Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants

doi:10.1056/NEJMoa2204399

Multicenter Study

. 2022 Jul 14;387(2):109-119.

doi: 10.1056/NEJMoa2204399. Epub 2022 Jun 22.

Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants

Natasha B Halasa¹, Samantha M Olson¹, Mary A Staat¹, Margaret M Newhams¹, Ashley M Price¹, Pia S Pannaraj¹, Julie A Boom¹, Leila C Sahni¹, Kathleen Chiotos¹, Melissa A Cameron¹, Katherine E Bline¹, Charlotte V Hobbs¹, Aline B Maddux¹, Bria M Coates¹, Kelly N Michelson¹, Sabrina M Heidemann¹, Katherine Irby¹, Ryan A Nofziger¹, Elizabeth H Mack¹, Laura Smallcomb¹, Stephanie P Schwartz¹, Tracie C Walker¹, Shira J Gertz¹, Jennifer E Schuster¹, Satoshi Kamidani¹, Keiko M Tarquinio¹, Samina S Bhumbra¹, Mia Maamari¹, Janet R Hume¹, Hillary Crandall¹, Emily R Levy¹, Matt S Zinter¹, Tamara T Bradford¹, Heidi R Flori¹, Melissa L Cullimore¹, Michele Kong¹, Natalie Z Cvijanovich¹, Suzanne M Gilboa¹, Kara N Polen¹, Angela P Campbell¹, Adrienne G Randolph¹, Manish M Patel¹; Overcoming Covid-19 Investigators

Collaborators, Affiliations

Collaborators

Overcoming Covid-19 Investigators:
Michele Kong, Meghan Murdock, Katherine Irby, Ronald C Sanders, Masson Yates, Chelsea Smith, Melissa A Cameron, Katheryn Crane, Natalie Z Cvijanovich, Geraldina Lionetti, Juliana Murcia-Montoya, Matt S Zinter, Denise Villarreal-Chico, Pia S Pannaraj, Adam L Skura, Daniel Hakimi, Harvey Peralta, Yea Ji Sea, Kennis-Grace Mrotek, Aline B Maddux, Justin M Lockwood, Emily Port, Imogene Carson, Satoshi Kamidani, Keiko M Tarquinio, Laila Hussaini, Nadine Baida, Kelly N Michelson, Bria M Coates, Simone T Rhodes, Hassan A Khan, Samina S Bhumbra, Courtney M Rowan, Mary Stumpf, Tamara T Bradford, Marla S Johnston, Adrienne G Randolph, Margaret M Newhams, Suden Kucukak, Amber O Orzel, Sabrina R Chen, Benjamin J Boutselis, Timothy P McCadden, Edie Weller, Laura Berbert, Jie He, Sabrina M Heidemann, Heidi R Flori, Patrick Moran, Janet R Hume, Ellen R Bruno, Lexie A Goertzen, Emily R Levy, Supriya Behl, Noelle M Drapeau, Charlotte V Hobbs, Lora Martin, Lacy Malloch, Virginia Austin Harrison, Cameron Sanders, Kayla Patterson, Chidinma A Chikere, Jennifer E Schuster, Shannon M Hill, Melissa Sullivan, Melissa L Cullimore, Valerie H Rinehart, Lauren A Hoody, Shira J Gertz, Stephanie P Schwartz, Tracie C Walker, Paris C Bennett, Ryan A Nofziger, Nicole A Twinem, Merry L Tomcany, Mary Allen Staat, Chelsea C Rohlfs, Katherine Bline, Amber Wolfe, Kathleen Chiotos, Rebecca L Douglas, Kathlyn Phengchomphet, Elizabeth H Mack, Megan M Bickford, Lauren E Wakefield, Laura Smallcomb, Natasha B Halasa, Haya Hayek, Yesenia Romero, Julie A Boom, Leila C Sahni, Jennifer N Oates, Mia Maamari, Cindy Bowens, Hillary Crandall, Samantha M Olson, Ashley M Price, Suzanne M Gilboa, Kara N Polen, Laura D Zambrano, Angela P Campbell, Manish M Patel

Affiliation

¹ From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.).

PMID: 35731908
PMCID: PMC9342588
DOI: 10.1056/NEJMoa2204399

Multicenter Study

Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants

Natasha B Halasa et al. N Engl J Med. 2022.

. 2022 Jul 14;387(2):109-119.

doi: 10.1056/NEJMoa2204399. Epub 2022 Jun 22.

Authors

Collaborators

Overcoming Covid-19 Investigators:
Michele Kong, Meghan Murdock, Katherine Irby, Ronald C Sanders, Masson Yates, Chelsea Smith, Melissa A Cameron, Katheryn Crane, Natalie Z Cvijanovich, Geraldina Lionetti, Juliana Murcia-Montoya, Matt S Zinter, Denise Villarreal-Chico, Pia S Pannaraj, Adam L Skura, Daniel Hakimi, Harvey Peralta, Yea Ji Sea, Kennis-Grace Mrotek, Aline B Maddux, Justin M Lockwood, Emily Port, Imogene Carson, Satoshi Kamidani, Keiko M Tarquinio, Laila Hussaini, Nadine Baida, Kelly N Michelson, Bria M Coates, Simone T Rhodes, Hassan A Khan, Samina S Bhumbra, Courtney M Rowan, Mary Stumpf, Tamara T Bradford, Marla S Johnston, Adrienne G Randolph, Margaret M Newhams, Suden Kucukak, Amber O Orzel, Sabrina R Chen, Benjamin J Boutselis, Timothy P McCadden, Edie Weller, Laura Berbert, Jie He, Sabrina M Heidemann, Heidi R Flori, Patrick Moran, Janet R Hume, Ellen R Bruno, Lexie A Goertzen, Emily R Levy, Supriya Behl, Noelle M Drapeau, Charlotte V Hobbs, Lora Martin, Lacy Malloch, Virginia Austin Harrison, Cameron Sanders, Kayla Patterson, Chidinma A Chikere, Jennifer E Schuster, Shannon M Hill, Melissa Sullivan, Melissa L Cullimore, Valerie H Rinehart, Lauren A Hoody, Shira J Gertz, Stephanie P Schwartz, Tracie C Walker, Paris C Bennett, Ryan A Nofziger, Nicole A Twinem, Merry L Tomcany, Mary Allen Staat, Chelsea C Rohlfs, Katherine Bline, Amber Wolfe, Kathleen Chiotos, Rebecca L Douglas, Kathlyn Phengchomphet, Elizabeth H Mack, Megan M Bickford, Lauren E Wakefield, Laura Smallcomb, Natasha B Halasa, Haya Hayek, Yesenia Romero, Julie A Boom, Leila C Sahni, Jennifer N Oates, Mia Maamari, Cindy Bowens, Hillary Crandall, Samantha M Olson, Ashley M Price, Suzanne M Gilboa, Kara N Polen, Laura D Zambrano, Angela P Campbell, Manish M Patel

Affiliation

¹ From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.).

PMID: 35731908
PMCID: PMC9342588
DOI: 10.1056/NEJMoa2204399

Abstract

Background: Infants younger than 6 months of age are at high risk for complications of coronavirus disease 2019 (Covid-19) and are not eligible for vaccination. Transplacental transfer of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after maternal Covid-19 vaccination may confer protection against Covid-19 in infants.

Methods: We used a case-control test-negative design to assess the effectiveness of maternal vaccination during pregnancy against hospitalization for Covid-19 among infants younger than 6 months of age. Between July 1, 2021, and March 8, 2022, we enrolled infants hospitalized for Covid-19 (case infants) and infants hospitalized without Covid-19 (control infants) at 30 hospitals in 22 states. We estimated vaccine effectiveness by comparing the odds of full maternal vaccination (two doses of mRNA vaccine) among case infants and control infants during circulation of the B.1.617.2 (delta) variant (July 1, 2021, to December 18, 2021) and the B.1.1.259 (omicron) variant (December 19, 2021, to March 8, 2022).

Results: A total of 537 case infants (181 of whom had been admitted to a hospital during the delta period and 356 during the omicron period; median age, 2 months) and 512 control infants were enrolled and included in the analyses; 16% of the case infants and 29% of the control infants had been born to mothers who had been fully vaccinated against Covid-19 during pregnancy. Among the case infants, 113 (21%) received intensive care (64 [12%] received mechanical ventilation or vasoactive infusions). Two case infants died from Covid-19; neither infant's mother had been vaccinated during pregnancy. The effectiveness of maternal vaccination against hospitalization for Covid-19 among infants was 52% (95% confidence interval [CI], 33 to 65) overall, 80% (95% CI, 60 to 90) during the delta period, and 38% (95% CI, 8 to 58) during the omicron period. Effectiveness was 69% (95% CI, 50 to 80) when maternal vaccination occurred after 20 weeks of pregnancy and 38% (95% CI, 3 to 60) during the first 20 weeks of pregnancy.

Conclusions: Maternal vaccination with two doses of mRNA vaccine was associated with a reduced risk of hospitalization for Covid-19, including for critical illness, among infants younger than 6 months of age. (Funded by the Centers for Disease Control and Prevention.).

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Figures

**Figure 1. Study Enrollment and Outcomes (July 1, 2021–March 8, 2022).**
Women were considered to be fully vaccinated if they had completed a two-dose series of either the BNT162b2 or mRNA-1273 vaccine during pregnancy; women could have received the first dose before pregnancy and the second dose during pregnancy. Women were considered to be partially vaccinated if they had received one dose of vaccine during pregnancy and no dose before pregnancy. Women were considered to be unvaccinated if they had not received vaccine doses during pregnancy and before their infant’s hospitalization. Covid-19 denotes coronavirus disease 2019, and SARS-CoV-2 severe acute respiratory syndrome coronavirus 2.

**Figure 2. Clinical Severity of Covid-19 as Indicated by Outcomes among Case Infants, According to Maternal Vaccination Status.**
Critical Covid-19 was defined as Covid-19 leading to life-supporting interventions (i.e., noninvasive mechanical ventilation [bilevel positive airway pressure or continuous positive airway pressure], invasive mechanical ventilation, vasoactive infusions, or extracorporeal membrane oxygenation) or to death. An infant could have been included in more than one outcome category. Two infants who had been born to unvaccinated mothers (2 of 450 infants [<1%]) received extracorporeal membrane oxygenation. An additional 2 infants who had been born to unvaccinated mothers (2 of 442 infants [<1%]) died; among the 450 infants who had been born to unvaccinated mothers, 8 had mothers for whom data on hospital discharge were not available. ICU denotes intensive care unit.

**Figure 3. Effectiveness of Maternal Two-Dose mRNA Vaccination against Hospitalization for Covid-19 among Infants, Stratified According to Vaccination Timing, Variant, and Type of Admission.**
The delta-predominant period was defined as July 1, 2021, to December 18, 2021. The omicron-predominant period was defined as December 19, 2021, to March 8, 2022. The timing of maternal vaccination was based on the date of receipt of the second dose of a two-dose series of an mRNA Covid-19 vaccine during pregnancy. Gestational age was missing for 3 infants who had been born to vaccinated mothers with known timing of the second dose; for these infants, classification of vaccination timing was based on a gestational age of 40 weeks. For 16 infants who had been born to mothers who had been fully vaccinated during pregnancy, dates of vaccination were not available to determine the vaccination timing during pregnancy. Vaccine effectiveness was calculated as (1 − adjusted odds ratio) x 100, where the odds ratio is the odds of maternal vaccination among mothers of case infants as compared with control infants. The widths of the confidence intervals have not been adjusted for multiplicity and should not be used in place of a hypothesis test.

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Comment in

Covid-19 Vaccination during Pregnancy - Two for the Price of One.
Rasmussen SA, Jamieson DJ. Rasmussen SA, et al. N Engl J Med. 2022 Jul 14;387(2):178-179. doi: 10.1056/NEJMe2206730. Epub 2022 Jun 22. N Engl J Med. 2022. PMID: 35731898 Free PMC article. No abstract available.

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Covid-19 Vaccination during Pregnancy - Two for the Price of One.
Rasmussen SA, Jamieson DJ. Rasmussen SA, et al. N Engl J Med. 2022 Jul 14;387(2):178-179. doi: 10.1056/NEJMe2206730. Epub 2022 Jun 22. N Engl J Med. 2022. PMID: 35731898 Free PMC article. No abstract available.
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References

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1. DeSisto CL, Wallace B, Simeone RM, et al. Risk for stillbirth among women with and without COVID-19 at delivery hospitalization — United States, March 2020–September 2021. MMWR Morb Mortal Wkly Rep 2021;70:1640-1645. - PMC - PubMed
1. Butt AA, Chemaitelly H, Al Khal A, et al. SARS-CoV-2 vaccine effectiveness in preventing confirmed infection in pregnant women. J Clin Invest 2021;131(23):e153662-e153662. - PMC - PubMed
1. Dagan N, Barda N, Biron-Shental T, et al. Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy. Nat Med 2021;27:1693-1695 - PubMed
1. Lipkind HS, Vazquez-Benitez G, DeSilva M, et al. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birth — eight integrated health care organizations, United States, December 15, 2020–July 22, 2021. MMWR Morb Mortal Wkly Rep 2022;71:26-30. - PMC - PubMed

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[1] Zambrano LD, Ellington S, Strid P, et al. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1641-1647. - PMC - PubMed

[2] Zambrano LD, Ellington S, Strid P, et al. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1641-1647. - PMC - PubMed

[3] DeSisto CL, Wallace B, Simeone RM, et al. Risk for stillbirth among women with and without COVID-19 at delivery hospitalization — United States, March 2020–September 2021. MMWR Morb Mortal Wkly Rep 2021;70:1640-1645. - PMC - PubMed

[4] DeSisto CL, Wallace B, Simeone RM, et al. Risk for stillbirth among women with and without COVID-19 at delivery hospitalization — United States, March 2020–September 2021. MMWR Morb Mortal Wkly Rep 2021;70:1640-1645. - PMC - PubMed

[5] Butt AA, Chemaitelly H, Al Khal A, et al. SARS-CoV-2 vaccine effectiveness in preventing confirmed infection in pregnant women. J Clin Invest 2021;131(23):e153662-e153662. - PMC - PubMed

[6] Butt AA, Chemaitelly H, Al Khal A, et al. SARS-CoV-2 vaccine effectiveness in preventing confirmed infection in pregnant women. J Clin Invest 2021;131(23):e153662-e153662. - PMC - PubMed

[7] Dagan N, Barda N, Biron-Shental T, et al. Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy. Nat Med 2021;27:1693-1695 - PubMed

[8] Dagan N, Barda N, Biron-Shental T, et al. Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy. Nat Med 2021;27:1693-1695 - PubMed

[9] Lipkind HS, Vazquez-Benitez G, DeSilva M, et al. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birth — eight integrated health care organizations, United States, December 15, 2020–July 22, 2021. MMWR Morb Mortal Wkly Rep 2022;71:26-30. - PMC - PubMed

[10] Lipkind HS, Vazquez-Benitez G, DeSilva M, et al. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birth — eight integrated health care organizations, United States, December 15, 2020–July 22, 2021. MMWR Morb Mortal Wkly Rep 2022;71:26-30. - PMC - PubMed

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Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants

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Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants

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