Qiuyuan Qin, Kenneth Wilkins, Sara E Jones, K. Bradwell, Lauren E. Chan, Jing Sun, Jerrod Anzalone, Qulu Zheng, Michael Liebman, Federico Mariona, Emily A. Groene Faherty, A. Challa, Elaine Hill, Rena C Patel
{"title":"评估COVID-19疫苗在美国孕妇中的前德尔塔期、德尔塔期和奥密克隆期的有效性：国家 COVID 协作队列 (N3C) 中全国抽样队列的回顾性队列分析","authors":"Qiuyuan Qin, Kenneth Wilkins, Sara E Jones, K. Bradwell, Lauren E. Chan, Jing Sun, Jerrod Anzalone, Qulu Zheng, Michael Liebman, Federico Mariona, Emily A. Groene Faherty, A. Challa, Elaine Hill, Rena C Patel","doi":"10.1136/bmjph-2023-000770","DOIUrl":null,"url":null,"abstract":"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.Retrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative, 10 December 2020 –7 June 2022.Cohort 1 included pregnant people (15–55 years) and cohort 2 included vaccinated females of reproductive age (15–55 years).(1) COVID-19 vaccination and (2) pregnancy.Adjusted HRs (aHRs) for COVID-19 incident or breakthrough infections and severe infections (ie, COVID-19 infections with related hospitalisations).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.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. 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Challa, Elaine Hill, Rena C Patel\",\"doi\":\"10.1136/bmjph-2023-000770\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"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.Retrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative, 10 December 2020 –7 June 2022.Cohort 1 included pregnant people (15–55 years) and cohort 2 included vaccinated females of reproductive age (15–55 years).(1) COVID-19 vaccination and (2) pregnancy.Adjusted HRs (aHRs) for COVID-19 incident or breakthrough infections and severe infections (ie, COVID-19 infections with related hospitalisations).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. 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引用次数: 0
摘要
通过(1)接种COVID-19疫苗的孕妇与未接种者之间的COVID-19事件和严重感染情况，以及(2)接种COVID-19疫苗后接种孕妇与未接种孕妇之间的突破性感染和严重感染情况，评估COVID-19疫苗（初次接种和加强接种）在孕妇的Delta、Delta和Omicron优势期接种的有效性。队列 1 包括孕妇（15-55 岁），队列 2 包括已接种疫苗的育龄女性（15-55 岁）。(在队列 1 中，纳入了 301 107 名孕妇。与未接种疫苗的孕妇相比，在德尔塔期和欧米克隆期，孕期初次接种疫苗的孕妇发生COVID-19事件的aHRs分别为0.77（95% CI 0.62至0.96）和0.88（95% CI 0.73至1.07），发生严重COVID-19感染的aHRs分别为0.65（95% CI 0.47至0.90）和0.79（95% CI 0.51至1.21）。与初次接种全部疫苗的孕妇相比，接种加强疫苗的孕妇在 Omicron 期间发生 COVID-19 的 aHR 为 0.64（95% CI 0.58 至 0.71）。在队列 2 中，共纳入了 934 337 名接种者。与接种过疫苗的非怀孕女性相比，怀孕期间初次接种过疫苗的人在Omicron期间感染严重COVID-19的aHRs为2.71（95% CI为1.31至5.60）。在大流行的各个阶段，怀孕期间初次接种过疫苗和加强接种过疫苗的孕妇与未接种过疫苗的孕妇相比，发生COVID-19感染和感染严重COVID-19的风险较低。然而，与未怀孕的女性相比，接种过疫苗的孕妇发生严重感染的风险仍然较高。
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)
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.Retrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative, 10 December 2020 –7 June 2022.Cohort 1 included pregnant people (15–55 years) and cohort 2 included vaccinated females of reproductive age (15–55 years).(1) COVID-19 vaccination and (2) pregnancy.Adjusted HRs (aHRs) for COVID-19 incident or breakthrough infections and severe infections (ie, COVID-19 infections with related hospitalisations).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.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.
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