Maternal third dose of BNT162b2 mRNA vaccine and risk of infant COVID-19 hospitalization

Michal Lipschuetz, Joshua Guedalia, Sarah M. Cohen, Yishai Sompolinsky, Galit Shefer, Eli Melul, Zivanit Ergaz-Shaltiel, Debra Goldman-Wohl, Simcha Yagel, Ronit Calderon-Margalit, Ofer Beharier*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Infants are at a higher risk of Coronavirus Disease 2019 (COVID-19)-related hospitalizations compared to older children. In this study, we investigated the effect of the recommended third maternal dose of BNT162b2 COVID-19 vaccine during pregnancy on rates of infant COVID-19-related hospitalizations. We conducted a nationwide cohort study of all live-born infants delivered in Israel between 24 August 2021 and 15 March 2022 to estimate the effectiveness of the third booster dose versus the second dose against infant COVID-19-related hospitalizations. Data were analyzed for the overall study period, and the Delta and Omicron periods were analyzed separately. Cox proportional hazard regression models estimated hazard ratios and 95% confidence intervals (CIs) for infant hospitalizations according to maternal vaccination status at delivery. Among 48,868 live-born infants included in the analysis, rates of COVID-19 hospitalization were 0.4%, 0.6% and 0.7% in the third-dose, second-dose and unvaccinated groups, respectively. Compared to the second dose, the third dose was associated with reduced infant hospitalization with estimated effectiveness of 53% (95% CI: 36–65%). Greater protection was associated with a shorter interval between vaccination and delivery. A third maternal dose during pregnancy reduced the risk of infant hospitalization for COVID-19 during the first 4 months of life, supporting clinical and public health guidance for maternal booster vaccination to prevent infant COVID-19 hospitalization.

Original languageAmerican English
Pages (from-to)1155–1163
Number of pages9
JournalNature Medicine
Issue number5
StatePublished - May 2023

Bibliographical note

Funding Information:
This study was supported by the Magda and Richard Hoffman Center for Human Placental Research and the ‘Ofek’ Program of the Hadassah Medical Center. The grantors had no role in the conduct of the study or the writing of the manuscript.

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature America, Inc.


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