Pfizer-BioNTech and Oxford AstraZeneca COVID-19 vaccine effectiveness and immune response amongst individuals in clinical risk groups

Heather J. Whitaker, Ruby S.M. Tsang, Rachel Byford, Nick J. Andrews, Julian Sherlock, Praveen Sebastian Pillai, John Williams, Elizabeth Button, Helen Campbell, Mary Sinnathamby, William Victor, Sneha Anand, Ezra Linley, Jacqueline Hewson, Silvia DArchangelo, Ashley D. Otter, Joanna Ellis, Richard F.D. Hobbs, Gary Howsam, Maria ZambonMary Ramsay, Kevin E. Brown, Simon de Lusignan, Gayatri Amirthalingam, Jamie Lopez Bernal*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)

Abstract

Background: COVID-19 vaccines approved in the UK are highly effective in general population cohorts, however, data on effectiveness amongst individuals with clinical conditions that place them at increased risk of severe disease are limited. 

Methods: We used GP electronic health record data, sentinel virology swabbing and antibody testing within a cohort of 712 general practices across England to estimate vaccine antibody response and vaccine effectiveness against medically attended COVID-19 amongst individuals in clinical risk groups using cohort and test-negative case control designs. 

Findings: There was no reduction in S-antibody positivity in most clinical risk groups, however reduced S-antibody positivity and response was significant in the immunosuppressed group. Reduced vaccine effectiveness against clinical disease was also noted in the immunosuppressed group; after a second dose, effectiveness was moderate (Pfizer: 59.6%, 95%CI 18.0–80.1%; AstraZeneca 60.0%, 95%CI -63.6–90.2%). 

Interpretation: In most clinical risk groups, immune response to primary vaccination was maintained and high levels of vaccine effectiveness were seen. Reduced antibody response and vaccine effectiveness were seen after 1 dose of vaccine amongst a broad immunosuppressed group, and second dose vaccine effectiveness was moderate. These findings support maximising coverage in immunosuppressed individuals and the policy of prioritisation of this group for third doses.

Original languageEnglish
Pages (from-to)675-683
Number of pages9
JournalJournal of Infection
Volume84
Issue number5
Early online date3 Jan 2022
DOIs
Publication statusPublished - 5 May 2022

Bibliographical note

Funding Information: Simon de Lusignan is the Director of the Oxford-RCGP RSC and
has received funding through his University for studies from Astra-Zeneca, Eli Lilly, Sanofi, GSK, MSD. Seqirus and Takeda; and been member of advisory boards for Astra-Zeneca, Seqirus and Sanofi. Ezra Linley reports that the UKHSA Vaccine Evaluation Unit performs contract research on behalf of GSK, Sanofi and Pfizer which is outside the submitted work.

Open Access: Free to read, but no Open Access licence.

Publisher Copyright: © 2021 Published by Elsevier Ltd on behalf of The British Infection Association.

Citation: Heather J. Whitaker, Ruby S.M. Tsang, Rachel Byford, Nick J. Andrews, Julian Sherlock, Praveen Sebastian Pillai, John Williams, Elizabeth Button, Helen Campbell, Mary Sinnathamby, William Victor, Sneha Anand, Ezra Linley, Jacqueline Hewson, Silvia DArchangelo, Ashley D. Otter, Joanna Ellis, Richard F.D. Hobbs, Gary Howsam, Maria Zambon, Mary Ramsay, Kevin E. Brown, Simon de Lusignan, Gayatri Amirthalingam, Jamie Lopez Bernal, Pfizer-BioNTech and Oxford AstraZeneca COVID-19 vaccine effectiveness and immune response amongst individuals in clinical risk groups, Journal of Infection, Volume 84, Issue 5, 2022, Pages 675-683, ISSN 0163-4453,

DOI: https://doi.org/10.1016/j.jinf.2021.12.044.

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