Effectiveness of First Dose of COVID-19 Vaccines Against Hospital Admissions in Scotland: National Prospective Cohort Study of 5.4 Million People

Vasileiou, Eleftheria; Bradley, Declan; Chuter, Antony; Lusignan, Simon de; Docherty, Annemarie B; Ford, David; Hobbs, F D Richard; Joy, Mark; Katikireddi, Srinivasa Vittal; Marple, James; McCowan, Colin; Simpson, Colin R; McGagh, Dylan; McMenamin, Jim; Moore, Emily; Murray, Janet Horowitz; Pan, Jiafeng; Ritchie, Lewis D; Shah, Syed Ahmar; Stock, Sarah; Torabi, Fatemeh; Tsang, Ruby S M; Robertson, Chris; Wood, Rachael; Woolhouse, Mark; Sheikh, Aziz; Shi, Ting; Kerr, Steven; Agrawal, Utkarsh; Akbari, Ashley; Bedston, Stuart; Beggs, Jillian

doi:10.2139/ssrn.3789264

Cited by 100 publications

(96 citation statements)

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“…The only available data in LTCF residents, from a Danish observational study, suggests that a single dose of BNT162b2 is ineffective in preventing infection, 27 however participants received the second vaccine dose 24 days following the first dose on average, which, based on our findings, is likely too short to capture the protective effects of a single vaccine dose. Two other observational studies report VE from adults aged over 70-80 years, and report similar or slightly higher estimates from 28-34 days, 15,16 although results are not directly comparable to our findings as these studies examine VE against symptomatic infection and hospitalisation only, due to the lack of routine testing outside health and care settings.…”

Section: Discussioncontrasting

confidence: 88%

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Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of Long-Term Care Facilities (VIVALDI study)

Shrotri

Krutikov²,

Palmer³

et al. 2021

Preprint

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Background The effectiveness of SARS-CoV-2 vaccines in frail older adults living in Long-Term Care Facilities (LTCFs) is uncertain. We estimated protective effects of the first dose of ChAdOx1 and BNT162b2 vaccines against infection in this population. Methods Cohort study comparing vaccinated and unvaccinated LTCF residents in England, undergoing routine asymptomatic testing (8 December 2020 - 15 March 2021). We estimated the relative hazard of PCR-positive infection using Cox proportional hazards regression, adjusting for age, sex, prior infection, local SARS-CoV-2 incidence, LTCF bed capacity, and clustering by LTCF. Results Of 10,412 residents (median age 86 years) from 310 LTCFs, 9,160 were vaccinated with either ChAdOx1 (6,138; 67%) or BNT162b2 (3,022; 33%) vaccines. A total of 670,628 person days and 1,335 PCR-positive infections were included. Adjusted hazard ratios (aHRs) for PCR-positive infection relative to unvaccinated residents declined from 28 days following the first vaccine dose to 0.44 (0.24, 0.81) at 28-34 days and 0.38 (0.19, 0.77) at 35-48 days. Similar effect sizes were seen for ChAdOx1 (aHR 0.32 [0.15-0.66] and BNT162b2 (aHR 0.35 [0.17, 0.71]) vaccines at 35-48 days. Mean PCR cycle threshold values were higher, implying lower infectivity, for infections 28 or more days post-vaccination compared with those prior to vaccination (31.3 vs 26.6, p<0.001). Interpretation The first dose of BNT162b2 and ChAdOx1 vaccines was associated with substantially reduced SARS-CoV-2 infection risk in LTCF residents from 4 weeks to at least 7 weeks. Funding UK Government Department of Health and Social Care.

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Section: Discussioncontrasting

confidence: 88%

“…10,11 Consequently, trial estimates of vaccine efficacy may not be generalisable to LTCF residents due to age-related differences in vaccine-induced immune responses. 12–14 Observational data from post-licensure studies in older adults are emerging, 15,16 but few studies report specifically on LTCF populations.…”

Section: Introductionmentioning

confidence: 99%

Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of Long-Term Care Facilities (VIVALDI study)

Shrotri

Krutikov²,

Palmer³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…There is current controversy about the most efficient strategy regarding the use of available vaccines in order to offer a wider population protection[9,10]. In this regards results from the UK suggest a decrease of COVID-19 following a program of single dose vaccination [11]. In addition, this strategy may reduce the exacerbated clinical symptoms associated with the second dose in seropositive individuals [5].…”

Section: Discussionmentioning

confidence: 99%

Impact of previous COVID-19 on immune response after a single dose of BNT162b2 SARS-CoV-2 vaccine

Velasco

Galín

Casas

et al. 2021

Preprint

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“…The emergence of SARS-CoV-2 in December, 2019 and the ensuing pandemic has unveiled the potential of this platform 9-11 . In the United States, more than 80 million people have received one of the two SARS-CoV-2 mRNAbased vaccines that were granted emergency use authorization by the FDA in December, 2020.Both vaccines demonstrated remarkable immunogenicity in phase 1/2 studies and effectiveness in phase 3 studies [1][2][3][4][12][13][14] . Whether these vaccines induce germinal center (GC) reactions that are critical for high-affinity and durable antibody responses has not been examined in humans.…”

mentioning

confidence: 99%

SARS-CoV-2 mRNA vaccines induce a robust germinal centre reaction in humans

Ellebedy¹,

Turner²,

O'Halloran³

et al. 2021

Preprint

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA)-based vaccines are ~95% effective in preventing coronavirus disease 2019. However, the dynamics of antibody secreting plasmablasts (PBs) and germinal centre (GC) B cells induced by these vaccines in SARS-CoV-2 naïve and antigen-experienced humans remains unclear. Here we examined peripheral blood and/or lymph node (LN) antigen-specific B cell responses in 32 individuals who received two doses of BNT162b2, an mRNA-based vaccine encoding the full-length SARS-CoV-2 spike (S) gene. Circulating IgG- and IgA-secreting PBs targeting the S protein peaked one week after the second immunization then declined and were undetectable three weeks later. PB responses coincided with maximal levels of serum anti-S binding and neutralizing antibodies to a historical strain as well as emerging variants, especially in individuals previously infected with SARS-CoV-2, who produced the most robust serological responses. Fine needle aspirates of draining axillary LNs identified GC B cells that bind S protein in all participants sampled after primary immunization. GC responses increased after boosting and were detectable in two distinct LNs in several participants. Remarkably, high frequencies of S-binding GC B cells and PBs were maintained in draining LNs for up to seven weeks after first immunization, with a substantial fraction of the PB pool class-switched to IgA. GC B cell-derived monoclonal antibodies predominantly targeted the RBD, with fewer clones binding to the N-terminal domain or shared epitopes within the S proteins of human betacoronaviruses OC43 and HKU1. Our studies demonstrate that SARS-CoV-2 mRNA-based vaccination of humans induces a robust and persistent GC B cell response that engages pre-existing as well as new B cell clones, which enables generation of high-affinity, broad, and durable humoral immunity.

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Effectiveness of First Dose of COVID-19 Vaccines Against Hospital Admissions in Scotland: National Prospective Cohort Study of 5.4 Million People

Cited by 100 publications

References 0 publications

Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of Long-Term Care Facilities (VIVALDI study)

Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of Long-Term Care Facilities (VIVALDI study)

Impact of previous COVID-19 on immune response after a single dose of BNT162b2 SARS-CoV-2 vaccine

SARS-CoV-2 mRNA vaccines induce a robust germinal centre reaction in humans

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