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

Author

Listed:
  • Joshua Guedalia

    (Faculty of Medicine of the Hebrew University of Jerusalem)

  • Michal Lipschuetz

    (Faculty of Medicine of the Hebrew University of Jerusalem
    Henrietta Szold Hadassah Hebrew University School of Nursing in the Faculty of Medicine)

  • Ronit Calderon-Margalit

    (Faculty of Medicine of the Hebrew University of Jerusalem)

  • Sarah M. Cohen

    (Faculty of Medicine of the Hebrew University of Jerusalem)

  • Debra Goldman-Wohl

    (Faculty of Medicine of the Hebrew University of Jerusalem)

  • Tali Kaminer

    (Israel Ministry of Health)

  • Eli Melul

    (Israel Ministry of Health)

  • Galit Shefer

    (Israel Ministry of Health)

  • Yishai Sompolinsky

    (Faculty of Medicine of the Hebrew University of Jerusalem)

  • Asnat Walfisch

    (Tel Aviv University)

  • Simcha Yagel

    (Faculty of Medicine of the Hebrew University of Jerusalem)

  • Ofer Beharier

    (Faculty of Medicine of the Hebrew University of Jerusalem)

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.

Suggested Citation

  • 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 & Ofe, 2022. "Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel," Nature Communications, Nature, vol. 13(1), pages 1-7, December.
    • Handle: RePEc:nat:natcom:v:13:y:2022:i:1:d:10.1038_s41467-022-34605-x
    DOI: 10.1038/s41467-022-34605-x
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    References listed on IDEAS

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    1. Smriti Prasad & Erkan Kalafat & Helena Blakeway & Rosemary Townsend & Pat O’Brien & Edward Morris & Tim Draycott & Shakila Thangaratinam & Kirsty Le Doare & Shamez Ladhani & Peter von Dadelszen & Laur, 2022. "Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy," Nature Communications, Nature, vol. 13(1), pages 1-8, December.
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    Cited by:

    1. Elisabeth A. Murphy & Camila Guzman-Cardozo & Ashley C. Sukhu & Debby J. Parks & Malavika Prabhu & Iman Mohammed & Magdalena Jurkiewicz & Thomas J. Ketas & Sunidhi Singh & Marie Canis & Eva Bednarski , 2023. "SARS-CoV-2 vaccination, booster, and infection in pregnant population enhances passive immunity in neonates," Nature Communications, Nature, vol. 14(1), pages 1-10, December.
    2. Joshua Guedalia & Michal Lipschuetz & Adva Cahen-Peretz & Sarah M. Cohen & Yishai Sompolinsky & Galit Shefer & Eli Melul & Zivanit Ergaz-Shaltiel & Debra Goldman-Wohl & Simcha Yagel & Ronit Calderon-M, 2024. "Maternal hybrid immunity and risk of infant COVID-19 hospitalizations: national case-control study in Israel," Nature Communications, Nature, vol. 15(1), pages 1-9, December.

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