Evaluating COVID-19 vaccine effectiveness during pre-Delta, Delta and Omicron dominant periods among pregnant people in the U.S.: Retrospective cohort analysis from a nationally sampled cohort in National COVID Collaborative Cohort (N3C)

Objectives To evaluate the effectiveness of COVID-19 vaccinations (initial and booster) during pre-Delta, Delta and Omicron dominant periods among pregnant people via (1) COVID-19 incident and severe infections among pregnant people who were vaccinated versus unvaccinated and (2) post-COVID-19 vacci...

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Main Authors: Nasia Safdar (Author), Harold Lehmann (Author), Jing Sun (Author), Brijesh Patel (Author), Hongfang Liu (Author), Peter Robinson (Author), Elaine Hill (Author), Justin Guinney (Author), Joel Gagnier (Author), Cavin Ward-Caviness (Author), Noha Sharafeldin (Author), Justin Starren (Author), Amit Saha (Author), Lesley Cottrell (Author), Melissa A Haendel (Author), Vignesh Subbian (Author), Kristin Kostka (Author), Farrukh M Koraishy (Author), Andrew E Williams (Author), Robert Hurley (Author), Steve Johnson (Author), Usman Sheikh (Author), Rishi Kamaleswaran (Author), Christopher Dillon (Author), Rena C Patel (Author), Michele Morris (Author), Randeep Jawa (Author), Hemalkumar Mehta (Author), Benjamin Bates (Author), Tellen D Bennett (Author), Nabeel Qureshi (Author), Qiuyuan Qin (Author), Kenneth Wilkins (Author), Sara E Jones (Author), Katie Rebecca Bradwell (Author), Lauren Chan (Author), Jerrod Anzalone (Author), Qulu Zheng (Author), Michael Liebman (Author), Federico Mariona (Author), Emily A Groene Faherty (Author), Anup P Challa (Author), Adam B Wilcox (Author), Adam M Lee (Author), Alexis Graves (Author), Alfred Anzalone (Author), Amin Manna (Author), Amy Olex (Author), Andrea Zhou (Author), Andrew Southerland (Author), Andrew T Girvin (Author), Anita Walden (Author), Anjali A Sharathkumar (Author), Benjamin Amor (Author), Brian Hendricks (Author), Caleb Alexander (Author), Caroline Signore (Author), Carolyn Bramante (Author), Charisse Madlock-Brown (Author), Christine Suver (Author), Christopher Chute (Author), Chunlei Wu (Author), Clare Schmitt (Author), Cliff Takemoto (Author), Dan Housman (Author), Davera Gabriel (Author), David A Eichmann (Author), Diego Mazzotti (Author), Eilis Boudreau Don Brown (Author), Elizabeth Zampino (Author), Emily Carlson Marti (Author), Emily R Pfaff (Author), Evan French (Author), Fred Prior (Author), George Sokos (Author), Greg Martin (Author), Heidi Spratt (Author), Hythem Sidky (Author), JW Awori Hayanga (Author), Jami Pincavitch (Author), Jaylyn Clark (Author), Jeremy Richard Harper (Author), Jessica Islam (Author), Jin Ge (Author), Joel H Saltz (Author), Joel Saltz (Author), Johanna Loomba (Author), John Buse (Author), Jomol Mathew (Author), Joni L Rutter (Author), Julie A McMurry (Author), Karen Crowley (Author), Kellie M Walters (Author), Ken Wilkins (Author), Kenneth R Gersing (Author), Kenrick Dwain Cato (Author), Kimberly Murray (Author), Lavance Northington (Author), Lee Allan Pyles (Author), Leonie Misquitta (Author), Lili Portilla (Author), Mariam Deacy (Author), Mark M Bissell (Author), Marshall Clark (Author), Mary Emmett (Author), Mary Morrison Saltz (Author), Matvey B Palchuk (Author), Meredith Adams (Author), Meredith Temple-O'Connor (Author), Michael G Kurilla (Author), Nicole Garbarini (Author), Ofer Sadan (Author), Patricia A Francis (Author), Penny Wung Burgoon (Author), Philip RO Payne (Author), Rafael Fuentes (Author), Rebecca Erwin-Cohen (Author), Richard A Moffitt (Author), Richard L Zhu (Author), Robert T Miller (Author), Saiju Pyarajan (Author), Sam G Michael (Author), Samuel Bozzette (Author), Sandeep Mallipattu (Author), Satyanarayana Vedula (Author), Scott Chapman (Author), T Shawn (Author), Soko Setoguchi O'Neil (Author), Stephanie S Hong (Author), Tiffany Callahan (Author), Umit Topaloglu (Author), Valery Gordon (Author), Warren A Kibbe (Author), Wenndy Hernandez (Author), Will Beasley (Author), Will Cooper (Author), William Hillegass (Author), Xiaohan Tanner Zhang (Author)
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Published: BMJ Publishing Group, 2024-03-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Nasia Safdar  |e author 
700 1 0 |a Harold Lehmann  |e author 
700 1 0 |a Jing Sun  |e author 
700 1 0 |a Brijesh Patel  |e author 
700 1 0 |a Hongfang Liu  |e author 
700 1 0 |a Peter Robinson  |e author 
700 1 0 |a Elaine Hill  |e author 
700 1 0 |a Justin Guinney  |e author 
700 1 0 |a Joel Gagnier  |e author 
700 1 0 |a Cavin Ward-Caviness  |e author 
700 1 0 |a Noha Sharafeldin  |e author 
700 1 0 |a Justin Starren  |e author 
700 1 0 |a Amit Saha  |e author 
700 1 0 |a Lesley Cottrell  |e author 
700 1 0 |a Melissa A Haendel  |e author 
700 1 0 |a Vignesh Subbian  |e author 
700 1 0 |a Kristin Kostka  |e author 
700 1 0 |a Farrukh M Koraishy  |e author 
700 1 0 |a Andrew E Williams  |e author 
700 1 0 |a Robert Hurley  |e author 
700 1 0 |a Steve Johnson  |e author 
700 1 0 |a Usman Sheikh  |e author 
700 1 0 |a Rishi Kamaleswaran  |e author 
700 1 0 |a Christopher Dillon  |e author 
700 1 0 |a Rena C Patel  |e author 
700 1 0 |a Michele Morris  |e author 
700 1 0 |a Randeep Jawa  |e author 
700 1 0 |a Hemalkumar Mehta  |e author 
700 1 0 |a Benjamin Bates  |e author 
700 1 0 |a Tellen D Bennett  |e author 
700 1 0 |a Nabeel Qureshi  |e author 
700 1 0 |a Qiuyuan Qin  |e author 
700 1 0 |a Kenneth Wilkins  |e author 
700 1 0 |a Sara E Jones  |e author 
700 1 0 |a Katie Rebecca Bradwell  |e author 
700 1 0 |a Lauren Chan  |e author 
700 1 0 |a Jerrod Anzalone  |e author 
700 1 0 |a Qulu Zheng  |e author 
700 1 0 |a Michael Liebman  |e author 
700 1 0 |a Federico Mariona  |e author 
700 1 0 |a Emily A Groene Faherty  |e author 
700 1 0 |a Anup P Challa  |e author 
700 1 0 |a Adam B Wilcox  |e author 
700 1 0 |a Adam M Lee  |e author 
700 1 0 |a Alexis Graves  |e author 
700 1 0 |a Alfred Anzalone  |e author 
700 1 0 |a Amin Manna  |e author 
700 1 0 |a Amy Olex  |e author 
700 1 0 |a Andrea Zhou  |e author 
700 1 0 |a Andrew Southerland  |e author 
700 1 0 |a Andrew T Girvin  |e author 
700 1 0 |a Anita Walden  |e author 
700 1 0 |a Anjali A Sharathkumar  |e author 
700 1 0 |a Benjamin Amor  |e author 
700 1 0 |a Brian Hendricks  |e author 
700 1 0 |a Caleb Alexander  |e author 
700 1 0 |a Caroline Signore  |e author 
700 1 0 |a Carolyn Bramante  |e author 
700 1 0 |a Charisse Madlock-Brown  |e author 
700 1 0 |a Christine Suver  |e author 
700 1 0 |a Christopher Chute  |e author 
700 1 0 |a Chunlei Wu  |e author 
700 1 0 |a Clare Schmitt  |e author 
700 1 0 |a Cliff Takemoto  |e author 
700 1 0 |a Dan Housman  |e author 
700 1 0 |a Davera Gabriel  |e author 
700 1 0 |a David A Eichmann  |e author 
700 1 0 |a Diego Mazzotti  |e author 
700 1 0 |a Eilis Boudreau Don Brown  |e author 
700 1 0 |a Elizabeth Zampino  |e author 
700 1 0 |a Emily Carlson Marti  |e author 
700 1 0 |a Emily R Pfaff  |e author 
700 1 0 |a Evan French  |e author 
700 1 0 |a Fred Prior  |e author 
700 1 0 |a George Sokos  |e author 
700 1 0 |a Greg Martin  |e author 
700 1 0 |a Heidi Spratt  |e author 
700 1 0 |a Hythem Sidky  |e author 
700 1 0 |a JW Awori Hayanga  |e author 
700 1 0 |a Jami Pincavitch  |e author 
700 1 0 |a Jaylyn Clark  |e author 
700 1 0 |a Jeremy Richard Harper  |e author 
700 1 0 |a Jessica Islam  |e author 
700 1 0 |a Jin Ge  |e author 
700 1 0 |a Joel H Saltz  |e author 
700 1 0 |a Joel Saltz  |e author 
700 1 0 |a Johanna Loomba  |e author 
700 1 0 |a John Buse  |e author 
700 1 0 |a Jomol Mathew  |e author 
700 1 0 |a Joni L Rutter  |e author 
700 1 0 |a Julie A McMurry  |e author 
700 1 0 |a Karen Crowley  |e author 
700 1 0 |a Kellie M Walters  |e author 
700 1 0 |a Ken Wilkins  |e author 
700 1 0 |a Kenneth R Gersing  |e author 
700 1 0 |a Kenrick Dwain Cato  |e author 
700 1 0 |a Kimberly Murray  |e author 
700 1 0 |a Lavance Northington  |e author 
700 1 0 |a Lee Allan Pyles  |e author 
700 1 0 |a Leonie Misquitta  |e author 
700 1 0 |a Lili Portilla  |e author 
700 1 0 |a Mariam Deacy  |e author 
700 1 0 |a Mark M Bissell  |e author 
700 1 0 |a Marshall Clark  |e author 
700 1 0 |a Mary Emmett  |e author 
700 1 0 |a Mary Morrison Saltz  |e author 
700 1 0 |a Matvey B Palchuk  |e author 
700 1 0 |a Meredith Adams  |e author 
700 1 0 |a Meredith Temple-O'Connor  |e author 
700 1 0 |a Michael G Kurilla  |e author 
700 1 0 |a Nicole Garbarini  |e author 
700 1 0 |a Ofer Sadan  |e author 
700 1 0 |a Patricia A Francis  |e author 
700 1 0 |a Penny Wung Burgoon  |e author 
700 1 0 |a Philip RO Payne  |e author 
700 1 0 |a Rafael Fuentes  |e author 
700 1 0 |a Rebecca Erwin-Cohen  |e author 
700 1 0 |a Richard A Moffitt  |e author 
700 1 0 |a Richard L Zhu  |e author 
700 1 0 |a Robert T Miller  |e author 
700 1 0 |a Saiju Pyarajan  |e author 
700 1 0 |a Sam G Michael  |e author 
700 1 0 |a Samuel Bozzette  |e author 
700 1 0 |a Sandeep Mallipattu  |e author 
700 1 0 |a Satyanarayana Vedula  |e author 
700 1 0 |a Scott Chapman  |e author 
700 1 0 |a T Shawn  |e author 
700 1 0 |a Soko Setoguchi O'Neil  |e author 
700 1 0 |a Stephanie S Hong  |e author 
700 1 0 |a Tiffany Callahan  |e author 
700 1 0 |a Umit Topaloglu  |e author 
700 1 0 |a Valery Gordon  |e author 
700 1 0 |a Warren A Kibbe  |e author 
700 1 0 |a Wenndy Hernandez  |e author 
700 1 0 |a Will Beasley  |e author 
700 1 0 |a Will Cooper  |e author 
700 1 0 |a William Hillegass  |e author 
700 1 0 |a Xiaohan Tanner Zhang  |e author 
245 0 0 |a Evaluating COVID-19 vaccine effectiveness during pre-Delta, Delta and Omicron dominant periods among pregnant people in the U.S.: Retrospective cohort analysis from a nationally sampled cohort in National COVID Collaborative Cohort (N3C) 
260 |b BMJ Publishing Group,   |c 2024-03-01T00:00:00Z. 
500 |a 10.1136/bmjph-2023-000770 
500 |a 2753-4294 
520 |a Objectives To evaluate the effectiveness of COVID-19 vaccinations (initial and booster) during pre-Delta, Delta and Omicron dominant periods among pregnant people via (1) COVID-19 incident and severe infections among pregnant people who were vaccinated versus unvaccinated and (2) post-COVID-19 vaccination breakthrough infections and severe infections among vaccinated females who were pregnant versus non-pregnant.Design Retrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative, 10 December 2020 -7 June 2022.Participants Cohort 1 included pregnant people (15-55 years) and cohort 2 included vaccinated females of reproductive age (15-55 years).Exposures (1) COVID-19 vaccination and (2) pregnancy.Main outcome measures Adjusted HRs (aHRs) for COVID-19 incident or breakthrough infections and severe infections (ie, COVID-19 infections with related hospitalisations).Results In cohort 1, 301 107 pregnant people were included. Compared with unvaccinated pregnant people, the aHRs for pregnant people with initial vaccinations during pregnancy of incident COVID-19 were 0.77 (95% CI 0.62 to 0.96) and 0.88 (95% CI 0.73 to 1.07) and aHRs of severe COVID-19 infections were 0.65 (95% CI 0.47 to 0.90) and 0.79 (95% CI 0.51 to 1.21) during the Delta and Omicron periods, respectively. Compared with pregnant people with full initial vaccinations, the aHR of incident COVID-19 for pregnant people with booster vaccinations was 0.64 (95% CI 0.58 to 0.71) during the Omicron period. In cohort 2, 934 337 vaccinated people were included. Compared with vaccinated non-pregnant females, the aHRs of severe COVID-19 infections for people with initial vaccinations during pregnancy was 2.71 (95% CI 1.31 to 5.60) during the Omicron periods.Conclusions Pregnant people with initial and booster vaccinations during pregnancy had a lower risk of incident and severe COVID-19 infections compared with unvaccinated pregnant people across the pandemic stages. However, vaccinated pregnant people still had a higher risk of severe infections compared with non-pregnant females. 
546 |a EN 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n BMJ Public Health, Vol 2, Iss 1 (2024) 
787 0 |n https://bmjpublichealth.bmj.com/content/2/1/e000770.full 
787 0 |n https://doaj.org/toc/2753-4294 
856 4 1 |u https://doaj.org/article/8dbc4ccf41e8439fbb2c1e6c27fb4854  |z Connect to this object online.