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Master of Public Health

Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19-Associated Hospitalization in Infants Aged <6 Months - 17 States, July 2021-January 2022

AUTHORS

Halasa NB , Olson SM , Staat MA , Newhams MM , Price AM , Boom JA , Sahni LC , Cameron MA , Pannaraj PS , Bline KE , Bhumbra SS , Bradford TT , Chiotos K , Coates BM , Cullimore ML , Cvijanovich NZ , Flori HR , Gertz SJ , Heidemann SM , Hobbs CV , Hume JR , Irby K , Kamidani S , Kong M , Levy ER , Mack EH , Maddux AB , Michelson KN , Nofziger RA , Schuster JE , Schwartz SP , Smallcomb L , Tarquinio KM , Walker TC , Zinter MS , Gilboa SM , Polen KN , Campbell AP , Randolph AG , Patel MM , , , . MMWR. Morbidity and mortality weekly report. 2022 2 18; 71(7). 264-270

ABSTRACT

COVID-19 vaccination is recommended for persons who are pregnant, breastfeeding, trying to get pregnant now, or who might become pregnant in the future, to protect them from COVID-19. Infants are at risk for life-threatening complications from COVID-19, including acute respiratory failure (1). Evidence from other vaccine-preventable diseases suggests that maternal immunization can provide protection to infants, especially during the high-risk first 6 months of life, through passive transplacental antibody transfer (2). Recent studies of COVID-19 vaccination during pregnancy suggest the possibility of transplacental transfer of SARS-CoV-2-specific antibodies that might provide protection to infants (3-5); however, no epidemiologic evidence currently exists for the protective benefits of maternal immunization during pregnancy against COVID-19 in infants. The Overcoming COVID-19 network conducted a test-negative, case-control study at 20 pediatric hospitals in 17 states during July 1, 2021-January 17, 2022, to assess effectiveness of maternal completion of a 2-dose primary mRNA COVID-19 vaccination series during pregnancy against COVID-19 hospitalization in infants. Among 379 hospitalized infants aged <6 months (176 with COVID-19 [case-infants] and 203 without COVID-19 [control-infants]), the median age was 2 months, 21% had at least one underlying medical condition, and 22% of case- and control-infants were born premature (<37 weeks gestation). Effectiveness of maternal vaccination during pregnancy against COVID-19 hospitalization in infants aged <6 months was 61% (95% CI = 31%-78%). Completion of a 2-dose mRNA COVID-19 vaccination series during pregnancy might help prevent COVID-19 hospitalization among infants aged <6 months.

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