Effectiveness of Maternal mRNA COVID-19 Vaccination During Pregnancy Against COVID-19–Associated Hospitalizations in Infants Aged &lt;6 Months During SARS-CoV-2 Omicron Predominance — 20 States, March 9, 2022–May 31, 2023

Simeone, Regina M.; Zambrano, Laura D.; Halasa, Natasha B.; Fleming-Dutra, Katherine E.; Newhams, Margaret M.; Wu, Michael J.; Orzel-Lockwood, Amber O.; Kamidani, Satoshi; Pannaraj, Pia S.; Irby, Katherine; Maddux, Aline B.; Hobbs, Charlotte V.; Cameron, Melissa A.; Boom, Julie A.; Sahni, Leila C.; Kong, Michele; Nofziger, Ryan A.; Schuster, Jennifer E.; Crandall, Hillary; Hume, Janet R.; Staat, Mary A.; Mack, Elizabeth H.; Bradford, Tamara T.; Heidemann, Sabrina M.; Levy, Emily R.; Gertz, Shira J.; Bhumbra, Samina S.; Walker, Tracie C.; Bline, Katherine E.; Michelson, Kelly N.; Zinter, Matt S.; Flori, Heidi R.; Campbell, Angela P.; Randolph, Adrienne G.; ,; Colston, Candice; Kelley, Heather; Murdock, Meghan; Miron, Laura; Sanders, Ronald C.; Hakimi, Daniel; Jumarang, Jaycee; Mrotek, Kennis-Grace; Niell, Liria Muriscot; Baig, Natasha; Petruccelli, Lexi; Sierra, Yamila; Temte, Elizabeth; Thayer, Imogene; Zorensky, Frances; Baida, Nadine; Choi, Jong-Ha C.; Ciric, Caroline R.; Gonzalez, Mark D.; Coates, Bria M.; Price, Heather E.; Stumpf, Mary; Clark, Maya; Dittrich, Rylie; Kucukak, Suden; Listerud, Eve; Moran, Patrick; Drapeau, Noelle M.; Johnson, Brandi A.; Malloch, Lacy; Martin, Lora; Martin, Maygan; Patterson, Kayla; Sanders, Cameron; Pruitt, Shannon; Kansas City, Children’s Mercy; Sullivan, Melissa; Schwartz, Stephanie P.; Tomcany, Merry; Rohlfs, Chelsea C.; Wolfe, Amber; Mohammed, Fatima A.; Reed, J. Nelson; Rusler, Zachary; Thomas, Jack; Wakser, Cayla; Fernandez, Kailee; Stewart, Laura S.; Abojaib, Leenah; Kyles, Molly J.

doi:10.15585/mmwr.mm7239a3

Cited by 15 publications

(4 citation statements)

References 9 publications

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“…11 Mounting evidence has demonstrated that COVID-19 vaccination in pregnancy provides both maternal and neonatal benefit, with reductions in severe maternal COVID-19 12 and neonatal COVID-19 hospitalization. [13][14][15][16] Despite benefits to the maternal-newborn dyad, vaccine hesitancy remains a public health challenge. 11 Stillbirth (fetal death at 20 weeks of gestation or later) has been identified as an important outcome to include when evaluating the safety of vaccines in pregnancy and addressing vaccine hesitancy.…”

Section: Discussionmentioning

confidence: 99%

Coronavirus Disease 2019 (COVID-19) Vaccination and Stillbirth in the Vaccine Safety Datalink

Denoble,

Vazquez-Benitez,

Sheth

et al. 2024

Obstetrics &Amp; Gynecology

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OBJECTIVE: Coronavirus disease 2019 (COVID-19) vaccination is recommended in pregnancy to reduce the risk of severe morbidity from COVID-19. However, vaccine hesitancy persists among pregnant people, with risk of stillbirth being a primary concern. Our objective was to examine the association between COVID-19 vaccination and stillbirth. METHODS: We performed a matched case–control study in the Vaccine Safety Datalink (VSD). Stillbirths and live births were selected from singleton pregnancies among persons aged 16–49 years with at least one prenatal, delivery, or postpartum visit at eight participating VSD sites. Stillbirths identified through diagnostic codes were adjudicated to confirm the outcome, date, and gestational age at fetal death. Confirmed antepartum stillbirths that occurred between February 14, 2021, and February 27, 2022, then were matched 1:3 to live births by pregnancy start date, VSD site, and maternal age at delivery. Associations among antepartum stillbirth and COVID-19 vaccination in pregnancy, vaccine manufacturer, number of vaccine doses received, and vaccination within 6 weeks before stillbirth (or index date in live births) were evaluated using conditional logistic regression. RESULTS: In the matched analysis of 276 confirmed antepartum stillbirths and 822 live births, we found no association between COVID-19 vaccination during pregnancy and stillbirth (38.4% stillbirths vs 39.3% live births in vaccinated individuals, adjusted odds ratio [aOR] 1.02, 95% CI, 0.76–1.37). Furthermore, no association between COVID-19 vaccination and stillbirth was detected by vaccine manufacturer (Moderna: aOR 1.00, 95% CI, 0.62–1.62; Pfizer-BioNTech: aOR 1.00, 95% CI, 0.69–1.43), number of vaccine doses received during pregnancy (1 vs 0: aOR 1.17, 95% CI, 0.75–1.83; 2 vs 0: aOR 0.98, 95% CI, 0.81–1.17), or COVID-19 vaccination within the 6 weeks before stillbirth or index date compared with no vaccination (aOR 1.16, 95% CI, 0.74–1.83). CONCLUSION: No association was found between COVID-19 vaccination and stillbirth. These findings further support recommendations for COVID-19 vaccination in pregnancy.

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Section: Discussionmentioning

confidence: 99%

Coronavirus Disease 2019 (COVID-19) Vaccination and Stillbirth in the Vaccine Safety Datalink

Denoble,

Vazquez-Benitez,

Sheth

et al. 2024

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…The bivalent variant-adapted vaccines have been shown to elicit robust neutralizing antibody responses to recent variants, including BA.5, BQ.1, and XBB.1.5, in maternal blood and umbilical cord blood [ 167 ]. The effectiveness of original COVID-19 mRNA vaccines in pregnant individuals and their infants is well established [ 168 , 169 ]. In line with this, the bivalent BNT162b2 and mRNA-1273 original/Omicron BA.4–5 vaccines have been shown to be effective against emergency department or urgent care encounters in immunocompetent pregnant persons.…”

Section: Populations Of Interestmentioning

confidence: 99%

“…In a study of 191 pregnant people who received bivalent variant-adapted vaccine and 1701 unvaccinated pregnant people, the effectiveness of the vaccine during the period from September 2022 to May 2023 was 61% (95% CI: 22–81; median interval since vaccination 56 days) [ 137 ]. Maternal vaccination with COVID-19 mRNA vaccines has also been shown to provide protection against hospitalization of infants <6 months of age during a period when bivalent vaccines were being rolled out (although the number of pregnant people receiving the bivalent vaccine was small) [ 137 , 169 ]. Effectiveness of the monovalent XBB.1.5 vaccines in pregnant people will be monitored throughout rollout.…”

Section: Populations Of Interestmentioning

confidence: 99%

Responses to Common Misconceptions Relating to COVID-19 Variant-Adapted mRNA Vaccines

Kassianos,

MacDonald,

Aloysius

et al. 2024

Vaccines

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The evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the waning of immunity over time has necessitated the use of booster doses of original coronavirus disease 2019 (COVID-19) vaccines. This has also led to the development and implementation of variant-adapted messenger RNA (mRNA) vaccines that include an Omicron sub-lineage component in addition to the antigen based on the wild-type virus spike protein. Subsequent emergence of the recombinant XBB sub-lineages triggered the development of monovalent XBB-based variant-adapted mRNA vaccines, which are available for vaccination campaigns in late 2023. Misconceptions about new variant-adapted vaccines may exacerbate vaccine fatigue and drive the lack of vaccine acceptance. This article aims to address common concerns about the development and use of COVID-19 variant-adapted mRNA vaccines that have emerged as SARS-CoV-2 has continued to evolve.

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“…Additional pathological findings can accompany SARS-CoV-2 placentitis that include findings of maternal vascular malperfusion (MVM) and fetal vascular malperfusion (FVM), villitis, hemorrhages, and thrombohematomas [38]. Schwartz et al examined when community herd immunity to SARS-CoV-2 is high [45]. The Omicron variants have produced large numbers of infections due to their highly contagious nature, and that plus continued distribution of COVID-19 vaccines including the BA.4/BA.5-Adapted Bivalent Booster has increased herd immunity to the virus.…”

Section: Placental Effects Of Covid-19 Vaccine Refusalmentioning

confidence: 99%

Causes and Effects of COVID-19 Vaccine Hesitancy Among Pregnant Women and its Association with Adverse Maternal, Placental, and Perinatal Outcomes

Moriarty,

Oyenuga,

Olafuyi

et al. 2024

Yale J Biol Med

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Populations identified to be severely affected by COVID-19, such as pregnant patients, require special consideration in vaccine counseling, access, and provider education. Maternal infection with COVID-19 poses a significant risk to the maternal-fetal dyad with known adverse placenta destruction [1][2][3][4][5]. Despite the widespread access and availability of vaccinations, vaccine hesitancy continues to persist and is highly prevalent in pregnant populations [6][7][8][9]. Addressing the multitude of social ecological factors surrounding vaccine hesitancy can aid in providing holistic counseling [10]. However, such factors are foremost shaped by maternal concern over possible fetal effects from vaccination. While changes in policy can help foster vaccine access and acceptance, increasing global provider education and incorporation of motivational interviewing skills are the first steps towards increasing maternal acceptance.

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Effectiveness of Maternal mRNA COVID-19 Vaccination During Pregnancy Against COVID-19–Associated Hospitalizations in Infants Aged <6 Months During SARS-CoV-2 Omicron Predominance — 20 States, March 9, 2022–May 31, 2023

Cited by 15 publications

References 9 publications

Coronavirus Disease 2019 (COVID-19) Vaccination and Stillbirth in the Vaccine Safety Datalink

Coronavirus Disease 2019 (COVID-19) Vaccination and Stillbirth in the Vaccine Safety Datalink

Responses to Common Misconceptions Relating to COVID-19 Variant-Adapted mRNA Vaccines

Causes and Effects of COVID-19 Vaccine Hesitancy Among Pregnant Women and its Association with Adverse Maternal, Placental, and Perinatal Outcomes

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