Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel

Joshua Guedalia; Michal Lipschuetz; Ronit Calderon-Margalit; Sarah M. Cohen; Debra Goldman-Wohl; Tali Kaminer; Eli Melul; Galit Shefer; Yishai Sompolinsky; Asnat Walfisch; Simcha Yagel; Ofer Beharier

doi:10.1038/s41467-022-34605-x

Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel

Joshua Guedalia, Michal Lipschuetz, Ronit Calderon-Margalit, Sarah M. Cohen, Debra Goldman-Wohl, Tali Kaminer, Eli Melul, Galit Shefer, Yishai Sompolinsky, Asnat Walfisch, Simcha Yagel, Ofer Beharier

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

The Centers for Disease Control (CDC) recommend a third dose of COVID-19 vaccine for pregnant women, although data regarding effectiveness during pregnancy are lacking. This national, population-based, historical cohort study of pregnant women in Israel, delivering between August 1, 2021 and March 22, 2022, aims to analyze and compare the third and second doses’ vaccine effectiveness in preventing COVID-19-related hospitalizations during pregnancy during two COVID-19 waves (Delta variant in the summer of 2021 and Omicron, BA.1, variant in the winter of 2022). Time-dependent Cox proportional-hazards regression models estimate the hazard ratios (HR) and 95% confidence intervals (CI) for COVID-related outcomes according to vaccine dose, and vaccine effectiveness as 1-HR. Study includes 82,659 and 33,303 pregnant women from the Delta and Omicron waves, respectively. Compared with the second dose, the third dose effectively prevents overall hospitalizations with SARS-CoV-2 infections, with estimated effectiveness of 92% (95% CI 83–96%) during Delta, and enhances protection against significant disease during Omicron, with effectiveness of 92% (95% CI 26–99%), and 48% (95% CI 37–57%) effectiveness against hospitalization overall. A third dose of the BNT162b2 mRNA COVID-19 vaccine during pregnancy, given at least 5 months after the second vaccine dose, enhances protection against adverse COVID-19-related outcomes.

Original language	English
Article number	6961
Journal	Nature Communications
Volume	13
Issue number	1
DOIs	https://doi.org/10.1038/s41467-022-34605-x
State	Published - Dec 2022
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Funding

This work was supported by the “Ofek” Program of the Hadassah Medical Center. Figure was created with BioRender.com.

Funders	Funder number
Hadassah Medical Organization

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Guedalia, J., Lipschuetz, M., Calderon-Margalit, R., Cohen, S. M., Goldman-Wohl, D., Kaminer, T., Melul, E., Shefer, G., Sompolinsky, Y., Walfisch, A., Yagel, S., & Beharier, O. (2022). Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel. Nature Communications, 13(1), Article 6961. https://doi.org/10.1038/s41467-022-34605-x

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title = "Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel",

abstract = "The Centers for Disease Control (CDC) recommend a third dose of COVID-19 vaccine for pregnant women, although data regarding effectiveness during pregnancy are lacking. This national, population-based, historical cohort study of pregnant women in Israel, delivering between August 1, 2021 and March 22, 2022, aims to analyze and compare the third and second doses{\textquoteright} vaccine effectiveness in preventing COVID-19-related hospitalizations during pregnancy during two COVID-19 waves (Delta variant in the summer of 2021 and Omicron, BA.1, variant in the winter of 2022). Time-dependent Cox proportional-hazards regression models estimate the hazard ratios (HR) and 95% confidence intervals (CI) for COVID-related outcomes according to vaccine dose, and vaccine effectiveness as 1-HR. Study includes 82,659 and 33,303 pregnant women from the Delta and Omicron waves, respectively. Compared with the second dose, the third dose effectively prevents overall hospitalizations with SARS-CoV-2 infections, with estimated effectiveness of 92% (95% CI 83–96%) during Delta, and enhances protection against significant disease during Omicron, with effectiveness of 92% (95% CI 26–99%), and 48% (95% CI 37–57%) effectiveness against hospitalization overall. A third dose of the BNT162b2 mRNA COVID-19 vaccine during pregnancy, given at least 5 months after the second vaccine dose, enhances protection against adverse COVID-19-related outcomes.",

author = "Joshua Guedalia and Michal Lipschuetz and Ronit Calderon-Margalit and Cohen, {Sarah M.} and Debra Goldman-Wohl and Tali Kaminer and Eli Melul and Galit Shefer and Yishai Sompolinsky and Asnat Walfisch and Simcha Yagel and Ofer Beharier",

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Guedalia, J, Lipschuetz, M, Calderon-Margalit, R, Cohen, SM, Goldman-Wohl, D, Kaminer, T, Melul, E, Shefer, G, Sompolinsky, Y, Walfisch, A, Yagel, S & Beharier, O 2022, 'Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel', Nature Communications, vol. 13, no. 1, 6961. https://doi.org/10.1038/s41467-022-34605-x

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AU - Guedalia, Joshua

AU - Lipschuetz, Michal

AU - Calderon-Margalit, Ronit

AU - Cohen, Sarah M.

AU - Goldman-Wohl, Debra

AU - Kaminer, Tali

AU - Melul, Eli

AU - Shefer, Galit

AU - Sompolinsky, Yishai

AU - Walfisch, Asnat

AU - Yagel, Simcha

AU - Beharier, Ofer

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N2 - The Centers for Disease Control (CDC) recommend a third dose of COVID-19 vaccine for pregnant women, although data regarding effectiveness during pregnancy are lacking. This national, population-based, historical cohort study of pregnant women in Israel, delivering between August 1, 2021 and March 22, 2022, aims to analyze and compare the third and second doses’ vaccine effectiveness in preventing COVID-19-related hospitalizations during pregnancy during two COVID-19 waves (Delta variant in the summer of 2021 and Omicron, BA.1, variant in the winter of 2022). Time-dependent Cox proportional-hazards regression models estimate the hazard ratios (HR) and 95% confidence intervals (CI) for COVID-related outcomes according to vaccine dose, and vaccine effectiveness as 1-HR. Study includes 82,659 and 33,303 pregnant women from the Delta and Omicron waves, respectively. Compared with the second dose, the third dose effectively prevents overall hospitalizations with SARS-CoV-2 infections, with estimated effectiveness of 92% (95% CI 83–96%) during Delta, and enhances protection against significant disease during Omicron, with effectiveness of 92% (95% CI 26–99%), and 48% (95% CI 37–57%) effectiveness against hospitalization overall. A third dose of the BNT162b2 mRNA COVID-19 vaccine during pregnancy, given at least 5 months after the second vaccine dose, enhances protection against adverse COVID-19-related outcomes.

AB - The Centers for Disease Control (CDC) recommend a third dose of COVID-19 vaccine for pregnant women, although data regarding effectiveness during pregnancy are lacking. This national, population-based, historical cohort study of pregnant women in Israel, delivering between August 1, 2021 and March 22, 2022, aims to analyze and compare the third and second doses’ vaccine effectiveness in preventing COVID-19-related hospitalizations during pregnancy during two COVID-19 waves (Delta variant in the summer of 2021 and Omicron, BA.1, variant in the winter of 2022). Time-dependent Cox proportional-hazards regression models estimate the hazard ratios (HR) and 95% confidence intervals (CI) for COVID-related outcomes according to vaccine dose, and vaccine effectiveness as 1-HR. Study includes 82,659 and 33,303 pregnant women from the Delta and Omicron waves, respectively. Compared with the second dose, the third dose effectively prevents overall hospitalizations with SARS-CoV-2 infections, with estimated effectiveness of 92% (95% CI 83–96%) during Delta, and enhances protection against significant disease during Omicron, with effectiveness of 92% (95% CI 26–99%), and 48% (95% CI 37–57%) effectiveness against hospitalization overall. A third dose of the BNT162b2 mRNA COVID-19 vaccine during pregnancy, given at least 5 months after the second vaccine dose, enhances protection against adverse COVID-19-related outcomes.

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Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel

Abstract

Bibliographical note

Funding

UN SDGs

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