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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

Matthew L Bosworth Orcid Logo, Ryan Schofield, Daniel Ayoubkhani, Loes Charlton, Vahé Nafilyan, Kamlesh Khunti, Francesco Zaccardi, Clare Gillies, Ashley Akbari Orcid Logo, Marian Knight Orcid Logo, Rachael Wood Orcid Logo, Pia Hardelid Orcid Logo, Luisa Zuccolo, Camille Harrison

BMJ Medicine, Volume: 2, Issue: 1, Start page: e000403

Swansea University Author: Ashley Akbari Orcid Logo

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DOI (Published version): 10.1136/bmjmed-2022-000403

Abstract

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 s...

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Published in: BMJ Medicine
ISSN: 2754-0413
Published: BMJ 2023
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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 &gt;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.</abstract><type>Journal Article</type><journal>BMJ Medicine</journal><volume>2</volume><journalNumber>1</journalNumber><paginationStart>e000403</paginationStart><paginationEnd/><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2754-0413</issnElectronic><keywords>Vaccine effectiveness, Covid-19, SARS-CoV-2, pandemic, pregnancy, hospital admission</keywords><publishedDay>30</publishedDay><publishedMonth>6</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-06-30</publishedDate><doi>10.1136/bmjmed-2022-000403</doi><url>http://dx.doi.org/10.1136/bmjmed-2022-000403</url><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This study received no dedicated funding. AA is part of, and supported by, the Con-COV team funded by the Medical Research Council (grant No MR/V028367/1), and also supported by Health Data Research UK (grant No HDR-9006) and Administrative Data Research (ADR) Wales (grant No ES/W012227/1). DA is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM). LZ received support from the Data and Connectivity National Core Study funding scheme, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant No MC_PC_20058), and also supported by the Alan Turing Institute from Towards Turing 2.0 EPSRC Grant Funding. MK is an NIHR senior investigator. 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spelling v2 63854 2023-07-11 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 aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 2023-07-11 HDAT 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. Journal Article BMJ Medicine 2 1 e000403 BMJ 2754-0413 Vaccine effectiveness, Covid-19, SARS-CoV-2, pandemic, pregnancy, hospital admission 30 6 2023 2023-06-30 10.1136/bmjmed-2022-000403 http://dx.doi.org/10.1136/bmjmed-2022-000403 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University This study received no dedicated funding. AA is part of, and supported by, the Con-COV team funded by the Medical Research Council (grant No MR/V028367/1), and also supported by Health Data Research UK (grant No HDR-9006) and Administrative Data Research (ADR) Wales (grant No ES/W012227/1). DA is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM). LZ received support from the Data and Connectivity National Core Study funding scheme, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant No MC_PC_20058), and also supported by the Alan Turing Institute from Towards Turing 2.0 EPSRC Grant Funding. MK is an NIHR senior investigator. PH is based at the UCL Great Ormond Street Institute of Child Health; the institute is supported by the NIHR Great Ormond Street Hospital Biomedical Research Centre (grant No IS-BRC-1215–20012). 2023-11-14T16:29:31.1309476 2023-07-11T10:56:46.9149691 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Matthew L Bosworth 0000-0003-1391-7515 1 Ryan Schofield 2 Daniel Ayoubkhani 3 Loes Charlton 4 Vahé Nafilyan 5 Kamlesh Khunti 6 Francesco Zaccardi 7 Clare Gillies 8 Ashley Akbari 0000-0003-0814-0801 9 Marian Knight 0000-0002-1984-4575 10 Rachael Wood 0000-0003-4453-623x 11 Pia Hardelid 0000-0002-0154-1306 12 Luisa Zuccolo 13 Camille Harrison 14 63854__28287__5aa9124ac9bb4e12a28dd5b62c4849d7.pdf 63854.VOR.pdf 2023-08-11T10:21:05.7112557 Output 777727 application/pdf Version of Record true © The Author(s) 2023. Distributed under the terms of a Creative Commons Attribution 4.0 License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
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
spellingShingle 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
Ashley Akbari
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_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_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
author_id_str_mv aa1b025ec0243f708bb5eb0a93d6fb52
author_id_fullname_str_mv aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
author Ashley Akbari
author2 Matthew L Bosworth
Ryan Schofield
Daniel Ayoubkhani
Loes Charlton
Vahé Nafilyan
Kamlesh Khunti
Francesco Zaccardi
Clare Gillies
Ashley Akbari
Marian Knight
Rachael Wood
Pia Hardelid
Luisa Zuccolo
Camille Harrison
format Journal article
container_title BMJ Medicine
container_volume 2
container_issue 1
container_start_page e000403
publishDate 2023
institution Swansea University
issn 2754-0413
doi_str_mv 10.1136/bmjmed-2022-000403
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1136/bmjmed-2022-000403
document_store_str 1
active_str 0
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.
published_date 2023-06-30T16:29:34Z
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