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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
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URI: https://cronfa.swan.ac.uk/Record/cronfa61634
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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.</abstract><type>Journal Article</type><journal>International Journal of Epidemiology</journal><volume>52</volume><journalNumber>1</journalNumber><paginationStart>22</paginationStart><paginationEnd>31</paginationEnd><publisher>Oxford University Press (OUP)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0300-5771</issnPrint><issnElectronic>1464-3685</issnElectronic><keywords>COVID-19, vaccine effectiveness, vaccine waning</keywords><publishedDay>8</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-02-08</publishedDate><doi>10.1093/ije/dyac199</doi><url>http://dx.doi.org/10.1093/ije/dyac199</url><notes>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.</notes><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><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.</funders><projectreference/><lastEdited>2023-06-27T16:33:49.9923819</lastEdited><Created>2022-10-23T21:27:12.1925952</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Steven</firstname><surname>Kerr</surname><order>1</order></author><author><firstname>Stuart</firstname><surname>Bedston</surname><order>2</order></author><author><firstname>Declan T</firstname><surname>Bradley</surname><order>3</order></author><author><firstname>Mark</firstname><surname>Joy</surname><order>4</order></author><author><firstname>Emily</firstname><surname>Lowthian</surname><order>5</order></author><author><firstname>Rachel M</firstname><surname>Mulholland</surname><order>6</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>7</order></author><author><firstname>F D Richard</firstname><surname>Hobbs</surname><order>8</order></author><author><firstname>Srinivasa Vittal</firstname><surname>Katikireddi</surname><orcid>0000-0001-6593-9092</orcid><order>9</order></author><author><firstname>Simon de</firstname><surname>Lusignan</surname><orcid>0000-0002-8553-2641</orcid><order>10</order></author><author><firstname>Igor</firstname><surname>Rudan</surname><order>11</order></author><author><firstname>Fatemeh</firstname><surname>Torabi</surname><orcid>0000-0002-5853-4625</orcid><order>12</order></author><author><firstname>Ruby S M</firstname><surname>Tsang</surname><order>13</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>14</order></author><author><firstname>Chris</firstname><surname>Robertson</surname><order>15</order></author><author><firstname>Aziz</firstname><surname>Sheikh</surname><order>16</order></author></authors><documents><document><filename>61634__27618__209c0c61c5b747d2bb2503e37a8e15d7.pdf</filename><originalFilename>61634.VOR.pdf</originalFilename><uploaded>2023-05-26T11:14:17.2951022</uploaded><type>Output</type><contentLength>800939</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: The Author(s) 2022. 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spelling v2 61634 2022-10-23 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 c79d07eaba5c9515c0df82b372b76a41 Stuart Bedston Stuart Bedston true false db5bc529b8a9dfca2b4a268d14e03479 Emily Lowthian Emily Lowthian true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false f569591e1bfb0e405b8091f99fec45d3 0000-0002-5853-4625 Fatemeh Torabi Fatemeh Torabi true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2022-10-23 HDAT 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. Journal Article International Journal of Epidemiology 52 1 22 31 Oxford University Press (OUP) 0300-5771 1464-3685 COVID-19, vaccine effectiveness, vaccine waning 8 2 2023 2023-02-08 10.1093/ije/dyac199 http://dx.doi.org/10.1093/ije/dyac199 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. COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 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. 2023-06-27T16:33:49.9923819 2022-10-23T21:27:12.1925952 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Steven Kerr 1 Stuart Bedston 2 Declan T Bradley 3 Mark Joy 4 Emily Lowthian 5 Rachel M Mulholland 6 Ashley Akbari 0000-0003-0814-0801 7 F D Richard Hobbs 8 Srinivasa Vittal Katikireddi 0000-0001-6593-9092 9 Simon de Lusignan 0000-0002-8553-2641 10 Igor Rudan 11 Fatemeh Torabi 0000-0002-5853-4625 12 Ruby S M Tsang 13 Ronan Lyons 0000-0001-5225-000X 14 Chris Robertson 15 Aziz Sheikh 16 61634__27618__209c0c61c5b747d2bb2503e37a8e15d7.pdf 61634.VOR.pdf 2023-05-26T11:14:17.2951022 Output 800939 application/pdf Version of Record true Copyright: The Author(s) 2022. Distributed under the terms of a Creative Commons Attribution 4.0 License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
title 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
spellingShingle 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
Stuart Bedston
Emily Lowthian
Ashley Akbari
Fatemeh Torabi
Ronan Lyons
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
author_id_str_mv c79d07eaba5c9515c0df82b372b76a41
db5bc529b8a9dfca2b4a268d14e03479
aa1b025ec0243f708bb5eb0a93d6fb52
f569591e1bfb0e405b8091f99fec45d3
83efcf2a9dfcf8b55586999d3d152ac6
author_id_fullname_str_mv c79d07eaba5c9515c0df82b372b76a41_***_Stuart Bedston
db5bc529b8a9dfca2b4a268d14e03479_***_Emily Lowthian
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
f569591e1bfb0e405b8091f99fec45d3_***_Fatemeh Torabi
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Stuart Bedston
Emily Lowthian
Ashley Akbari
Fatemeh Torabi
Ronan Lyons
author2 Steven Kerr
Stuart Bedston
Declan T Bradley
Mark Joy
Emily Lowthian
Rachel M Mulholland
Ashley Akbari
F D Richard Hobbs
Srinivasa Vittal Katikireddi
Simon de Lusignan
Igor Rudan
Fatemeh Torabi
Ruby S M Tsang
Ronan Lyons
Chris Robertson
Aziz Sheikh
format Journal article
container_title International Journal of Epidemiology
container_volume 52
container_issue 1
container_start_page 22
publishDate 2023
institution Swansea University
issn 0300-5771
1464-3685
doi_str_mv 10.1093/ije/dyac199
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
url http://dx.doi.org/10.1093/ije/dyac199
document_store_str 1
active_str 0
description 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.
published_date 2023-02-08T16:33:45Z
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score 11.036684

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