omicron hospitalization rate vaccinated by age

SARS-CoV-2 delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. All other authors declare no competing interests. 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). The risk of hospitalisation appeared to increase when comparing delta with alpha infections. Mothers were classified as either having had 2 doses or one dose of mRNA COVID-19 vaccines during pregnancy (and completed more than 14 days prior to delivery) or not having had any COVID-19 vaccines prior to delivery. To ensure stability and reliability of rates by vaccination status, data are presented beginning 14 days after at least 5% of the age group-specific population of the COVID-NET surveillance catchment area has received an additional or booster dose. JAMA Intern. Percentages presented for the overall number are weighted row percentages. We were not able to evaluate more detailed measures of relative clinical severity in hospitalised patients (such as intensive care unit admittance), but our finding that estimated severity reductions comparing omicron with delta are larger for more severe endpoints (death and hospital admission versus hospital attendance) agrees with observations that the proportion of hospitalised COVID-19 patients requiring intensive care or mechanical ventilation (or both) has been substantially lower during the omicron wave in England than the preceding delta wave. Persons who received no doses of any COVID-19 vaccine were considered unvaccinated. Introduction: A rapid increase in COVID-19 cases due to the spread of the Delta and Omicron variants in vaccinated populations has raised concerns about the hospitalization risk associated with, and the effectiveness of, COVID-19 vaccines. But the average . But those countries have high vaccination rates, and there, too, Omicron has spread most quickly among younger adults. Late last year, as Omicron was spreading fast in the US, hospitalization rates per 100,000 rose sharply among unvaccinated adults, while rates in those who were fully vaccinated remained. pdf files, Omicron: fewer adverse outcomes come with new dangers, Statement on offensive historical content, Redistribute or republish the final article, Reuse portions or extracts from the article in other works. For mothers of infants in the cohort, we extracted from the electronic health record data: age at pregnancy onset, self-reported race/ethnicity (Asian, Black, Hispanic, Pacific Islander, Multiracial, Native American, Other, White), the primary KPNC facility at which the woman received most of their health care, insurance payor (dichotomized as Medicare/Medicaid/other subsidized insurance and Other), neighborhood deprivation index [NDI]35 categorized into quartiles with higher values representing greater deprivation), pre-pregnancy body mass index (BMI=kg/m2; underweight <18.5, normal 18.524.9, overweight 25.029.9, obese 30.0), pre-pregnancy diabetes status, pre-pregnancy hypertension, and parity (0, 1, 2, 3, 4). During the Omicron dominant period, maternal vaccination with at least two doses reduced the infants risk of testing SARS-CoV-2 positive by 43% (95% CI: 4, 69) during the first 2 months of life, 36% (95% CI:11, 55) during the first 4 months of life, and 41% (95% CI: 25, 53) during the first 6 months of life (Supplemental Table2). 40, e137e145 (2021). A free-text field for other types of residences was examined; patients with an LTCF-type residence were also categorized as LTCF residents. Article Age-adjusted rates were calculated by dividing the number of hospitalized COVID-19 patients by population estimates for race/ethnicity, and vaccination status in the catchment area. As of December 25, the rate among unvaccinated people was 78 per 100,000, compared to 4 per 100,000 among fully vaccinated people, the CDC reported. Monthly incidence is based on SARS-CoV-2 positive test result date or, if not known, hospital admission date. Proportions between the pre-Delta and Delta period were compared using chi-square tests; p-values <0.05 were considered statistically significant, adjusted for multiple comparisons using the Bonferroni correction method. https://doi.org/10.1016/j.jpeds.2022.09.059 (2022). Children born at Kaiser Permanente Northern California from December 15, 2020, through May 31, 2022. J. Epidemiol. 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 Pediatr. of pages found at these sites. Publishers note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. SARS-CoV-2 variants of concern and variants under investigation in England: technical briefing 35. Laurie M. Billing and Kenzie Teno report grants from the Council of State and Territorial Epidemiologists during the conduct of the study. The results were published yesterday in JAMA Network Open. MB), Help with PubMed 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. 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. The state has administered 3.2 million vaccine doses since Dec. 1 alone, but lagging rates between full vaccination and first doses for adults especially (82.6% vs. 95%) are becoming a point of . Waning 2-dose and 3-dose effectiveness of mRNA vaccines against COVID-19-associated emergency department and urgent care encounters and hospitalizations among adults during periods of delta and omicron variant predominanceVISION Network, 10 states, August 2021-January 2022. A study from the U.K. government, published last week, found that three doses of vaccine. Risk was especially high for people with severe combined immunodeficiency (HR, 6.2). Kim, L. et al. endorsement of these organizations or their programs by CDC or the U.S. Relative to unvaccinated hospitalized patients, hospitalized vaccinees were more likely to be older (median age, 70 vs 58 years) and to have at least three underlying conditions (77.8% vs 51.6%). While Omicron caused a big spike in COVID-19 cases, vaccinated people continued to be less likely to be hospitalized than the unvaccinated. Data requests may be sent to Kaiser Permanente Division of Research: DOR.IRB.Submissions@kp.org. Defined as one or more of the following: chronic lung disease including asthma, chronic metabolic disease including diabetes mellitus, blood disorder/hemoglobinopathy, cardiovascular disease, neurologic disorder, immunocompromising condition, renal disease, gastrointestinal/liver disease, rheumatologic/autoimmune/inflammatory condition, obesity, feeding tube dependency, and wheelchair dependency. But the charts are in line with data from the UK Health Safety Agency, which found that protection from a third dose of Pfizer or Moderna vaccine against hospitalization with Omicron was about 89%, waning slightly to 83% at 10 weeks, Insider's Catherine Schuster Bruce reported. Analyses were conducted using SAS statistical software survey procedures (version 9.4; SAS Institute). 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. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birtheight integrated Health Care Organizations, United States, December 15, 2020-July 22, 2021. Relative to the Delta-predominant period, the proportion of cases in non-Hispanic Asian or Pacific Islanders also increased, whereas the proportion in all other racial and ethnic groups decreased. Taken together, these findings suggest that the increased risk for hospitalization among Black adults during the Omicron-predominant period might also be due, in part, to lower proportions of Black adults receiving both the primary vaccination series and booster doses. This analysis describes weekly hospitalization rates during Delta- and Omicron-predominant periods. Vaccine 35, 58505857 (2017). On March 18, 2022, this report was posted online as an MMWR Early Release. Among these infants, for our main analysis, we excluded 21,891 (35.2%) based on maternal exclusion criteria and 10,412 (16.8%) after applying infant exclusion criteria (Fig. Baxter, R., Bartlett. Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. They help us to know which pages are the most and least popular and see how visitors move around the site. We use cookies to help provide and enhance our service and tailor content and ads. of Omicron-infected patients with a high rate of vaccination in China. First, COVID-19associated hospitalizations might have been missed because of hospital testing practices and test availability. Persons with multiple, unknown, or missing race accounted for 6.9% (weighted) of all cases. URL addresses listed in MMWR were current as of The outcomes were the infants first positive nasal/throat swab for SARS-CoV-2 by PCR, and the first COVID-19-related hospitalization, occurring during the first 6 months of life and recorded in the electronic health record. Access your favorite topics in a personalized feed while you're on the go. The proportion of hospitalized adults who received booster or additional doses increased from 1.3% during the Delta-predominant period to 13.4% during the Omicron-predominant period (p<0.01)***; among these, 10.7% were long-term care facility residents and 69.5% had an immunosuppressive condition. Black adults accounted for 25.2% of all unvaccinated persons hospitalized during the Delta-predominant period; that proportion increased by 23%, to 31.0% during the Omicron-predominant period. By comparison, from two to 25 weeks after the second dose, protection against Omicron hospitalization was 64%, the UKHSA said. Google Scholar. T.R. CDC is not responsible for the content We observed that infants protection through vaccination during pregnancy decreased as they aged from 2 months to 6 months. 2022 The Authors. Estimated effectiveness of COVID-19 vaccines against omicron or delta symptomatic infection and severe outcomes. J. The cohort analyses may be biased toward the null if some infected infants were misclassified as uninfected due to the absence of a SARS-CoV-2 test result in the medical record. Vaccine effectiveness of cell-culture relative to egg-based inactivated influenza vaccine during the 2017-18 influenza season. Most mothers (1032 of 1138) who received only one dose received the vaccine during the third trimester. KPNC has a comprehensive electronic health record system (Kaiser Permanente HealthConnect, a customized EPIC system), that captures detailed information on all medical services, including immunization, membership enrollment including place of residence, demographics, and pregnancy-related care from pregnancy onset to delivery, and beyond. Adults whose vaccination status had not yet been verified using the immunization information system data were considered to have unknown vaccination status and were included in total proportions but not stratified by vaccination status. Rep. 69, 10811088 (2020). 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. TN and NMF were responsible for visualisation. CDC twenty four seven. ISSN 2041-1723 (online). Danino, D. et al. Data about boosters was only available for those over 50. Acosta AM, Garg S, Pham H, et al. supervised chart reviews. The research was published yesterday in JAMA Internal Medicine. CAS Foo, D., Sarna, M., Pereira, G., Moore, H. C. & Regan, A. K. Longitudinal, population-based cohort study of prenatal influenza vaccination and influenza infection in childhood. Risk of hospitalisation associated with infection with SARS-CoV-2 lineage B.1.1.7 in Denmark: an observational cohort study. Schrag, S. J. et al. Racial and ethnic disparities in rates of COVID-19associated hospitalization, intensive care unit admission, and in-hospital death in the United States from March 2020 to February 2021. 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. Klein, N. P. et al. the date of publication. DOI: http://dx.doi.org/10.15585/mmwr.mm7112e2. On the bias of estimates of influenza vaccine effectiveness from test-negative studies. Association of COVID-19 vaccination during pregnancy with incidence of SARS-CoV-2 infection in infants. 386, 15321546 (2022). Jackson, M. L. & Nelson, J. C. The test-negative design for estimating influenza vaccine effectiveness. "The high hospitalization rates in unvaccinated compared with vaccinated persons with and without a booster dose underscores the importance of COVID-19 vaccinations in preventing hospitalizations and suggests that increasing vaccination coverage, including booster dose coverage, can prevent hospitalizations, serious illness, and death," the researchers wrote. Hobbs, C. V. et al. However, in contrast with the Norwegian study which reported that infants of mothers who were vaccinated had a 33% decreased risk of testing positive during the first 4 months of life during the Omicron period17, our study found a 13% reduced risk that was not statistically significant. This is consistent with data showing the incidence of positive SARS-CoV-2 test results or death from COVID-19 is higher among unvaccinated adults and adults who have not received a booster than among those who have received a booster or additional dose (5). 20, 15225 (2016). 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. Aircraft wastewater surveillance could be used with traveler-based surveillance to provide an early warning system for COVID-19 and other pathogens. If material is not included in the articles Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Sarah J. Although all data used in this analysis were anonymised, the individual-level nature of the data used risks individuals being identified, or being able to self-identify, if the data are released publicly. (2021) Omicron is supercharging the COVID vaccine booster debate. . The final study population included 30311 (48.8%) infants who were KPNC members at least 2 months after birth. Suggested citation for this article: Taylor CA, Whitaker M, Anglin O, et al. Zerbo, O. et al. J. Med. MMWR Morb Mortal Wkly Rep 2022;71:1328. Like influenza and Tdap vaccines15,16, data suggest that vaccination during pregnancy may protect infants who are not old enough to be vaccinated against COVID-19. Gordon, N. & Lin, T. The Kaiser Permanente Northern California adult member health survey. Buchan, S. A. et al. New charts from the Centers for Disease Control and Prevention (CDC) showed that hospitalization rates were much lower among those who were vaccinated even as Omicron was sweeping the nation. Pre-Omicron versions of Covid, in. * https://covid.cdc.gov/covid-data-tracker/#variant-proportions, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covid-net/purpose-methods.html. Wkly Rep. 71, 352358 (2022). The efficacy of COVID 19 vaccines for reducing the risk of severe COVID-19 infection is demonstrated in real life. Starting the week ending December 4, 2021, Maryland data are not included in weekly rate calculations but are included in previous weeks. TN, NMF, SB, EV, SRS, DDA, and AMP developed the methodology. Hospitalization rates among non-Hispanic Black adults increased more than rates in other racial/ethnic groups. During the first 6 months of life, 940 (3.10%) infants tested positive for SARS-CoV-2 by polymerase chain reaction (PCR) test and 10 (0.03%) infants were hospitalized with a positive SARS-CoV-2 test. part 46, 21 C.F.R. Background: Risk stratification models have been developed to identify patients that are at a higher risk of COVID-19 infection and severe illness. Am. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. MMWR Morb Mortal Wkly Rep 2021;70:108893. Most mothers (66.14%) were between ages 25 and <35 years, and more than a quarter (27.27%) were of Asian race, 5.16% were Black, 24.44% were of Hispanic ethnicity and 37.57% were White. A recent study found that the mean titer of maternally derived antibodies in infants of vaccinated mothers were higher at age 2 months compared with antibody titers at age 6 months23. Age-adjusted hospitalization rates among Black adults peaked at 94.7 (January 8, 2022), higher than that among all other racial and ethnic groups, 3.8 times the rate among White adults (24.8) for the same week, and 2.5 times the previous peak (January 16, 2021) among Black adults (37.2). Iowa did not provide immunization data but is included in the overall population-based hospitalization rates. Includes current treatment or recent diagnosis of an immunosuppressive condition or use of an immunosuppressive therapy during the preceding 12 months. Article 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 . 241(d); 5 U.S.C. Vaccinations were limited only to those received during pregnancy. However, vaccination during pregnancy was less effective at protecting infants against SARS-CoV-2 infection during the Omicron period. part 56; 42 U.S.C. It is critical that nursing home residents stay up to date with CO VID-19 vaccines and receive a bivalent booster dose to maximize protection against COVID-19. 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. They, as well as vaccinated people who are immunocompromised and at higher risk of severe COVID-19, are still vulnerable to being infected by a vaccinated person. Department of Health and Human Services. O.Z. Models were adjusted for the covariates listed above. 385, 13551371 (2021). Finally, we conducted additional supplemental analyses to estimate VE among children whose mothers received at least one vaccine dose prior to pregnancy onset and at least one dose during pregnancy. 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. The aim of the secondary design was to compare the results of the cohort with TND. Experts say they. Among the infants in the cohort, 19,418 (64.06%) of the mothers were unvaccinated during pregnancy, 1138 (3.75%) of the mothers received one dose of an mRNA COVID-19 vaccine and 9755 (32.18%) received 2 doses during pregnancy (Table1). JAMA Netw. 383, 26032615 (2020). References to non-CDC sites on the Internet are 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. Adults with no documented receipt of any COVID-19 vaccine dose before the test date were considered unvaccinated. Two to 4 weeks after a booster dose, vaccine effectiveness ranged from around 65-75%, dropped to 55-70% at 5 to 9 weeks, and 40-50% from 10 weeks or more after a booster dose. Morb. Third, because immunocompromise status is not always known, it is not possible to distinguish between booster and additional doses; this could have influenced observed rates. Iowa does not provide data on vaccination status. The development of a standardized neighborhood deprivation index. The study had limitations worth noting. Overall, 63% of Americans are fully vaccinated. JAMA Netw. J. Med. And in a second large study during the Omicron period, older people, men, and residents of nursing homes or in low-income areas were most at risk for post-booster COVID-19 death in England, but the risk was very low. Gynecol. 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. Fully-vaccinated in this chart meant one dose of the J&J vaccine or two doses of Pfizer or Moderna. J. Med. Johnson AG, Amin AB, Ali AR, et al. Thank you for taking the time to confirm your preferences. 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. Adults with a positive result whose SARS-CoV-2 test date was 14 days after the first dose of a 2-dose series but <14 days after receipt of the second dose were considered partially vaccinated. Partially vaccinated adults, and those who received a single dose of a 1-dose product <14 days before the positive SARS-CoV-2 test result were not included in analyses by vaccination status but were included in rates and overall proportions that were not stratified by vaccination status. Vaccination offers the best way to protect against COVID-19 and its complications. Ousseny Zerbo. In this analysis, vaccine effectiveness was evaluated as 1 minus the odds ratio. Compared with the Delta-predominant period, the proportion of unvaccinated hospitalized Black adults increased during the Omicron-predominant period. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. 384, 22732282 (2021). J. Med. Accessed March 10, 2022. Requests for access to the underlying source data should be directed to UKHSA. National influenza and COVID-19 surveillance report: 27 January 2022 (week 4). Adults who received booster doses were classified as those who completed the primary series and received an additional or booster dose on or after August 13, 2021, at any time after completion of the primary series, and 14 days before a positive test result for SARS-CoV-2, as 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). The TND, a case-control study, has been commonly used in studies of the effectiveness of influenza vaccines and more recently COVID-19 vaccines. Ainslie, K. E. C., Shi, M., Haber, M. & Orenstein, W. A. We did not assess whether vaccines received before pregnancy or immediately after pregnancy were associated with a reduced risk of testing positive for SARS-CoV-2 in infants. Published by Elsevier Ltd. This case-positive, control-test-negative design also referred to as the test-negative design (TND) has often been used in studies of vaccine effectiveness. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.. Open 5, e2232760 (2022). 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).