| Title: |
Effectiveness of mRNA COVID-19 Vaccines as First Booster Doses in England: An Observational Study in OpenSAFELY-TPP. |
| Authors: |
Horne, Elsie MF; Hulme, William J; Parker, Edward PK; Keogh, Ruth H; Williamson, Elizabeth J; Walker, Venexia M; Palmer, Tom M; Denholm, Rachel; Knight, Rochelle; Curtis, Helen J; Walker, Alex J; Andrews, Colm D; Mehrkar, Amir; Morley, Jessica; MacKenna, Brian; Bacon, Sebastian CJ; Goldacre, Ben; Hernán, Miguel A; Sterne, Jonathan AC; and the OpenSAFELY collaborative |
| Publisher Information: |
Lippincott, Williams & Wilkins |
| Publication Year: |
2024 |
| Collection: |
London School of Hygiene & Tropical Medicine: LSHTM Research Online |
| Description: |
BACKGROUND: The UK delivered its first "booster" COVID-19 vaccine doses in September 2021, initially to individuals at high risk of severe disease, then to all adults. The BNT162b2 Pfizer-BioNTech vaccine was used initially, then also Moderna mRNA-1273. METHODS: With the approval of the National Health Service England, we used routine clinical data to estimate the effectiveness of boosting with BNT162b2 or mRNA-1273 compared with no boosting in eligible adults who had received two primary course vaccine doses. We matched each booster recipient with an unboosted control on factors relating to booster priority status and prior COVID-19 immunization. We adjusted for additional factors in Cox models, estimating hazard ratios up to 182 days (6 months) following booster dose. We estimated hazard ratios overall and within the following periods: 1-14, 15-42, 43-69, 70-97, 98-126, 127-152, and 155-182 days. Outcomes included a positive SARS-CoV-2 test, COVID-19 hospitalization, COVID-19 death, non-COVID-19 death, and fracture. RESULTS: We matched 8,198,643 booster recipients with unboosted controls. Adjusted hazard ratios over 6-month follow-up were: positive SARS-CoV-2 test 0.75 (0.74, 0.75); COVID-19 hospitalization 0.30 (0.29, 0.31); COVID-19 death 0.11 (0.10, 0.14); non-COVID-19 death 0.22 (0.21, 0.23); and fracture 0.77 (0.75, 0.78). Estimated effectiveness of booster vaccines against severe COVID-19-related outcomes peaked during the first 3 months following the booster dose. By 6 months, the cumulative incidence of positive SARS-CoV-2 test was higher in boosted than unboosted individuals. CONCLUSIONS: We estimate that COVID-19 booster vaccination, compared with no booster vaccination, provided substantial protection against COVID-19 hospitalization and COVID-19 death but only limited protection against positive SARS-CoV-2 test. Lower rates of fracture in boosted than unboosted individuals may suggest unmeasured confounding. Observational studies should report estimated vaccine effectiveness against nontarget and ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
1044-3983 |
| Relation: |
https://researchonline.lshtm.ac.uk/id/eprint/4681322/1/Horne-etal-Effectiveness-of-mRNA-COVID-19-Vaccines-as-First-Booster-Doses-in-England.pdf; Horne, Elsie MFORCID logo; Hulme, William JORCID logo; Parker, Edward PK ORCID logo; Keogh, Ruth H ORCID logo; Williamson, Elizabeth J; Walker, Venexia M; Palmer, Tom MORCID logo; Denholm, Rachel; Knight, RochelleORCID logo; Curtis, Helen JORCID logo; +10 more.Walker, Alex JORCID logo; Andrews, Colm DORCID logo; Mehrkar, AmirORCID logo; Morley, JessicaORCID logo; MacKenna, BrianORCID logo; Bacon, Sebastian CJORCID logo; Goldacre, Ben ORCID logo; Hernán, Miguel AORCID logo; Sterne, Jonathan ACORCID logo; and and the OpenSAFELY collaborative (2024) Effectiveness of mRNA COVID-19 Vaccines as First Booster Doses in England: An Observational Study in OpenSAFELY-TPP. Epidemiology, 35 (4). pp. 568-578. ISSN 1044-3983 DOI:10.1097/EDE.0000000000001747 |
| DOI: |
10.1097/ede.0000000000001747 |
| Availability: |
https://researchonline.lshtm.ac.uk/id/eprint/4681322/; https://doi.org/10.1097/ede.0000000000001747 |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.AD5FFEF7 |
| Database: |
BASE |