Background The ChAdOx1 nCoV-19 (AZD1222) vaccine has been approved for emergency use by the UK regulatory authority, Medicines and Healthcare products Regulatory Agency, with a regimen of two standard doses given with an interval of 4–12 weeks. The planned roll-out in the UK will involve vaccinating people in high-risk categories with their first dose immediately, and delivering the second dose 12 weeks later. Here, we provide both a further prespecified pooled analysis of trials of ChAdOx1 nCoV-19 and exploratory analyses of the impact on immunogenicity and efficacy of extending the interval between priming and booster doses. In addition, we show the immunogenicity and protection afforded by the first dose, before a booster dose has been offered. Methods We present data from three single-blind randomised controlled trials—one phase 1/2 study in the UK (COV001), one phase 2/3 study in the UK (COV002), and a phase 3 study in Brazil (COV003)—and one double-blind phase 1/2 study in South Africa (COV005). As previously described, individuals 18 years and older were randomly assigned 1:1 to receive two standard doses of ChAdOx1 nCoV-19 (5 × 10 10 viral particles) or a control vaccine or saline placebo. In the UK trial, a subset of participants received a lower dose (2·2 × 10 10 viral particles) of the ChAdOx1 nCoV-19 for the first dose. The primary outcome was virologically confirmed symptomatic COVID-19 disease, defined as a nucleic acid amplification test (NAAT)-positive swab combined with at least one qualifying symptom (fever ≥37·8°C, cough, shortness of breath, or anosmia or ageusia) more than 14 days after the second dose. Secondary efficacy analyses included cases occuring at least 22 days after the first dose. Antibody responses measured by immunoassay and by pseudovirus neutralisation were exploratory outcomes. All cases of COVID-19 with a NAAT-positive swab were adjudicated for inclusion in the analysis by a masked independent endpoint review committee. The primary analysis included all participants who were SARS-CoV-2 N protein seronegative at baseline, had had at least 14 days of follow-up after the second dose, and had no evidence of previous SARS-CoV-2 infection from NAAT swabs. Safety was assessed in all participants who received at least one dose. The four trials are registered at ISRCTN89951424 (COV003) and ClinicalTrials.gov , NCT04324606 (COV001), NCT04400838 (COV002), and NCT04444674 (COV005). Findings Between April 23 and Dec 6, 2020, 24 422 participants were recruited and vaccinated across the four studies, of whom 17 178 were included in the primary analysis (8597 receiving ChAdOx1 nCoV-19 and 8581 receiving control vaccine). The data cutoff for these analyses was Dec 7, 2020. 332 NAAT-positive infections met the primary endpoint of symptomatic infection more t...

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all at affiliation 2); Miles W. Carroll (at affiliation 7); and Annina Schmid (at affiliation 9). Also, two author names (Rachel Varughes and Gary Mallett) were incorrect; the correct names are 'Rachel Varughese' and 'Garry Mallett' (respectively). The errors have been corrected in the HTML and PDF versions of the article.

Abstract. We surveyed 377 undergraduates, half in the spring (i.e., before COVID-19) and half in the fall (i.e., during COVID-19) term of 2020 on explicit attitudes toward and intention to work with older adults (OAs). We asked open-ended questions about their attitudes toward OAs resulting from COVID-19. We found significant differences with small effect sizes between the cohorts on explicit ageism. Thematic content analyses found that most students themselves did not perceive a change in their explicit attitudes toward OAs. Negative ageism predicted intention to work with OAs for the spring cohort, but this shifted to positive ageism for the fall cohort.

Ageism is recognized around the world as detrimental to older adults’ health and well-being, and there are differences in how cultures view older adults. Infrequently are ageist attitudes among cultures compared within one study. Here, we sought to examine views on older adults across cultures in a sample of university students attending school in North America (n=31). As part of a larger survey of ageist attitudes, we conducted a thematic analysis on open-ended responses to the question “How are older adults viewed in your culture?” Half of the respondents were international students. Results found similarities and differences between groups. First, both groups saw older adults as individuals who are and should be respected. Second, however, North American students viewed older adults as “important” and “role models”, whereas international students viewed older adults as “leaders” of and at the “head of the family”. Third, North American students saw older adults as “needing extra help.” In contrast, international students reported that families “should provide care” as a duty or responsibility. Fourth, North American students believed older adults provide “wisdom,” “love,” and “support” but the international students felt older adults provided knowledge, experience, and opinions that are valued by the family and society that are important to decision making. Finally, North American students describe negative perceptions and experiences with older adults, which was completely absent from the international students responses. Results are discussed in a cultural context of personal and formal relationships with elders.

The COVID-19 pandemic has shed light on the far reaches of ageism in our society. The current study sought to better understand ageist beliefs in Canadian undergraduate students during the pandemic. As part of a larger survey on ageism, we conducted a thematic analysis on open-ended responses to the following questions: 1) “Has your relationship with older adults in your life changed as a result of the COVID-19 pandemic?” and 2) “Have you noticed that attitudes or opinions towards older adults in your community have changed as a result of the COVID-19 pandemic?” Students felt that older adults should be treated differently during the pandemic because they are seen as “high risk” or “vulnerable.” Furthermore, students felt that they needed to be more cautious around older adults because older adults need to be taken care of. Students expressed fear about transmitting the virus to older adults in their lives so chose to isolate from grandparents or avoid older adults in the community in an effort to keep them safe. Finally, examples of negative and positive ageism were present in responses. Negative ageism was seen in comments about how older adults were going to die anyway, the assumption that older adults need more help, and the belief that older adults should be staying home during the pandemic. Positive ageism was present where students realized the importance of their relationships with the older adults in their lives. Results are discussed using the framework of implicit and explicit ageism.