Bosworth, Matthew L; Schofield, Ryan; Ayoubkhani, Daniel; Charlton, Loes; Nafilyan, Vahé; Khunti, Kamlesh; Zaccardi, Francesco; ... Harrison, Camille; + view all Bosworth, Matthew L; Schofield, Ryan; Ayoubkhani, Daniel; Charlton, Loes; Nafilyan, Vahé; Khunti, Kamlesh; Zaccardi, Francesco; Gillies, Clare; Akbari, Ashley; Knight, Marian; Wood, Rachael; Hardelid, Pia; Zuccolo, Luisa; Harrison, Camille; - view fewer (2023) 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 , 2 (1) , Article e000403. 10.1136/bmjmed-2022-000403.

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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 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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