Babies too young to be vaccinated had the highest covid hospitalization rate of any age group except people over 75.

The study looked at infant medical data from October 2022 to April 2024 in 12 states and underscores the critical importance of vaccinating pregnant people. It also echoes what physicians have anecdotally reported for more than three years — that people are still skeptical of covid vaccines due to persistent misinformation.

Of the 1,470 infants sick enough to be hospitalized due to covid, severe outcomes occurred “frequently,” according to the report. Excluding newborns hospitalized at birth, about 1 in 5 infants hospitalized with covid required intensive care, and nearly 1 in 20 required a ventilator.

“These aren’t necessarily high-risk, ill newborns. These are just regular, full-term, healthy newborn kids who happen to get covid and wind up on a ventilator in the hospital,” said Neil Silverman, a professor of clinical obstetrics and gynecology and the director of the Infectious Diseases in Pregnancy Program at the David Geffen School of Medicine at UCLA.

Babies can’t get the covid vaccination until they are at least 6 months old. That leaves a “huge window” when infants are most vulnerable, Silverman said. Vaccinating pregnant women so they pass the antibodies on to their newborns is an effective way of protecting babies during that time. Vaccination during pregnancy also protects pregnant people from severe disease.

But persistent vaccine misinformation online has led to skepticism among Silverman’s pregnant patients.

“The most frustrating response that I get from folks is that they need to do more research before they think about getting the covid vaccine,” Silverman said. “We have dozens and dozens of studies showing the safety of the mRNA vaccine. I don’t know how much more research we can provide to skeptics.”

Among the 1,000-plus babies hospitalized with covid, the median age was just 2 months old, according to the report. Nine of the infants died.

South Carolina pediatrician Deborah Greenhouse said she plans to share the study with families she cares for. “There absolutely is a proportion of the population who will look at this and say, ‘Hey, wow, I should get that vaccine. It could protect my baby,’” she said.

Greenhouse believes the new data could solidify the risk of skipping the vaccine when she speaks to families.

“I think that it might help to convince some parents when you can actually show them hospitalization numbers and you can show them intensive care numbers and you can show them mechanical ventilation numbers,” Greenhouse said. “Those things are a big deal.”

Often, Greenhouse waits to be informed that a person is pregnant before bringing up the updated covid shot. Now she’s rethinking that strategy. “As pediatricians we do get moms in our office who are pregnant and we have an opportunity to intervene and to do some education and make them understand how important this is,” she said.

Physicians can encourage vaccination by making it as easy and simple as possible, Silverman said. He encouraged fellow doctors to offer the shots in their offices, rather than sending patients to pharmacies or other providers.

“We lose probably 30 to 40% of vaccination opportunities once someone has to leave the office to get a vaccine,” Silverman said.

But offering covid shots in their clinics leaves some doctors with a difficult calculation. They are struggling to predict how many patients will be interested in the vaccine and may not be able to return all their excess doses. Many providers can’t afford to lose money on doses that won’t be used, but they still need to order enough to vaccinate vulnerable patients who want the shot.

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Los hallazgos aparecen en el Informe Semanal de Morbilidad y Mortalidad de la agencia.

Los bebés que fueron demasiado pequeños para vacunarse tuvieron la tasa de hospitalización por covid más alta de cualquier grupo de edad, excepto las personas mayores de 75 años.

El estudio, que analizó los datos médicos de bebés desde octubre de 2022 hasta abril de 2024 en 12 estados, subraya la importancia crítica de vacunar a las embarazadas. También refuerza lo que los médicos han informado anecdóticamente durante más de tres años: que la gente sigue siendo escéptica sobre las vacunas contra covid debido a la desinformación persistente.

De los 1,470 bebés lo suficientemente enfermos como para ser hospitalizados debido a covid, los resultados graves ocurrieron “con frecuencia”, según el informe. Excluyendo a los recién nacidos hospitalizados al nacer, alrededor de 1 de cada 5 bebés que tuvieron que ser internados con covid requirió cuidados intensivos, y casi 1 de cada 20 necesitó un ventilador.

“Estos no son necesariamente recién nacidos de alto riesgo o enfermos. Estos son solo recién nacidos regulares, a término y saludables que contraen covid y terminan en un ventilador en el hospital”, dijo Neil Silverman, profesor de obstetricia y ginecología clínica y director del Programa de Enfermedades Infecciosas en el Embarazo en la Escuela de Medicina David Geffen de UCLA.

Los bebés no pueden recibir la vacuna contra covid hasta que tienen al menos 6 meses. Eso deja una “gran ventana” cuando los bebés son más vulnerables, dijo Silverman. Vacunar a las mujeres embarazadas para que transmitan los anticuerpos a sus recién nacidos es una forma efectiva de proteger a los bebés durante ese tiempo. La vacunación durante el embarazo también protege a las personas embarazadas de enfermedades graves.

Pero la desinformación persistente sobre las vacunas que circula en internet ha generado escepticismo entre las pacientes embarazadas de Silverman.

“La respuesta más frustrante que recibo de la gente es que necesitan investigar más antes de considerar ponerse la vacuna contra covid”, dijo Silverman. “Tenemos decenas y decenas de estudios que muestran la seguridad de la vacuna de ARNm. No sé cuánta más investigación podemos proporcionar a los escépticos”.

Entre los más de 1,000 bebés hospitalizados con covid, la edad media fue de solo 2 meses, según el informe. Nueve de los bebés murieron.

Deborah Greenhouse, pediatra de Carolina del Sur, dijo que planea compartir el estudio con las familias que atiende. “Definitivamente hay una proporción de la población que mirará esto y dirá: ‘Oh, debería recibir esa vacuna. Podría proteger a mi bebé’”, dijo.

Greenhouse cree que los nuevos datos podrían ser una prueba sólida del riesgo de saltarse la vacuna cuando hable con las familias.

“Creo que podría ayudar a convencer a algunos padres cuando se les pueden mostrar los números de hospitalización, los números de cuidados intensivos y los números de ventilación mecánica”, dijo Greenhouse. “Esas cosas son importantes”.

A menudo, Greenhouse espera a que se le informe que una persona está embarazada antes de mencionar la vacuna actualizada contra covid. Ahora está repensando esa estrategia. “Como pediatras, tenemos mamás en nuestra consulta que están embarazadas y tenemos la oportunidad de intervenir, educarlas y hacerles entender lo importante que es esto”, dijo.

Los médicos pueden alentar la vacunación haciéndola lo más fácil y simple posible, dijo Silverman. Animó a sus colegas médicos a ofrecerlas en sus consultas, en lugar de enviar a los pacientes a farmacias u otros proveedores.

“Probablemente perdemos entre el 30 y el 40% de las oportunidades de vacunación una vez que alguien tiene que salir del consultorio para vacunarse”, dijo Silverman.

Pero ofrecer las vacunas contra covid en sus clínicas deja a algunos médicos con un cálculo difícil. Están luchando por predecir cuántos pacientes estarán interesados en la vacuna y pueden no ser capaces de devolver todas sus dosis sobrantes. Muchos proveedores no pueden permitirse perder dinero en dosis que no se usarán, pero aún necesitan pedir lo suficiente para vacunar a los pacientes vulnerables que quieren la vacuna.

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“This is where we usually store our covid vaccines, but we don’t have any right now because they all expired at the end of last year and we had to dispose of them,” said Ball, who is part of a pediatric practice in Orange County, California.

“We thought demand would be way higher than it was.”

Pediatricians across the country are pre-ordering the updated and reformulated covid-19 vaccine for the fall and winter respiratory virus season, but some doctors said they’re struggling to predict whether parents will be interested. Providers like Ball don’t want to waste money ordering doses that won’t be used, but they need enough on hand to vaccinate vulnerable children.

The Centers for Disease Control and Prevention recommends that anyone 6 months or older get the updated covid vaccination, but in the 2023-24 vaccination season only about 15% of eligible children in the U.S. got a shot.

Ball said it was difficult to let vaccines go to waste last year. It was the first time the federal government was no longer picking up the tab for the shots, and providers had to pay upfront for the vaccines. Parents would often skip the covid shot, which can have a very short shelf life compared with other vaccines.

“Watching it sitting on our shelves expiring every 30 days, that’s like throwing away $150 repeatedly every day, multiple times a month,” Ball said.

This year, Ball slashed his fall vaccine order to the bare minimum to avoid another costly mistake.

“We took the number of flu vaccines that we order, and then we ordered 5% of that in covid vaccines,” Ball said. “It’s a guess.”

That small vaccine order cost more than $63,000, he said.

Pharmacists, pharmacy interns, and techs are allowed to give covid vaccines only to children age 3 and up, meaning babies and toddlers would need to visit a doctor’s office for inoculation.

It’s difficult to predict how parents will feel about the shots this fall, said Chicago pediatrician Scott Goldstein. Unlike other vaccinations, covid shots aren’t required for kids to attend school, and parental interest seems to wane with each new formulation, he said. For a physician-owned practice such as Goldstein’s, the upfront cost of the vaccine can be a gamble.

“The cost of vaccines, that’s far and away our biggest expense. But it’s also the most important thing we do, you could argue, is vaccinating kids,” Goldstein said.

Insurance doesn’t necessarily cover vaccine storage accidents, which can put the practice at risk of financial ruin.

“We’ve had things happen like a refrigerator gets unplugged. And then we’re all of a sudden out $80,000 overnight,” Goldstein said.

South Carolina pediatrician Deborah Greenhouse said she would order more covid vaccines for older children if the pharmaceutical companies that she buys from had a more forgiving return policy.

“Pfizer is creating that situation. If you’re only going to let us return 30%, we’re not going to buy much,” she said. “We can’t.”

Greenhouse owns her practice, so the remaining 70% of leftover shots would come out of her pocket.

Vaccine maker Pfizer will take back all unused covid shots for young children, but only 30% of doses for people 12 and older.

Pfizer said in an Aug. 20 emailed statement, “The return policy was instituted as we recognize both the importance and the complexity of pediatric vaccination and wanted to ensure that pediatric offices did not have hurdles to providing vaccine to their young patients.”

Pfizer’s return policy is similar to policies from other drugmakers for pediatric flu vaccines, also recommended during the fall season. Physicians who are worried about unwanted covid vaccines expiring on the shelves said flu shots cost them about $20 per dose, while covid shots cost around $150 per dose.

“We run on a very thin margin. If we get stuck holding a ton of vaccine that we cannot return, we can’t absorb that kind of cost,” Greenhouse said.

Vaccine maker Moderna will accept covid vaccine returns, but the amount depends on the individual contract with a provider. Novavax will accept the return of only unopened vaccines and doesn’t specify the amount they’ll accept.

Greenhouse wants to vaccinate as many children as possible but said she can’t afford to stock shots with a short shelf life. Once she runs out of the doses she’s ordered, Greenhouse said, she plans to tell families to go to a pharmacy to get older children vaccinated. If pediatricians around the country are making the same calculations, doses for very small children could be harder to find at doctors’ offices.

“Frankly, it’s not an ideal situation, but it’s what we have to do to stay in business,” she said.

Ball, the California pediatrician, worries that parents’ limited interest has caused pediatricians to minimize their vaccine orders, in turn making the newest covid shots difficult to find once they become available.

“I think there’s just a misperception that it’s less of a big deal to get covid, but I’m still sending babies to the hospital with covid,” Ball said. “We’re still seeing kids with long covid. This is with us forever.”

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