Qin Qiuyuan Crystal, Wilkins Kenneth J, Jones Sara E, Bradwell Katie R, Chan Lauren E, Sun Jing, Anzalone Jerrod, Zheng Qulu, Liebman Michael, Mariona Federico, Faherty Emily A Groene, Challa Anup P, Hill Elaine, Patel Rena C
Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.
Biostatistics Program / Office of Clinical Research Support, Office of the Director, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
BMJ Public Health. 2024 Jul;2(1). doi: 10.1136/bmjph-2023-000770. Epub 2024 Jun 3.
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 vs. unvaccinated and (2) post-COVID-19 vaccination breakthrough infections and severe infections among vaccinated females who were pregnant vs. non-pregnant.
Retrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative (N3C), December 10, 2020, to June 07, 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 hazard ratios (aHRs) for COVID-19 incident or breakthrough infections and severe infections (i.e., COVID-19 infections with related hospitalizations).
In Cohort 1, 301,107 pregnant people were included. Compared to unvaccinated pregnant people, the aHRs for pregnant people with initial vaccinations pregnancy of incident COVID-19 were 0.77 (95% CI: 0.62, 0.96) and 0.88 (95%CI: 0.73, 1.07) and aHRs of severe COVID-19 infections were 0.65 (95% CI: 0.47, 0.90) and 0.79 (95% CI: 0.51, 1.21) during the Delta and Omicron periods, respectively. Compared to 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, 0.71) during the Omicron period. In Cohort 2, 934,337 vaccinated people were included. Compared to vaccinated non-pregnant females, the aHRs of severe COVID-19 infections for people with initial vaccinations pregnancy was 2.71 (95% CI: 1.31, 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 to unvaccinated pregnant people across the pandemic stages. However, vaccinated pregnant people still had a higher risk of severe infections compared to non-pregnant females.
通过（1）接种疫苗与未接种疫苗的孕妇中新冠病毒感染及重症感染情况，以及（2）接种新冠疫苗的孕妇与非孕妇中疫苗突破性感染及重症感染情况，评估在德尔塔毒株出现前、德尔塔毒株流行期和奥密克戎毒株流行期孕妇接种新冠疫苗（初始接种和加强接种）的效果。
回顾性队列研究，使用来自国家新冠队列协作组（N3C）的全国抽样电子健康记录数据，时间范围为2020年12月10日至2022年6月7日。
队列1包括15至55岁的孕妇，队列2包括15至55岁的育龄接种疫苗女性。
（1）新冠疫苗接种；（2）怀孕。
新冠病毒感染或突破性感染及重症感染（即因新冠病毒感染而住院）的调整风险比（aHRs）。
在队列1中，纳入了301,107名孕妇。与未接种疫苗的孕妇相比，在德尔塔毒株流行期和奥密克戎毒株流行期，初始接种疫苗的孕妇发生新冠病毒感染的aHR分别为0.77（95%置信区间：0.62, 0.96）和0.88（95%置信区间：0.73, 1.07），发生新冠重症感染的aHR分别为0.65（95%置信区间：0.47,）和0.79（95%置信区间：0.51, 1.21）。与初始全程接种疫苗的孕妇相比，在奥密克戎毒株流行期，接种加强针的孕妇发生新冠病毒感染的aHR为0.64（95%置信区间：0.58, 0.71）。在队列2中，纳入了934,337名接种疫苗者。与接种疫苗的非孕妇相比，在奥密克戎毒株流行期，初始接种疫苗且怀孕的人群发生新冠重症感染的aHR为2.71（95%置信区间：1.31, 5.60）。
在整个疫情阶段，孕期接种初始疫苗和加强针的孕妇与未接种疫苗的孕妇相比，发生新冠病毒感染及重症感染的风险更低。然而，与未怀孕的女性相比，接种疫苗的孕妇发生重症感染的风险仍然更高。
