Univ South Carolina, Dept Pediat, Charleston, SC USA

[29] Univ North Carolina, Chapel Hill Childrens Hosp, Dept Pediat, Chapel Hill, NC USA

[30] Cooperman Barnabas Med Ctr, Div Pediat Crit Care, Dept Pediat rics, Livingston, NJ USA

[31] Childrens Mercy Kansas City, Div Pediat Infect Dis, Dept Pediatr, Kansas City, MO USA

[32] Indiana Univ Sch Med, Dept Pediat, Ryan White Ctr Pediat Infect Dis & Global Hlth, Indianapolis, IN USA

[33] Univ Texas SouthWestern, Div Crit Care Med, Dept Pediat, Childrens Med Ctr, Dallas, TX USA

[34] Univ Minnesota, Div Pediat Crit Care, Mason Childrens Hosp, Minneapolis, MN USA

[35] Mayo Clin, Div Pediat Infect Dis & Pediat Crit Care Med, Dept Pediat & Adolescent Med, Rochester, MN USA

[36] Univ Utah, Div Pediat Crit Care, Dept Pediat, Salt Lake City, UT USA

[37] Louisiana State Univ, Div Cardiol, Dept Pediatr, Hlth Sci Ctr, New Orleans, LA USA

[38] Childrens Hosp & Med Ctr, Div Pediat Crit Care, Dept Pediat, Omaha, NE USA

[39] Univ Alabama Birmingham, Div Pediat Crit Care Med, Dept Pediat, Birmingham, AL USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2022年 / 387卷 / 02期

关键词：

MESSENGER-RNA VACCINATION; PREGNANT-WOMEN; UNITED-STATES; CHILDREN;

D O I：

10.1056/NEJMoa2204399

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：109 / 119

页数：11

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