{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:49:14Z","timestamp":1792554554665,"version":"4.5.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Pregnant people are at high risk for severe COVID-19 but were excluded from mRNA vaccine trials; data on COVID-19 vaccine effectiveness (VE) are needed.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the estimated effectiveness of mRNA vaccination against medically attended COVID-19 among pregnant people during Delta and Omicron predominance.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This test-negative, case-control study was conducted from June 2021 to June 2022 in a network of 306 hospitals and 164 emergency department and urgent care (ED\/UC) facilities across 10 US states, including 4517 ED\/UC encounters and 975 hospitalizations among pregnant people with COVID-19\u2013like illness (CLI) who underwent SARS-CoV-2 molecular testing.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Two doses (14-149 and \u2265150 days prior) and 3 doses (7-119 and \u2265120 days prior) of COVID-19 mRNA vaccine (\u22651 dose received during pregnancy) vs unvaccinated.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Estimated VE against laboratory-confirmed COVID-19\u2013associated ED\/UC encounter or hospitalization, based on the adjusted odds ratio (aOR) for prior vaccination; VE was calculated as (1\u2009\u2212\u2009aOR)\u2009\u00d7\u2009100%.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 4517 eligible CLI-associated ED\/UC encounters and 975 hospitalizations, 885 (19.6%) and 334 (34.3%) were SARS-CoV-2 positive, respectively; the median (IQR) patient age was 28 (24-32) years and 31 (26-35) years, 537 (12.0%) and 118 (12.0%) were non-Hispanic Black and 1189 (26.0%) and 240 (25.0%) were Hispanic. During Delta predominance, the estimated VE against COVID-19\u2013associated ED\/UC encounters was 84% (95% CI, 69% to 92%) for 2 doses within 14 to 149 days, 75% (95% CI, 5% to 93%) for 2 doses 150 or more days prior, and 81% (95% CI, 30% to 95%) for 3 doses 7 to 119 days prior; estimated VE against COVID-19\u2013associated hospitalization was 99% (95% CI, 96% to 100%), 96% (95% CI, 86% to 99%), and 97% (95% CI, 79% to 100%), respectively. During Omicron predominance, for ED\/UC encounters, the estimated VE of 2 doses within 14 to 149 days, 2 doses 150 or more days, 3 doses within 7 to 119 days, and 3 doses 120 or more days prior was 3% (95% CI, \u221249% to 37%), 42% (95% CI, \u221216% to 72%), 79% (95% CI, 59% to 89%), and \u2212124% (95% CI, \u2212414% to 2%), respectively; for hospitalization, estimated VE was 86% (95% CI, 41% to 97%), 64% (95% CI, \u2212102% to 93%), 86% (95% CI, 28% to 97%), and \u221253% (95% CI, \u22121254% to 83%), respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, maternal mRNA COVID-19 vaccination, including booster dose, was associated with protection against medically attended COVID-19. VE estimates were higher against COVID-19\u2013associated hospitalization than ED\/UC visits and lower against the Omicron variant than the Delta variant. Protection waned over time, particularly during Omicron predominance.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.33273","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T11:31:46Z","timestamp":1664191906000},"page":"e2233273","source":"Crossref","is-referenced-by-count":66,"title":["Estimation of COVID-19 mRNA Vaccine Effectiveness Against Medically Attended COVID-19 in Pregnancy During Periods of Delta and Omicron Variant Predominance in the United States"],"prefix":"10.1001","volume":"5","author":[{"given":"Stephanie J.","family":"Schrag","sequence":"first","affiliation":[{"name":"CDC COVID-19 Emergency Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Verani","sequence":"additional","affiliation":[{"name":"CDC COVID-19 Emergency Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian 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