Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2022/02/covid-19-scan-feb-11-2022
COVID-19 Scan for Feb 11, 2022
COVID-19 vaccines in pregnancy; Mix-and-match COVID vaccines
Filed Under:
COVID-19
Maternal COVID-19 vaccination not tied to poor infant outcomes
A new study on outcomes among infants whose mothers received the Pfizer-BioNTech mRNA vaccine in pregnancy showed that no detrimental outcomes were associated with maternal vaccination, including preterm birth, small birth weight for gestational age (SGA), congenital malformations, and infant death.
It was published yesterday in JAMA Pediatrics.
The population-based cohort study, which included all singleton live births in March through September 2021, included women and infants seen within a large state-mandated healthcare organization in Israel. A total of 24,288 eligible newborns were included, of whom 16,697 were expose in the first (2,134 infants) or second (9,364) trimester to maternal vaccination in utero.
In January 2021, Israel officially recommended vaccination with the two-dose Pfizer vaccine for all pregnant women. Women who were vaccinated in pregnancy tended to be older, more affluent, and have higher uptake of the seasonal influenza vaccine.
The risk of any congenital malformation was not significantly different among exposed or unexposed infants, with a risk ratio (RR) of 0.69 (95% confidence interval [CI], 0.44 to 1.04), similar to the RR for heart malformations of 0.75 (95% CI, 0.43 to 1.26). The risk for major heart malformations was lower among the exposed group, with an RR of 0.46 (95% CI, 0.24 to 0.82), the authors found. There were no differences observed for hospitalization.
"This large, nationally representative study examined various congenital outcomes and detected no increased risk for early infant morbidity or mortality among live-born infants prenatally exposed to BNT162b2 [Pfizer] vaccination as compared with unexposed infants," the authors concluded.
Feb 10 JAMA Pediatr study
Mix 'n' match COVID-19 vaccine boosting may lower breakthrough cases
A study this week in the New England Journal of Medicine (NEJM) finds that receiving a booster dose of a different brand of COVID-19 vaccine after receiving the Johnson & Johnson (J&J) vaccine in the primary series may prevent more breakthrough infections.
Researchers at the Veterans Affairs Pittsburgh Healthcare System studied 4,806,026 veterans in a database containing information on all veterans diagnosed as having COVID-19.
The veterans were grouped according to whether their primary series was with either the J&J vaccine (43,394 participants) or the Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines (965,063). Each participant who received a different (heterologous) vaccine as a booster dose was matched with a peer who received the same (homologous) vaccine.
Among the veterans who had received the J&J primary series, there were 415 COVID-19 infections, including 34 with moderate illness and 12 with severe or critical disease. Of the infections, 278 occurred in veterans who had received a homologous booster, and 137 occurred in those given a heterologous booster, for a roughly 50% lower incidence among the heterologous group (adjusted rate ratio [aRR], 0.49). Likewise, the aRRs for moderate and severe illness were lower in the heterologous group.
Among participants whose primary series was with the Pfizer or Moderna vaccine, there were 362 infections, including 23 veterans with moderate illness and 8 with severe or critical disease. There was no difference between the incidence of COVID-19 infection of any severity among veterans in the heterologous or homologous group (aRR, 1.10), and outcomes were comparable in those who received either mRNA vaccine.
The authors noted that recent clinical trials of COVID-19 boosters have found that heterologous boosting provokes a greater antibody response than homologous doses in healthy adults.
"Our findings support the results of these clinical trials since we observed the largest number of documented breakthrough infections in participants who had received a homologous Ad26.COV2.S [J&J] booster," the study authors wrote. "Our analysis provides further evidence that the infection rate is lower in persons who are boosted with a heterologous mRNA vaccine."
Feb 9 NEJM research letter
COVID-19 Scan for Feb 11, 2022
COVID-19 vaccines in pregnancy; Mix-and-match COVID vaccines
Filed Under:
COVID-19
Maternal COVID-19 vaccination not tied to poor infant outcomes
A new study on outcomes among infants whose mothers received the Pfizer-BioNTech mRNA vaccine in pregnancy showed that no detrimental outcomes were associated with maternal vaccination, including preterm birth, small birth weight for gestational age (SGA), congenital malformations, and infant death.
It was published yesterday in JAMA Pediatrics.
The population-based cohort study, which included all singleton live births in March through September 2021, included women and infants seen within a large state-mandated healthcare organization in Israel. A total of 24,288 eligible newborns were included, of whom 16,697 were expose in the first (2,134 infants) or second (9,364) trimester to maternal vaccination in utero.
In January 2021, Israel officially recommended vaccination with the two-dose Pfizer vaccine for all pregnant women. Women who were vaccinated in pregnancy tended to be older, more affluent, and have higher uptake of the seasonal influenza vaccine.
The risk of any congenital malformation was not significantly different among exposed or unexposed infants, with a risk ratio (RR) of 0.69 (95% confidence interval [CI], 0.44 to 1.04), similar to the RR for heart malformations of 0.75 (95% CI, 0.43 to 1.26). The risk for major heart malformations was lower among the exposed group, with an RR of 0.46 (95% CI, 0.24 to 0.82), the authors found. There were no differences observed for hospitalization.
"This large, nationally representative study examined various congenital outcomes and detected no increased risk for early infant morbidity or mortality among live-born infants prenatally exposed to BNT162b2 [Pfizer] vaccination as compared with unexposed infants," the authors concluded.
Feb 10 JAMA Pediatr study
Mix 'n' match COVID-19 vaccine boosting may lower breakthrough cases
A study this week in the New England Journal of Medicine (NEJM) finds that receiving a booster dose of a different brand of COVID-19 vaccine after receiving the Johnson & Johnson (J&J) vaccine in the primary series may prevent more breakthrough infections.
Researchers at the Veterans Affairs Pittsburgh Healthcare System studied 4,806,026 veterans in a database containing information on all veterans diagnosed as having COVID-19.
The veterans were grouped according to whether their primary series was with either the J&J vaccine (43,394 participants) or the Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines (965,063). Each participant who received a different (heterologous) vaccine as a booster dose was matched with a peer who received the same (homologous) vaccine.
Among the veterans who had received the J&J primary series, there were 415 COVID-19 infections, including 34 with moderate illness and 12 with severe or critical disease. Of the infections, 278 occurred in veterans who had received a homologous booster, and 137 occurred in those given a heterologous booster, for a roughly 50% lower incidence among the heterologous group (adjusted rate ratio [aRR], 0.49). Likewise, the aRRs for moderate and severe illness were lower in the heterologous group.
Among participants whose primary series was with the Pfizer or Moderna vaccine, there were 362 infections, including 23 veterans with moderate illness and 8 with severe or critical disease. There was no difference between the incidence of COVID-19 infection of any severity among veterans in the heterologous or homologous group (aRR, 1.10), and outcomes were comparable in those who received either mRNA vaccine.
The authors noted that recent clinical trials of COVID-19 boosters have found that heterologous boosting provokes a greater antibody response than homologous doses in healthy adults.
"Our findings support the results of these clinical trials since we observed the largest number of documented breakthrough infections in participants who had received a homologous Ad26.COV2.S [J&J] booster," the study authors wrote. "Our analysis provides further evidence that the infection rate is lower in persons who are boosted with a heterologous mRNA vaccine."
Feb 9 NEJM research letter
