COVID-19 vaccination significantly reduces risk to pregnant women and baby

New UBC research provides critical data for pregnant women, care providers and policymakers

University of British Columbia

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

Pregnant people who received a COVID-19 vaccine were far less likely to experience severe illness or deliver their babies prematurely, according to a major new UBC-led study published in JAMA. 

Drawing on data from nearly 20,000 pregnancies across Canada, the research found that vaccination was strongly associated with lower risks of hospitalization, intensive care admission and preterm birth. These benefits persisted as the virus evolved from the Delta variant to Omicron, which has evolved into newer sublineages that still dominate today. 

“Our findings provide clear, population-level evidence that COVID-19 vaccination protects pregnant people and their babies from serious complications,” said Dr. Deborah Money, a professor of obstetrics and gynaecology at UBC and senior author of the study. “Even as the virus evolved, vaccination continued to offer substantial benefits for both mother and child.” 

The study was conducted by the national CANCOVID-Preg surveillance network, led by UBC researchers, and represents one of the largest datasets on COVID-19 and pregnancy worldwide. 

The findings revealed that vaccinated people were about 60 per cent less likely to be hospitalized and 90 per cent less likely to require intensive care compared with those unvaccinated at the time of infection. Vaccination was also linked to fewer premature births (deliveries before 37 weeks of pregnancy), reducing the risk by 20 per cent during the Delta wave and 36 per cent during the Omicron wave. 

Notably, the analysis found that people vaccinated during pregnancy, as opposed to before pregnancy, had even lower rates of preterm birth and stillbirth. 

“There is never a bad time to be vaccinated—whether you’re currently pregnant or planning a pregnancy,” said Dr. Elisabeth McClymont, lead author and assistant professor in UBC’s department of obstetrics and gynaecology. “But our data suggest there may be added benefits to receiving the vaccine during pregnancy.”  

Informing maternal vaccine guidelines 

The findings arrive amid evolving vaccine guidance for pregnant people in some jurisdictions.  

In the U.S., the Advisory Committee on Immunization Practices (ACIP) recently did not include a specific recommendation for COVID-19 vaccination during pregnancy in its updated adult immunization schedule. Meanwhile, public health officials in Canada and at the World Health Organization continue to recommend that pregnant people receive a COVID-19 vaccine.  

The researchers say their findings provide timely evidence to inform ongoing policy discussions. 

 “The body of evidence is overwhelmingly clear: COVID-19 vaccination is safe and effective in pregnancy,” said Dr. Money. “These latest findings provide critical information for pregnant women and their care providers and strongly support public health guidance that recommends vaccination during pregnancy.”  

A pan-Canadian effort 

The analysis included data from nine Canadian provinces and one territory. Researchers used population-based health data to track outcomes from nearly 20,000 pregnancies affected by SARS-CoV-2 between April 2021 and December 2022. 

Even after adjusting for age, body mass index, and pre-existing conditions such as hypertension or diabetes, vaccination remained associated with markedly lower risks of hospitalization. 

Beyond COVID-19, researchers say the study underscores the importance of including pregnant people in vaccine research and planning for future respiratory virus outbreaks. 

“Pregnancy is a unique period of vulnerability but also of opportunity for prevention,” said Dr. McClymont. “This study reinforces how vaccination can make a real difference for maternal and newborn health.”  

The study was funded by the Public Health Agency of Canada through the COVID-19 Immunity Task Force, the Canadian Institutes of Health Research and the BC Women’s Health Foundation. 

Interview language(s): English 

---

Journal

JAMA

DOI

10.1001/jama.2025.21001 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

The Role of Vaccination in Maternal and Perinatal Outcomes Associated with COVID-19 in Pregnancy

Article Publication Date

15-Dec-2025

COI Statement

EM has received unrelated honoraria/consultation fees, as well as in-kind study support, from Merck & Co, Inc., as well as funding for unrelated research from Moderna. SB has no conflicts to disclose. LF has no conflicts to disclose. SC has no conflicts to disclose. GA has no conflicts to disclose. IB is funded by a “Fond de Recherche du Québec – Santé” salary award. IB has received consultant fees from Moderna, Pfizer, and Altona outside of the submitted work. KC has no conflicts to disclose. EC has no conflicts to disclose. JC has no conflicts to disclose. VK has no conflicts to disclose. GLC has no conflicts to disclose. PM has no conflicts to disclose. VP has received unrelated honorarium/consultation fees from GSK and SearchLight Pharma. SS has no conflicts to disclose. HS has no conflicts to disclose. PS has no conflicts to disclose. JS has received grant funding for unrelated research from CIHR, the Preeclampsia Foundation, and Roche Diagnostics Ltd. AS has no conflicts to disclose. MY has no conflicts to disclose. DM has ongoing in-kind support from Merck & Co, Inc. for unrelated research. DM has also received past funding for unrelated work from Merck, GSK, Sanofi, and Novartis.

Mayo Clinic smartwatch system helps parents shorten and defuse children's severe tantrums early

Mayo Clinic

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

ROCHESTER, Minn. — Mayo Clinic researchers have developed a smartwatch-based alert system that signals parents at the earliest signs of a tantrum in children with emotional and behavioral disorders — prompting them to intervene before it intensifies.  

In a new study published in JAMA Network Open, these alerts helped parents intervene within four seconds and shortened severe tantrums by an average of 11 minutes — about half the duration seen with standard therapy.  

In this system, a smartwatch worn by the child detects physiological stress signals, such as rising heart rate, or changes in movement or sleep, and sends them to an artificial intelligence (AI)-enabled app on the parent's smartphone. The app analyzes the data in real time and sends an alert as a cue for the parent to connect with their child. 

The findings demonstrate how smartwatch technology can help bridge a gap in pediatric mental healthcare by giving parents actionable support when professional help isn't immediately available. That need is widespread — nearly 1 in 5 U.S. children has a mental, behavioral or emotional health disorder, according to the Centers for Disease Control and Prevention.  

The approach shows how wearable technology, paired with patient-centric AI design, can support families beyond the clinic. 

Study design and results 

In the randomized clinical trial, 50 children aged 3 to 7 receiving Parent-Child Interaction Therapy at Mayo Clinic participated over 16 weeks. Half were assigned to use the smartwatch system, and half continued standard therapy. The study evaluated whether families would use the technology as intended and whether immediate alerts could measurably change parent response times and children's behavior. 

Notably, children wore the smartwatch for about 75% of the study period, demonstrating feasibility and family engagement. 

"This study shows that even small, well-timed interventions can change the trajectory of a child's emotional dysregulation episode," says Magdalena Romanowicz, M.D., a Mayo Clinic child psychiatrist who co-led the study. "These moments give parents a chance to step in with supportive actions — moving closer, offering reassurance, labeling emotions and redirecting attention before a tantrum intensifies." 

Building on earlier research 

This work builds on the team's earlier study, which used a machine learning algorithm to analyze smartwatch data — including heart rate, sleep and movement — to predict disruptive behaviors in hospitalized children receiving psychiatric care. 

That study, published in the Journal of Child and Adolescent Psychopharmacology, showed the algorithm could predict a child's behavioral state with 81% accuracy and provided a 30- to 60-minute advance warning of an impending outburst. 

"This work shows how basic science and clinical research can come together to transform patient care," says Arjun Athreya, Ph.D., who co-led the study and serves on the engineering faculty in Mayo Clinic's Department of Molecular Pharmacology and Experimental Therapeutics. "We've translated inpatient findings to outpatient care, and the results show how data from everyday smart devices can help families in real time." 

Empowering families with data-driven care 

Paul Croarkin, D.O., a Mayo Clinic child and adolescent psychiatrist and study co-author, says the findings highlight the power of data-driven care. "A smartwatch may seem simple, but when it's backed by evidence-based treatments and advanced analytics, it becomes a lifeline for families trying to manage severe behavioral symptoms at home."  

Julia Shekunov, M.D., medical director of Mayo Clinic's Child and Adolescent Psychiatry Inpatient Unit and also a study co-author, says the work addresses an urgent need. "We're seeing more children in crisis, and the severity is increasing. This system gives parents tools they can use immediately, even outside the clinic, to help their child regain control." 

Next steps 

Future studies will refine the system's predictive accuracy, test it in larger groups and assess its long-term benefits in routine outpatient care. 

This study was funded in part by a Mayo Clinic Clinical Trial Stimulus Fund and Mayo Clinic's Center for Individualized Medicine. For a complete list of authors, disclosures and funding, review the study.    

### 

About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. 

---

Journal

JAMA Network Open

Article Publication Date

15-Dec-2025

FOR PROFIT HEALTHCARE U$A

Behavioral health spending spikes to 40% of all children’s health expenditures, nearly doubling in a decade

New study reveals dramatic increase in pediatric behavioral health expenditures while families face mounting out-of-pocket costs

Ann & Robert H. Lurie Children's Hospital of Chicago

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

Behavioral health care has surged to represent 40% of all medical expenditures for U.S. children in 2022, nearly doubling from 22% in 2011, according to a new study published in JAMA Pediatrics. Researchers found that pediatric behavioral health expenditures totaled $41.8 billion in 2022, with families paying $2.9 billion out-of-pocket. Most concerning, out-of-pocket costs for children's behavioral health increased at more than twice the rate of other medical expenses, leaving many families struggling with significant financial burden.

The study analyzed data on nationally representative spending patterns for U.S. children ages 6-17 from 2011 to 2022. Researchers found that pediatric behavioral health out-of-pocket spending increased 6.4% annually, compared to 2.7% annually for non-behavioral health medical spending. By 2022, more than one-quarter of total pediatric out-of-pocket spending for health care was directed toward behavioral health.

          “We were surprised by the magnitude of spending for children’s behavioral health, and especially the dramatically rising out-of-pocket costs for families,” said senior author Kenneth Michelson, MD, MPH, emergency medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago and Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Our findings provide a striking perspective on the youth behavioral health crisis.”

The financial impact on families is substantial. The study found that 1 in 21 U.S. families experiences extreme financial burden due to out-of-pocket health care costs, meaning that more than 10% of family income is allocated towards those costs. Families with at least one child receiving behavioral health services were about 40% more likely to experience extreme financial burden.

“Many families are forced to seek care outside of their insurance network, facing higher out-of-pocket costs for their children’s behavioral health care. Our findings underscore the critical need for adequate networks and improved insurance coverage to reduce the financial burden on families,” said co-author Jennifer Hoffmann, MD, MS, emergency medicine physician at Lurie Children’s and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “We need stronger state-level insurance parity laws, meaning equal insurance coverage for behavioral and non-behavioral health care.”

The study also revealed significant shifts in how and where children receive behavioral health care. Expenditures increased dramatically for home health care (25% per year), outpatient in-person visits (11% per year), and outpatient telehealth visits (99% per year from 2020-2022).

“Telehealth rapidly expanded during the pandemic and is likely to remain a lasting component of behavioral health delivery in the U.S.,” said Dr. Hoffmann. “However, gaps in funding for telehealth remain. Better reimbursement rates are needed. Regulations also need to be adjusted to enable children to access telehealth across state lines.”

Ann & Robert H. Lurie Children’s Hospital of Chicago is a nonprofit organization committed to providing access to exceptional care for every child. It is the only independent, research-driven children’s hospital in Illinois and one of less than 35 nationally. This is where the top doctors go to train, practice pediatric medicine, teach, advocate, research and stay up to date on the latest treatments. Exclusively focused on children, all Lurie Children’s resources are devoted to serving their needs. Research at Lurie Children’s is conducted through Stanley Manne Children’s Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. Emergency medicine-focused research at Lurie Children’s is conducted through the Grainger Research Program in Pediatric Emergency Medicine.  

---

Journal

JAMA Pediatrics

Kids’ behavioral health is a growing

share of family health costs

University of California - San Francisco

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

Mental health, substance use, and other behavioral health care made up 40% of all health expenditures for U.S. children in 2022, according to a new study by researchers at UC San Francisco. That is almost twice what it was in 2011.

The costs to families for this type of care grew more than twice as fast as the costs for other types of medical care. Out-of-pocket spending on behavioral health rose an average of 6.4% each year for families, compared with 2.7% for non-behavioral health care.

“Families are bearing growing costs,” said Ashley Foster, MD, lead author of the study, which appears Dec. 15 in JAMA Pediatrics, and a pediatric emergency care physician at UCSF Benioff Children’s Hospitals. “As a country, we need to make sure behavioral health care is accessible and affordable for every family, regardless of insurance status.”

The researchers reviewed 11 years of national spending data from 2011 through 2022 for children between the ages of 6 and 17. By 2022, behavioral health accounted for $41.8 billion of overall health spending, and families were paying $2.9 billion — more than a quarter of their out of pocket health spending — for this type of care.

Having a child who needs behavioral health care increases a family’s risk of financial hardship.

“Families with at least one child who has behavioral health issues are 60% more likely to face a high financial burden, and 40% more likely to have an extreme financial burden — meaning more than 10% of their family income goes toward that care,” Foster said.

While the study wasn’t designed to investigate causes for the rise in spending, there are some clues in the data.

“It’s likely a combination of a few factors: more children having behavioral health challenges, in part due to the COVID-19 pandemic; a rise in costs per visit over time; and an increase in access to care,” Foster said. “Access has improved thanks to less stigma about mental health challenges and because there are more community-based care venues now.”

The research also revealed shifts in how and where children receive behavioral health treatment. Spending jumped 25% per year for home health services and 11% per year for in-person outpatient visits. The number of telehealth visits spiked 99% per year between 2020 and 2022.  “Telehealth is here to stay,” said Foster.

Journal: JAMA Pediatrics

Co-Authors: Please see the paper.

Funding and Disclosures: None to disclose.

---

Journal

JAMA Pediatrics