Vaccine effectiveness for prevention of covid-19 related hospital admission during pregnancy in England during the alpha and delta variant dominant periods of the SARS-CoV-2 pandemic: population based cohort study

Objective To estimate vaccine effectiveness for preventing covid-19 related hospital admission in individuals first infected with the SARS-CoV-2 virus during pregnancy compared with those of reproductive age who were not pregnant when first infected with the virus.Design Population based cohort stud...

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Main Authors: Marian Knight, Rachael Wood, Ashley Akbari, Pia Hardelid, Francesco Zaccardi, Kamlesh Khunti, Vahe Nafilyan, Clare Gillies, Daniel Ayoubkhani, Luisa Zuccolo, Matthew L Bosworth, Ryan Schofield, Camille Harrison, Loes Charlton
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Language:English
Published: BMJ Publishing Group 2023-10-01
Series:BMJ Medicine
Online Access:https://bmjmedicine.bmj.com/content/2/1/e000403.full
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author Marian Knight
Rachael Wood
Ashley Akbari
Pia Hardelid
Francesco Zaccardi
Kamlesh Khunti
Vahe Nafilyan
Clare Gillies
Daniel Ayoubkhani
Luisa Zuccolo
Matthew L Bosworth
Ryan Schofield
Camille Harrison
Loes Charlton
author_facet Marian Knight
Rachael Wood
Ashley Akbari
Pia Hardelid
Francesco Zaccardi
Kamlesh Khunti
Vahe Nafilyan
Clare Gillies
Daniel Ayoubkhani
Luisa Zuccolo
Matthew L Bosworth
Ryan Schofield
Camille Harrison
Loes Charlton
author_sort Marian Knight
collection DOAJ
description Objective To estimate vaccine effectiveness for preventing covid-19 related hospital admission in individuals first infected with the SARS-CoV-2 virus during pregnancy compared with those of reproductive age who were not pregnant when first infected with the virus.Design Population based cohort study.Setting Office for National Statistics Public Health Data Asset linked dataset, providing national linked census and administrative data in England, 8 December 2020 to 31 August 2021.Participants 815 477 females aged 18-45 years (mean age 30.4 years) who had documented evidence of a first SARS-CoV-2 infection in the NHS Test and Trace or Hospital Episode Statistics data.Main outcome measures Hospital admission where covid-19 was recorded as the primary diagnosis. Cox proportional hazards models, adjusted for calendar time of infection, sociodemographic factors, and pre-existing health conditions related to uptake of the covid-19 vaccine and risk of severe covid-19 outcomes, were used to estimate vaccine effectiveness as the complement of the hazard ratio for hospital admission for covid-19.Results Compared with pregnant individuals who were not vaccinated, the adjusted rate of hospital admission for covid-19 was 77% (95% confidence interval 70% to 82%) lower for pregnant individuals who had received one dose and 83% (76% to 89%) lower for those who had received two doses of vaccine. These estimates were similar to those found in the non-pregnant group: 79% (77% to 81%) for one dose and 83% (82% to 85%) for two doses of vaccine. Among those who were vaccinated >90 days before infection, having two doses of vaccine was associated with a greater reduction in risk than one dose.Conclusions Covid-19 vaccination was associated with reduced rates of hospital admission in pregnant individuals infected with the SARS-CoV-2 virus, and the reduction in risk was similar to that in non-pregnant individuals. Waning of vaccine effectiveness occurred more quickly after one than after two doses of vaccine.
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spelling doaj-art-7020741baa054b6db0ec78f0f78e8e242025-08-20T02:30:36ZengBMJ Publishing GroupBMJ Medicine2754-04132023-10-012110.1136/bmjmed-2022-000403Vaccine effectiveness for prevention of covid-19 related hospital admission during pregnancy in England during the alpha and delta variant dominant periods of the SARS-CoV-2 pandemic: population based cohort studyMarian Knight0Rachael Wood1Ashley Akbari2Pia Hardelid3Francesco Zaccardi4Kamlesh Khunti5Vahe Nafilyan6Clare Gillies7Daniel Ayoubkhani8Luisa Zuccolo9Matthew L Bosworth10Ryan Schofield11Camille Harrison12Loes Charlton13National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UKPublic Health Scotland, Edinburgh, UKSwansea University Medical School, Swansea, UKNIHR Great Ormond Street Hospital Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, UKsenior clinical research fellowDiabetes Research Centre, University of Leicester, Leicester, UKLondon School of Hygiene and Tropical Medicine, London, UKReal World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UKMethodology, Office for National Statistics, Newport, UKHealth Data Science Centre, Fondazione Human Technopole, Milan, ItalyOffice for National Statistics, Newport, UKOffice for National Statistics, Newport, UKOffice for National Statistics, Newport, UKOffice for National Statistics, Newport, UKObjective To estimate vaccine effectiveness for preventing covid-19 related hospital admission in individuals first infected with the SARS-CoV-2 virus during pregnancy compared with those of reproductive age who were not pregnant when first infected with the virus.Design Population based cohort study.Setting Office for National Statistics Public Health Data Asset linked dataset, providing national linked census and administrative data in England, 8 December 2020 to 31 August 2021.Participants 815 477 females aged 18-45 years (mean age 30.4 years) who had documented evidence of a first SARS-CoV-2 infection in the NHS Test and Trace or Hospital Episode Statistics data.Main outcome measures Hospital admission where covid-19 was recorded as the primary diagnosis. Cox proportional hazards models, adjusted for calendar time of infection, sociodemographic factors, and pre-existing health conditions related to uptake of the covid-19 vaccine and risk of severe covid-19 outcomes, were used to estimate vaccine effectiveness as the complement of the hazard ratio for hospital admission for covid-19.Results Compared with pregnant individuals who were not vaccinated, the adjusted rate of hospital admission for covid-19 was 77% (95% confidence interval 70% to 82%) lower for pregnant individuals who had received one dose and 83% (76% to 89%) lower for those who had received two doses of vaccine. These estimates were similar to those found in the non-pregnant group: 79% (77% to 81%) for one dose and 83% (82% to 85%) for two doses of vaccine. Among those who were vaccinated >90 days before infection, having two doses of vaccine was associated with a greater reduction in risk than one dose.Conclusions Covid-19 vaccination was associated with reduced rates of hospital admission in pregnant individuals infected with the SARS-CoV-2 virus, and the reduction in risk was similar to that in non-pregnant individuals. Waning of vaccine effectiveness occurred more quickly after one than after two doses of vaccine.https://bmjmedicine.bmj.com/content/2/1/e000403.full
spellingShingle Marian Knight
Rachael Wood
Ashley Akbari
Pia Hardelid
Francesco Zaccardi
Kamlesh Khunti
Vahe Nafilyan
Clare Gillies
Daniel Ayoubkhani
Luisa Zuccolo
Matthew L Bosworth
Ryan Schofield
Camille Harrison
Loes Charlton
Vaccine effectiveness for prevention of covid-19 related hospital admission during pregnancy in England during the alpha and delta variant dominant periods of the SARS-CoV-2 pandemic: population based cohort study
BMJ Medicine
title Vaccine effectiveness for prevention of covid-19 related hospital admission during pregnancy in England during the alpha and delta variant dominant periods of the SARS-CoV-2 pandemic: population based cohort study
title_full Vaccine effectiveness for prevention of covid-19 related hospital admission during pregnancy in England during the alpha and delta variant dominant periods of the SARS-CoV-2 pandemic: population based cohort study
title_fullStr Vaccine effectiveness for prevention of covid-19 related hospital admission during pregnancy in England during the alpha and delta variant dominant periods of the SARS-CoV-2 pandemic: population based cohort study
title_full_unstemmed Vaccine effectiveness for prevention of covid-19 related hospital admission during pregnancy in England during the alpha and delta variant dominant periods of the SARS-CoV-2 pandemic: population based cohort study
title_short Vaccine effectiveness for prevention of covid-19 related hospital admission during pregnancy in England during the alpha and delta variant dominant periods of the SARS-CoV-2 pandemic: population based cohort study
title_sort vaccine effectiveness for prevention of covid 19 related hospital admission during pregnancy in england during the alpha and delta variant dominant periods of the sars cov 2 pandemic population based cohort study
url https://bmjmedicine.bmj.com/content/2/1/e000403.full
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