A large multistate study, conducted by the Centers for Disease Control and Prevention’s (CDC’s) VISION Network, has found that COVID-19 vaccination given during pregnancy offered 52 percent protection, cutting risk of a COVID-19-associated emergency department or urgent care visit in half. This is especially significant because there is an increased risk of severe COVID-19 during pregnancy requiring hospitalization and potentially causing adverse pregnancy outcomes.
However, if received less than six months prior to pregnancy, vaccination effectiveness declined providing only moderate protection against COVID (28 percent). If received more than six months prior to pregnancy, vaccination provided little protection (6 percent) against COVID.
Similar to findings in previous VISION studies of those who were not pregnant, protection provided by vaccination against COVID for those who were pregnant waned over four to six months. Also, similar to COVID vaccines for individuals who are not pregnant, effectiveness was comparable to that of the flu vaccine.
The study looked at geographically and racially diverse data from electronic medical records captured during routine healthcare delivery. There was no difference in the protection provided by COVID vaccination by age or race in the study population of 7,677 pregnant 18- to 45-year-olds.
The authors of this study note that their findings, derived from real-world data, indicate the protection provided by either monovalent or bivalent COVID vaccination for those who were pregnant or became pregnant was lower as compared with previous studies, likely due to changes in virus subvariant predominance in 2022-23. Other VISION Network studies have had similar findings in non-pregnant populations.
“The VISION Network did this study to examine the effectiveness of the COVID-19 vaccine for individuals who were pregnant, because there have been a lot of questions as to whether pregnant people should be vaccinated or not,” said study co-author Brian Dixon, PhD, MPA. “Our data show that for Covid-19, vaccines are protective of pregnant persons, supporting CDC guidelines that recommend COVID vaccination.” Dr. Dixon is director and a research scientist with the Clem McDonald Center for Biomedical Informatics at Regenstrief Institute and a professor at the Indiana University Indianapolis Richard M. Fairbanks School of Public Health.
Significantly, deidentified data contributed to the study by Regenstrief Institute indicated that pregnant persons in Indiana were half as likely to be vaccinated for COVID-19 than pregnant persons in the other states, including California, Colorado, Minnesota, Oregon, Utah, Washington and Wisconsin, from which data was analyzed. Approximately 65 percent of those in Indiana who were pregnant were unvaccinated, compared to 30 to 45 percent in the other states.
“COVID-19 vaccination remains essential for pregnant women’s health,” said study co-author Shaun Grannis, M.D., M.S., vice president for data and analytics at the Regenstrief Institute and professor of family medicine at the Indiana University School of Medicine. “As a physician and data scientist, I encourage women to discuss with their doctors the benefits of getting vaccinated or revaccinated to stay protected during pregnancy. Our findings aim to spark vital conversations between physicians and pregnant women and those planning a pregnancy about the safety and protection that the COVID vaccine provides. We also hope this work will inspire public health leaders and policymakers in Indiana and across the nation to promote vaccination, reaching women, families, and communities. Ultimately, it’s crucial for pregnant individuals to remain current with CDC-recommended COVID-19 vaccinations to safeguard their health.”
The study was a collaboration among CDC and seven geographically diverse U.S. healthcare systems and research centers with integrated medical, laboratory and vaccination records – all members of the CDC’s VISION Network.
In addition to Regenstrief Institute, which contributed both data and scientific expertise, VISION sites participating in the study were Columbia University, Health Partners, Intermountain Health, Kaiser Permanente Northern California, Kaiser Permanente Northwest and University of Colorado.
“Effectiveness of the Original Monovalent and Bivalent COVID-19 Vaccines Against COVID-19-Associated Emergency Department and Urgent Care Encounters in Pregnant Persons Who Were Not Immunocompromised: VISION Network, June 2022-August 2023” is published in Open Forum Infectious Diseases.
All authors and affiliations, as listed in the publication, are:
Allison Avrich Ciesla1,2, Victoria Lazariu3, Kristin Dascomb4, Stephanie A Irving5, Brian E Dixon6,7, Manjusha Gaglani8,9,10, Allison L Naleway5, Shaun J Grannis6,11, Sarah Ball3, Anupam B Kharbanda12, Gabriela Vazquez-Benitez13, Nicola P Klein14, Karthik Natarajan15,16, Toan C Ong17, Peter J Embi18, Katherine E Fleming-Dutra1, Ruth Link-Gelles1,19, Ousseny Zerbo14
Affiliations
1Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
2Eagle Health Analytics, San Antonio, Texas, USA
3Westat, Rockville, Maryland, USA
4Division of Infectious Diseases and Clinical Epidemiology, Intermountain Health, Salt Lake City, Utah, USA
5Kaiser Permanente Center for Health Research, Portland, Oregon, USA
6Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, USA
7Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
8Section of Pediatric Infectious Diseases, Department of Pediatrics, Baylor Scott & White Health, Temple, Texas, USA
9Department of Pediatrics, Baylor College of Medicine, Temple, Texas, USA
10Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas, USA
11School of Medicine, Indiana University, Indianapolis, Indiana, USA
12Children’s Minnesota, Minneapolis, Minnesota, USA
13HealthPartners Institute, Minneapolis, Minnesota, USA
14Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California, USA
15Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
16NewYork-Presbyterian Hospital, New York, New York, USA
17School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
18Vanderbilt University Medical Center, Nashville, Tennessee, USA
19US Public Health Service Commissioned Corps, Rockville, Maryland, USA
About Brian E. Dixon, PhD, MPA
In addition to his role as the director of public health informatics at the Regenstrief Institute and Indiana University Indianapolis Richard M. Fairbanks School of Public Health, Brian E. Dixon, PhD, MPA, is the director and a research scientist with the Clem McDonald Center for Biomedical Informatics at the Regenstrief Institute and a professor of health management and policy at the Fairbanks School. He is also an affiliate scientist at the U.S. Department of Veterans Affairs Health Services Research and Development Center for Health Information and Communication, Richard L. Roudebush VA Medical Center.
About Shaun Grannis, M.D., M.S.
In addition to his role as the vice president of data and analytics at Regenstrief Institute, Shaun Grannis, M.D., M.S., holds the Regenstrief Chair in Medical Informatics and is a professor of family medicine at the Indiana University School of Medicine.
