Maternal third dose of BNT162b2 mRNA vaccine and risk of infant COVID-19 hospitalization

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Michal Lipschuetz1,2, Joshua Guedalia1, Sarah M Cohen1

  • 1Obstetrics & Gynecology Division Hadassah Medical Center, Faculty of Medicine of the Hebrew University of Jerusalem, Jerusalem, Israel.

Nature Medicine
|March 24, 2023
PubMed

Insights

A third maternal COVID-19 vaccine dose during pregnancy significantly reduced infant hospitalizations. This booster vaccination offers crucial protection for newborns against Coronavirus Disease 2019 (COVID-19).

Area of Science:

  • Immunology
  • Public Health
  • Pediatrics

Background:

  • Infants face higher risks for Coronavirus Disease 2019 (COVID-19) hospitalizations than older children.
  • Maternal vaccination during pregnancy is a strategy to protect infants.
  • The BNT162b2 vaccine's third dose effectiveness in pregnancy warrants investigation.

Purpose of the Study:

  • To evaluate the effectiveness of a third maternal dose of the BNT162b2 COVID-19 vaccine during pregnancy.
  • To assess the impact on infant COVID-19-related hospitalizations.
  • To compare protection from a third maternal dose versus a second dose.

Main Methods:

  • Nationwide cohort study of live-born infants in Israel (August 2021–March 2022).
  • Analysis of infant COVID-19 hospitalizations based on maternal vaccination status (third dose, second dose, unvaccinated).
  • Cox proportional hazard regression models used to estimate effectiveness.

Main Results:

  • Infant hospitalization rates were 0.4% (third dose), 0.6% (second dose), and 0.7% (unvaccinated).
  • The third maternal dose showed an estimated 53% effectiveness (95% CI: 36-65%) in reducing infant hospitalization compared to the second dose.
  • Protection was greater with a shorter interval between maternal vaccination and delivery.

Conclusions:

  • A third maternal dose of the BNT162b2 vaccine during pregnancy significantly reduces the risk of infant hospitalization for COVID-19.
  • This finding supports public health recommendations for maternal booster vaccination.
  • Maternal vaccination is a key strategy for protecting infants in their first months of life.

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