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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
BMJ Medicine, Volume: 2, Issue: 1, Start page: e000403
Swansea University Author: Ashley Akbari
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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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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.
Vaccine effectiveness, Covid-19, SARS-CoV-2, pandemic, pregnancy, hospital admission
Faculty of Medicine, Health and Life Sciences
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).