BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting

New England Journal of Medicine, Journal Year: 2021, Volume and Issue: 384(15), P. 1412 - 1423

Published: Feb. 24, 2021

BackgroundAs mass vaccination campaigns against coronavirus disease 2019 (Covid-19) commence worldwide, vaccine effectiveness needs to be assessed for a range of outcomes across diverse populations in noncontrolled setting. In this study, data from Israel's largest health care organization were used evaluate the BNT162b2 mRNA vaccine.MethodsAll persons who newly vaccinated during period December 20, 2020, February 1, 2021, matched unvaccinated controls 1:1 ratio according demographic and clinical characteristics. Study included documented infection with severe acute respiratory syndrome 2 (SARS-CoV-2), symptomatic Covid-19, Covid-19–related hospitalization, illness, death. We estimated each outcome as one minus risk ratio, using Kaplan–Meier estimator.ResultsEach study group 596,618 persons. Estimated at days 14 through 20 after first dose 7 or more second was follows: infection, 46% (95% confidence interval [CI], 40 51) 92% CI, 88 95); 57% 50 63) 94% 87 98); 74% 56 86) 87% 55 100); disease, 62% 39 80) 75 100), respectively. preventing death Covid-19 72% 19 100) dose. specific subpopulations consistent age groups, potentially slightly lower multiple coexisting conditions.ConclusionsThis nationwide setting suggests that is effective wide outcomes, finding randomized trial.

Language: Английский

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Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis

BMJ, Journal Year: 2020, Volume and Issue: unknown, P. m3320 - m3320

Published: Sept. 1, 2020

Abstract Objective To determine the clinical manifestations, risk factors, and maternal perinatal outcomes in pregnant recently women with suspected or confirmed coronavirus disease 2019 (covid-19). Design Living systematic review meta-analysis. Data sources Medline, Embase, Cochrane database, WHO COVID-19 China National Knowledge Infrastructure (CNKI), Wanfang databases from 1 December to 27 April 2021, along preprint servers, social media, reference lists. Study selection Cohort studies reporting rates, manifestations (symptoms, laboratory radiological findings), covid-19. extraction At least two researchers independently extracted data assessed study quality. Random effects meta-analysis was performed, estimates pooled as odds ratios difference proportions 95% confidence intervals. All analyses are updated regularly. Results 435 were included. Overall, 9% (95% interval 7% 10%; 149 studies, 926 232 women) of attending admitted hospital for any reason diagnosed having The most common covid-19 pregnancy fever cough (both 36%). Compared non-pregnant reproductive age, less likely report symptoms fever, dyspnoea, cough, myalgia. admission an intensive care unit (odds ratio 2.61, 1.84 3.71; I 2 =85.6%), invasive ventilation (2.41, 2.13 2.71; =0%) higher than age. 970 (0.2%, 123 179 981 died cause. In covid-19, non-white ethnicity, increased high body mass index, pre-existing comorbidity including chronic hypertension diabetes, specific complications such gestational diabetes pre-eclampsia, associated serious (severe unit, ventilation, death). without those had death 6.09, 1.82 20.38; =76.6%), (5.41, 3.59 8.14; =57.0%), caesarean section (1.17, 1.01 1.36; =80.3%), preterm birth (1.57, 1.36 1.81; =49.3%). stillbirth (1.81, 1.38 2.37, =0%), neonatal (2.18, 1.46 3.26, =85.4%) babies born versus Conclusion Pregnant hospitals manifest myalgia, but more be needing Pre-existing comorbidities, hypertension, index factors severe pregnancy. deliver have being unit. Their Systematic registration PROSPERO CRD42020178076. Readers’ note This article is a living that will reflect emerging evidence. Updates may occur up years date original publication. version update published on September 2020 ( BMJ 2020;370:m3320), previous updates can found supplements https://www.bmj.com/content/370/bmj.m3320/related#datasupp ). When citing this paper please consider adding number access clarity.

Language: Английский

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Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons

New England Journal of Medicine, Journal Year: 2021, Volume and Issue: 384(24), P. 2273 - 2282

Published: April 21, 2021

Many pregnant persons in the United States are receiving messenger RNA (mRNA) coronavirus disease 2019 (Covid-19) vaccines, but data limited on their safety pregnancy.From December 14, 2020, to February 28, 2021, we used from "v-safe after vaccination health checker" surveillance system, v-safe pregnancy registry, and Vaccine Adverse Event Reporting System (VAERS) characterize initial of mRNA Covid-19 vaccines persons.A total 35,691 participants 16 54 years age identified as pregnant. Injection-site pain was reported more frequently among than nonpregnant women, whereas headache, myalgia, chills, fever were less frequently. Among 3958 enrolled 827 had a completed pregnancy, which 115 (13.9%) resulted loss 712 (86.1%) live birth (mostly with third trimester). neonatal outcomes included preterm (in 9.4%) small size for gestational 3.2%); no deaths reported. Although not directly comparable, calculated proportions adverse vaccinated against who similar incidences studies involving women that conducted before pandemic. 221 pregnancy-related events VAERS, most event spontaneous abortion (46 cases).Preliminary findings did show obvious signals received vaccines. However, longitudinal follow-up, including follow-up large numbers earlier is necessary inform maternal, infant outcomes.

Language: Английский

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Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study

American Journal of Obstetrics and Gynecology, Journal Year: 2021, Volume and Issue: 225(3), P. 303.e1 - 303.e17

Published: March 26, 2021

Language: Английский

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The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review

Reproductive Health, Journal Year: 2021, Volume and Issue: 18(1)

Published: Jan. 18, 2021

Abstract Introduction The Covid-19 pandemic affects maternal health both directly and indirectly, direct indirect effects are intertwined. To provide a comprehensive overview on this broad topic in rapid format behooving an emergent we conducted scoping review. Methods A review was to compile evidence impacts of the most significant outcomes thus far. Working papers news articles were considered appropriate along with peer-reviewed publications order capture rapidly evolving updates. Literature English published from January 1st September 11 2020 included if it pertained or COVID-19 physical, mental, economic, social wellbeing pregnant people. Narrative descriptions written about subject areas for which authors found evidence. Results search yielded 396 publications, 95 included. Pregnant individuals be at heightened risk more severe symptoms than people who not pregnant. Intrauterine, vertical, breastmilk transmission unlikely. Labor, delivery, breastfeeding guidelines positive patients varied. Severe increases mental issues, such as clinically relevant anxiety depression, reported. Domestic violence appeared spike. Prenatal care visits decreased, healthcare infrastructure strained, potentially harmful policies implemented little Women likely lose their income due men, working mothers struggled increased childcare demands. Conclusion women higher infection pregnant, however symptomatic may experience adverse compared non-pregnant seem face disproportionate socio-economic consequences. High low- middle-income countries alike faced struggles. Further resources should directed towards quality epidemiological studies. Plain summary reproductive perinatal through itself but also indirectly consequence changes care, policy, economic circumstances. consequences have Intrauterine transmission, passage virus mother baby during delivery labor, vary, variability could create uncertainty unnecessary harm. high low/middle countries. impact is marked. frequency problems, epidemic reported many This reflects increase studies demonstrating true change lacking. vulnerable losing We make several recommendations: studies, services diminished, focus needed.

Language: Английский

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COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries

European Journal of Epidemiology, Journal Year: 2021, Volume and Issue: 36(2), P. 197 - 211

Published: Feb. 1, 2021

Abstract With the development of multiple effective vaccines, reducing global morbidity and mortality COVID-19 will depend on distribution acceptance vaccination. Estimates vaccine among pregnant women mothers young children are yet unknown. An understanding challenges correlates to aid acceleration administration within these populations. Acceptance vaccination younger than 18-years-old, as well potential predictors, were assessed through an online survey, administered by Pregistry between October 28 November 18, 2020. 17,871 total survey responses from 16 countries obtained. Given a 90% efficacy, 52.0% (n = 2747/5282) 73.4% non-pregnant 9214/12,562) indicated intention receive vaccine. 69.2% 11,800/17,054), both non-pregnant, vaccinate their children. Vaccine was generally highest in India, Philippines, all sampled Latin America; it lowest Russia, United States Australia. The strongest predictors included confidence safety or effectiveness, worrying about COVID-19, belief importance vaccines own country, compliance mask guidelines, trust public health agencies/health science, attitudes towards routine vaccines. its vary globally. Vaccination campaigns for should be specific each country order attain largest impact.

Language: Английский

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An update on COVID-19 and pregnancy

American Journal of Obstetrics and Gynecology, Journal Year: 2021, Volume and Issue: 226(2), P. 177 - 186

Published: Sept. 14, 2021

Language: Английский

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Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19)

Obstetrics and Gynecology, Journal Year: 2021, Volume and Issue: 137(4), P. 571 - 580

Published: Feb. 8, 2021

OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) severity in pregnant patients and evaluate the association between perinatal outcomes. METHODS: We conducted an observational cohort study of all with a singleton gestation positive test result for severe acute respiratory syndrome 2 (SARS-CoV-2) who delivered at 1 33 U.S. hospitals 14 states from March to July 31, 2020. Disease was classified by National Institutes Health criteria. Maternal, fetal, neonatal outcomes were abstracted centrally trained certified research staff. evaluated trends maternal characteristics across COVID-19 classes associations multivariable modeling. RESULTS: A total 1,219 included: 47% asymptomatic, 27% mild, 14% moderate, 8% severe, 4% critical. Overall, 53% Hispanic; there no trend race–ethnicity distribution severity. Those more illness had older mean age, higher median body mass index, pre-existing medical comorbidities. Four deaths (0.3%) attributed COVID-19. Frequency death or SARS-CoV-2 did not differ Adverse frequent among illness, including 6% (95% CI 2–11%) incidence venous thromboembolism those severe–critical compared 0.2% mild–moderate 0% asymptomatic ( P <.001 severity). In adjusted analyses, associated increased risk cesarean birth (59.6% vs 34.0%, relative [aRR] 1.57, 95% 1.30–1.90), hypertensive disorders pregnancy (40.4% 18.8%, aRR 1.61, 1.18–2.20), preterm (41.8% 11.9%, 3.53, 2.42–5.14) patients. Mild–moderate adverse CONCLUSION: Compared infection without symptoms, COVID-19, but complications.

Language: Английский

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Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy — SET-NET, 16 Jurisdictions, March 29–October 14, 2020

MMWR Morbidity and Mortality Weekly Report, Journal Year: 2020, Volume and Issue: 69(44), P. 1635 - 1640

Published: Nov. 2, 2020

Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness and might be preterm birth (1-3). The full impact of infection SARS-CoV-2, the virus that causes COVID-19, in pregnancy is unknown. Public health jurisdictions report information, including status, on confirmed probable COVID-19 cases to CDC through National Notifiable Diseases Surveillance System.* Through Emerging Threats Mothers Babies Network (SET-NET), 16 collected supplementary information infant outcomes among 5,252 laboratory-confirmed SARS-CoV-2 reported during March 29-October 14, 2020. Among 3,912 live births known gestational age, 12.9% were (<37 weeks), higher than 10.2% general U.S. population (4). 610 infants (21.3%) test results, perinatal was infrequent (2.6%) occurred primarily whose mother had identified within 1 week delivery. Because majority pregnant thus far experienced third trimester, ongoing surveillance needed assess effects infections early pregnancy, as well longer-term exposed infants. These findings can inform neonatal testing recommendations, clinical practice, public action used by care providers counsel risks infection, births. their household members should follow recommended prevention measures, wearing a mask, social distancing, frequent handwashing when going out or interacting others if there person who has exposure COVID-19.†.

Language: Английский

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Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women

JAMA, Journal Year: 2021, Volume and Issue: 325(23), P. 2370 - 2370

Published: May 13, 2021

Pregnant women are at increased risk of morbidity and mortality from COVID-19 but have been excluded the phase 3 vaccine trials. Data on safety immunogenicity in these populations therefore limited.

Language: Английский

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