Ben Glampson1, James Brittain2, Amit Kaura3, Abdulrahim Mulla2, Luca Mercuri2, Stephen J Brett3, Paul Aylin4, Tessa Sandall5, Ian Goodman5, Julian Redhead1, Kavitha Saravanakumar5, Erik K Mayer2,1. 1. NIHR Imperial Biomedical Research Centre, Imperial College Healthcare NHS Trust, Praed Street, W2 1NY, London, UK, London, GB. 2. Department of Surgery & Cancer, Imperial College London, 10th Floor QEQM building, St Marys Hospital Campus, Praed Street, W2 1NY, London, UK, 10th Floor QEQM building, St Marys Hospital CampusPraed Street, London, GB. 3. Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, W12 0HS, London, UK, London, GB. 4. School of Public Health, Imperial College London, Medical School Building, St Mary's Hospital, W2 1PG, London, UK, London, GB. 5. North West London Collaboration of Clinical Commissioning Groups, 15 Marylebone Road, NW1 5JD, London, UK;, London, GB.
Abstract
BACKGROUND: On March 11, 2020 the World Health Organisation declared the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causing Coronavirus Disease 2019 (COVID-19) syndrome, as a pandemic. The UK mass vaccination programme commenced on December 08, 2020 vaccinating groups of the population deemed to be most vulnerable to severe COVID-19 infection. OBJECTIVE: To assess the early vaccine administration coverage and outcome data across an integrated care system in North West London (NWL), leveraging a unique population-level care dataset. Vaccine effectiveness of a single dose of the Oxford/Astrazeneca and Pfizer/BioNtech vaccines were compared. METHODS: A retrospective cohort study identified 2,183,939 individuals eligible for COVID-19 vaccination between December 08, 2020 and February 24, 2021 within a primary, secondary and community care integrated care dataset. These data were used to assess vaccination hesitancy across ethnicity, gender and socio-economic deprivation measures (Pearson Product-Moment Correlations); investigated COVID-19 transmission related to vaccination hubs; and assessed the early effectiveness of COVID-19 vaccination (after a single dose) using time to event analyses with multivariable Cox regression analysis to investigate if vaccination independently predicted positive SARS-CoV-2 in those vaccinated compared to those unvaccinated. RESULTS: In the study 5.88% (24,332/413,919) of individuals declined and did not receive a vaccination. Black or Black British individuals had the highest rate of declining a vaccine at 16.14% (4,337/26,870). There was a strong negative association between socio-economic deprivation and rate of declining vaccination (r=-0.94, P=.002) with 13.5% (1980/14571) of individuals declining vaccination in the most deprived areas compared to 0.98% (869/9609) in the least. In the first six days after vaccination 344 of 389587 individuals tested positive for SARS-CoV-2 (0.09%). The rate increased to 0.13% (525/389,243) between days 7 and 13, before then gradually falling week on week. At 28 days post vaccination there was a 74% (HR 0.26 (0.19-0.35)) and 78% (HR 0.22 (0.18-0.27)) reduction in risk of testing positive for SARS-CoV-2 for individuals that received the Oxford/Astrazeneca and Pfizer/BioNTech vaccines respectively, when compared with unvaccinated individuals. A very low proportion of hospital admissions were seen in vaccinated individuals who tested positive for SARS-CoV-2 (0.01% of all patients vaccinated) providing evidence for vaccination effectiveness, after a single dose. CONCLUSIONS: There was no definitive evidence to suggest COVID-19 was transmitted as a result of vaccination hubs during the vaccine administration roll-out in NWL, and the risk of contracting COVID-19 and/or becoming hospitalised after vaccination has been demonstrated to be very low in the vaccinated population. This study provides further evidence that a single dose of either the Pfizer/BioNTech vaccine or the Oxford/Astrazeneca vaccine is effective at reducing the risk of testing positive for COVID-19 up to 60 days across all age groups, ethnic groups, and risk categories in an urban UK population.
BACKGROUND: On March 11, 2020 the World Health Organisation declared the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causing Coronavirus Disease 2019 (COVID-19) syndrome, as a pandemic. The UK mass vaccination programme commenced on December 08, 2020 vaccinating groups of the population deemed to be most vulnerable to severe COVID-19infection. OBJECTIVE: To assess the early vaccine administration coverage and outcome data across an integrated care system in North West London (NWL), leveraging a unique population-level care dataset. Vaccine effectiveness of a single dose of the Oxford/Astrazeneca and Pfizer/BioNtech vaccines were compared. METHODS: A retrospective cohort study identified 2,183,939 individuals eligible for COVID-19 vaccination between December 08, 2020 and February 24, 2021 within a primary, secondary and community care integrated care dataset. These data were used to assess vaccination hesitancy across ethnicity, gender and socio-economic deprivation measures (Pearson Product-Moment Correlations); investigated COVID-19 transmission related to vaccination hubs; and assessed the early effectiveness of COVID-19 vaccination (after a single dose) using time to event analyses with multivariable Cox regression analysis to investigate if vaccination independently predicted positive SARS-CoV-2 in those vaccinated compared to those unvaccinated. RESULTS: In the study 5.88% (24,332/413,919) of individuals declined and did not receive a vaccination. Black or Black British individuals had the highest rate of declining a vaccine at 16.14% (4,337/26,870). There was a strong negative association between socio-economic deprivation and rate of declining vaccination (r=-0.94, P=.002) with 13.5% (1980/14571) of individuals declining vaccination in the most deprived areas compared to 0.98% (869/9609) in the least. In the first six days after vaccination 344 of 389587 individuals tested positive for SARS-CoV-2 (0.09%). The rate increased to 0.13% (525/389,243) between days 7 and 13, before then gradually falling week on week. At 28 days post vaccination there was a 74% (HR 0.26 (0.19-0.35)) and 78% (HR 0.22 (0.18-0.27)) reduction in risk of testing positive for SARS-CoV-2 for individuals that received the Oxford/Astrazeneca and Pfizer/BioNTech vaccines respectively, when compared with unvaccinated individuals. A very low proportion of hospital admissions were seen in vaccinated individuals who tested positive for SARS-CoV-2 (0.01% of all patients vaccinated) providing evidence for vaccination effectiveness, after a single dose. CONCLUSIONS: There was no definitive evidence to suggest COVID-19 was transmitted as a result of vaccination hubs during the vaccine administration roll-out in NWL, and the risk of contracting COVID-19 and/or becoming hospitalised after vaccination has been demonstrated to be very low in the vaccinated population. This study provides further evidence that a single dose of either the Pfizer/BioNTech vaccine or the Oxford/Astrazeneca vaccine is effective at reducing the risk of testing positive for COVID-19 up to 60 days across all age groups, ethnic groups, and risk categories in an urban UK population.
Authors: Eva S L Pedersen; Maria Christina Mallet; Yin Ting Lam; Sara Bellu; Isabelle Cizeau; Fiona Copeland; Trini Lopez Fernandez; Michele Manion; Amanda L Harris; Jane S Lucas; Francesca Santamaria; Myrofora Goutaki; Claudia E Kuehni Journal: Vaccines (Basel) Date: 2021-12-17
Authors: Ruth Elizabeth Watkinson; Richard Williams; Stephanie Gillibrand; Caroline Sanders; Matt Sutton Journal: PLoS Med Date: 2022-03-03 Impact factor: 11.069
Authors: Amit Kaura; Adam Trickey; Anoop S V Shah; Umberto Benedetto; Ben Glampson; Abdulrahim Mulla; Luca Mercuri; Sanjay Gautama; Ceire E Costelloe; Ian Goodman; Julian Redhead; Kavitha Saravanakumar; Erik Mayer; Jamil Mayet Journal: EClinicalMedicine Date: 2022-03-12
Authors: Thomas Harder; Judith Koch; Sabine Vygen-Bonnet; Wiebe Külper-Schiek; Antonia Pilic; Sarah Reda; Stefan Scholz; Ole Wichmann Journal: Euro Surveill Date: 2021-07