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Waning of first- and second-dose ChAdOx1 and BNT162b2 COVID-19 vaccinations: a pooled target trial study of 12.9 million individuals in England, Northern Ireland, Scotland and Wales

Steven Kerr, Stuart Bedston, Declan T Bradley, Mark Joy, Emily Lowthian, Rachel M Mulholland, Ashley Akbari Orcid Logo, F D Richard Hobbs, Srinivasa Vittal Katikireddi Orcid Logo, Simon de Lusignan Orcid Logo, Igor Rudan, Fatemeh Torabi Orcid Logo, Ruby S M Tsang, Ronan Lyons Orcid Logo, Chris Robertson, Aziz Sheikh

International Journal of Epidemiology, Volume: 52, Issue: 1, Pages: 22 - 31

Swansea University Authors: Stuart Bedston, Emily Lowthian, Ashley Akbari Orcid Logo, Fatemeh Torabi Orcid Logo, Ronan Lyons Orcid Logo

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DOI (Published version): 10.1093/ije/dyac199

Abstract

Background: Several SARS-CoV-2 vaccines have been shown to provide protection against COVID-19 hospitalization and death. However, some evidence suggests that notable waning in effectiveness against these outcomes occurs within months of vaccination. We undertook a pooled analysis across the four na...

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Published in: International Journal of Epidemiology
ISSN: 0300-5771 1464-3685
Published: Oxford University Press (OUP) 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa61634
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Abstract: Background: Several SARS-CoV-2 vaccines have been shown to provide protection against COVID-19 hospitalization and death. However, some evidence suggests that notable waning in effectiveness against these outcomes occurs within months of vaccination. We undertook a pooled analysis across the four nations of the UK to investigate waning in vaccine effectiveness (VE) and relative vaccine effectiveness (rVE) against severe COVID-19 outcomes. Methods: We carried out a target trial design for first/second doses of ChAdOx1(Oxford–AstraZeneca) and BNT162b2 (Pfizer–BioNTech) with a composite outcome of COVID-19 hospitalization or death over the period 8 December 2020 to 30 June 2021. Exposure groups were matched by age, local authority area and propensity for vaccination. We pooled event counts across the four UK nations. Results: For Doses 1 and 2 of ChAdOx1 and Dose 1 of BNT162b2, VE/rVE reached zero by approximately Days 60–80 and then went negative. By Day 70, VE/rVE was –25% (95% CI: –80 to 14) and 10% (95% CI: –32 to 39) for Doses 1 and 2 of ChAdOx1, respectively, and 42% (95% CI: 9 to 64) and 53% (95% CI: 26 to 70) for Doses 1 and 2 of BNT162b2, respectively. rVE for Dose 2 of BNT162b2 remained above zero throughout and reached 46% (95% CI: 13 to 67) after 98 days of follow-up. Conclusions: We found strong evidence of waning in VE/rVE for Doses 1 and 2 of ChAdOx1, as well as Dose 1 of BNT162b2. This evidence may be used to inform policies on timings of additional doses of vaccine.
Item Description: Data availability:All code, metadata and documentation for this project is publicly available at https://github.com/EAVE-II/Covid-vaccine-waningpooled. Most of the data that were used in this study are highly sensitive and will not be made available publicly.
Keywords: COVID-19, vaccine effectiveness, vaccine waning
College: Faculty of Medicine, Health and Life Sciences
Funders: This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058). The Honest Broker Service (HBS) is funded by the Business Services Organisation (BSO) and the Department of Health for Northern Ireland. This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1). This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and the Wellcome Trust. This work was supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence that supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyse anonymized data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales.
Issue: 1
Start Page: 22
End Page: 31

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