- Halasa, Natasha;
- Olson, Samantha;
- Staat, Mary;
- Newhams, Margaret;
- Price, Ashley;
- Boom, Julie;
- Sahni, Leila;
- Cameron, Melissa;
- Pannaraj, Pia;
- Bline, Katherine;
- Bhumbra, Samina;
- Bradford, Tamara;
- Chiotos, Kathleen;
- Coates, Bria;
- Cullimore, Melissa;
- Cvijanovich, Natalie;
- Flori, Heidi;
- Gertz, Shira;
- Heidemann, Sabrina;
- Hobbs, Charlotte;
- Hume, Janet;
- Irby, Katherine;
- Kamidani, Satoshi;
- Kong, Michele;
- Levy, Emily;
- Mack, Elizabeth;
- Maddux, Aline;
- Michelson, Kelly;
- Nofziger, Ryan;
- Schuster, Jennifer;
- Schwartz, Stephanie;
- Smallcomb, Laura;
- Tarquinio, Keiko;
- Walker, Tracie;
- Zinter, Matt;
- Gilboa, Suzanne;
- Polen, Kara;
- Campbell, Angela;
- Randolph, Adrienne;
- Patel, Manish
COVID-19 vaccination is recommended for persons who are pregnant, breastfeeding, trying to get pregnant now, or who might become pregnant in the future, to protect them from COVID-19.§ Infants are at risk for life-threatening complications from COVID-19, including acute respiratory failure (1). Evidence from other vaccine-preventable diseases suggests that maternal immunization can provide protection to infants, especially during the high-risk first 6 months of life, through passive transplacental antibody transfer (2). Recent studies of COVID-19 vaccination during pregnancy suggest the possibility of transplacental transfer of SARS-CoV-2-specific antibodies that might provide protection to infants (3-5); however, no epidemiologic evidence currently exists for the protective benefits of maternal immunization during pregnancy against COVID-19 in infants. The Overcoming COVID-19 network conducted a test-negative, case-control study at 20 pediatric hospitals in 17 states during July 1, 2021-January 17, 2022, to assess effectiveness of maternal completion of a 2-dose primary mRNA COVID-19 vaccination series during pregnancy against COVID-19 hospitalization in infants. Among 379 hospitalized infants aged <6 months (176 with COVID-19 [case-infants] and 203 without COVID-19 [control-infants]), the median age was 2 months, 21% had at least one underlying medical condition, and 22% of case- and control-infants were born premature (<37 weeks gestation). Effectiveness of maternal vaccination during pregnancy against COVID-19 hospitalization in infants aged <6 months was 61% (95% CI = 31%-78%). Completion of a 2-dose mRNA COVID-19 vaccination series during pregnancy might help prevent COVID-19 hospitalization among infants aged <6 months.