Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study
Open accessAbstract
BACKGROUND: The BNT162b2 mRNA (Pfizer-BioNTech) and ChAdOx1 nCoV-19 (Oxford-AstraZeneca) COVID-19 vaccines have shown high efficacy against disease in phase 3 clinical trials and are now being used in national vaccination programmes in the UK and several other countries. Studying the real-world effects of these vaccines is an urgent requirement. The aim of our study was to investigate the association between the mass roll-out of the first doses of these COVID-19 vaccines and hospital admissions for COVID-19. METHODS: We did a prospective cohort study using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19-EAVE II-database comprising linked vaccination, primary care, real-time reverse transcription-PCR testing, and hospital admission patient records for 5·4 million people in Scotland (about 99% of the population) registered at 940 general practices. Individuals who had previously tested positive were excluded from the analysis. A time-dependent Cox model and Poisson regression models with inverse propensity weights were fitted to estimate effectiveness against COVID-19 hospital admission (defined as 1-adjusted rate ratio) following the first dose of vaccine. FINDINGS: Between Dec 8, 2020, and Feb 22, 2021, a total of 1 331 993 people were vaccinated over the study period. The mean age of those vaccinated was 65·0 years (SD 16·2). The first dose of the BNT162b2 mRNA vaccine was associated with a vaccine effect of 91% (95% CI 85-94) for reduced COVID-19 hospital admission at 28-34 days post-vaccination. Vaccine effect at the same time interval for the ChAdOx1 vaccine was 88% (95% CI 75-94). Results of combined vaccine effects against hospital admission due to COVID-19 were similar when restricting the analysis to those aged 80 years and older (83%, 95% CI 72-89 at 28-34 days post-vaccination). INTERPRETATION: Mass roll-out of the first doses of the BNT162b2 mRNA and ChAdOx1 vaccines was associated with substantial reductions in the risk of hospital admission due to COVID-19 in Scotland. There remains the possibility that some of the observed effects might have been due to residual confounding. FUNDING: UK Research and Innovation (Medical Research Council), Research and Innovation Industrial Strategy Challenge Fund, Health Data Research UK.
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The overall mean age of the vaccinated app users was higher than that of the general population (40.3 years) yet was lower than those of the samples within other UK COVID-19 effectiveness studies.
“The overall mean age of the vaccinated app users was higher than that of the general population (40·3 years)24 yet was lower than those of the samples within other UK COVID-19 effectiveness studies,11, 12 largely because of the presence of a small proportion of health-care workers among the participants of this study.”
From Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study (2021) · cites this paper as [12]
Given that strong reductions in COVID hospitalisations after vaccination were observed in nationwide studies in Scotland and England, collider bias is unlikely to underlie the reduction in infections seen in the data.
“However, given that strong reductions in COVID hospitalisations after vaccination were observed in nationwide studies in Scotland12 and England,11 we believe that collider bias is unlikely to underlie the reduction in infections seen in our data.”
From Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study (2021) · cites this paper as [12]
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Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine
Polack, F. P., Thomas, S. J., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S., Perez, J. L., Pérez Marc, G., Moreira, E. D., Zerbini, C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2034577 · Cited by 14,592 · see citing works
Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine
Baden, L. R., El Sahly, H. M., Essink, B., Kotloff, K., Frey, S., Novak, R., Diemert, D., Spector, S. A., Rouphael, N., Creech, C. B., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2035389 · Cited by 10,119 · see citing works
BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting
Dagan, N., Barda, N., Kepten, E., Miron, O., Perchik, S., Katz, M. A., Hernán, M. A., Lipsitch, M., Reis, B., & Balicer, R. D. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2101765 · Cited by 2,527 · see citing works
Bernal, J. L., Andrews, N., Gower, C., Stowe, J., Robertson, C., Tessier, E., Simmons, R., Cottrell, S., Roberts, R., O’Doherty, M., et al. (2021) · doi:10.1101/2021.03.01.21252652 · Cited by 1,389 · see citing works
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Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine through 6 Months
Thomas, S. J., Moreira, E. D., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S., Perez, J. L., Pérez Marc, G., Polack, F. P., Zerbini, C., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2110345 · Cited by 1,640 · see citing works
Haas, E. J., Angulo, F. J., McLaughlin, J. M., Anis, E., Singer, S. R., Khan, F., Brooks, N., Smaja, M., Mircus, G., Pan, K., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00947-8 · Cited by 1,564 · see citing works
Tartof, S. Y., Slezak, J. M., Fischer, H., Hong, V., Ackerson, B. K., Ranasinghe, O. N., Frankland, T. B., Ogun, O. A., Zamparo, J. M., Gray, S., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02183-8 · Cited by 1,167 · see citing works
Sheikh, A., McMenamin, J., Taylor, B., & Robertson, C. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01358-1 · Cited by 939 · see citing works
Self-citationMenni, C., Klaser, K., May, A., Polidori, L., Capdevila, J., Louca, P., Sudre, C. H., Nguyen, L. H., Drew, D. A., Merino, J., et al. (2021) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(21)00224-3 · Cited by 1,031 · see citing works
SARS-CoV-2 mRNA vaccines induce persistent human germinal centre responses
Turner, J. S., O’Halloran, J. A., Kalaidina, E., Kim, W., Schmitz, A. J., Zhou, J. Q., Lei, T., Thapa, M., Chen, R. E., Case, J. B., et al. (2021) · Nature · doi:10.1038/s41586-021-03738-2 · Cited by 831 · see citing works
Phase 3 Safety and Efficacy of AZD1222 (ChAdOx1 nCoV-19) Covid-19 Vaccine
Falsey, A. R., Sobieszczyk, M. E., Hirsch, I., Sproule, S., Robb, M. L., Corey, L., Neuzil, K. M., Hahn, W., Hunt, J., Mulligan, M. J., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2105290 · Cited by 670 · see citing works
Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection
Patone, M., Handunnetthi, L., Saatci, D., Pan, J., Katikireddi, S. V., Razvi, S., Hunt, D., Mei, X. W., Dixon, S., Zaccardi, F., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01556-7 · Cited by 394 · see citing works
Self-citationAndrews, N., Stowe, J., Kirsebom, F., Toffa, S., Sachdeva, R., Gower, C., Ramsay, M., & Lopez Bernal, J. (2022) · Nature Medicine · doi:10.1038/s41591-022-01699-1 · Cited by 453 · see citing works
Accelerated COVID-19 vaccine development: milestones, lessons, and prospects
Bok, K., Sitar, S., Graham, B. S., & Mascola, J. R. (2021) · Immunity · doi:10.1016/j.immuni.2021.07.017 · Cited by 254 · see citing works
Katikireddi, S. V., Cerqueira-Silva, T., Vasileiou, E., Robertson, C., Amele, S., Pan, J., Taylor, B., Boaventura, V., Werneck, G. L., Flores-Ortiz, R., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02754-9 · Cited by 124 · see citing works
Self-citationBNT162b2 and ChAdOx1 nCoV-19 Vaccine Effectiveness against Death from the Delta Variant
Sheikh, A., Robertson, C., & Taylor, B. (2021) · New England Journal of Medicine · doi:10.1056/nejmc2113864 · Cited by 101 · see citing works
Self-citationVaccine effectiveness studies in the field
Evans, S. J. W., & Jewell, N. P. (2021) · New England Journal of Medicine · doi:10.1056/nejme2110605 · Cited by 65 · see citing works
Low, J. G., de Alwis, R., Chen, S., Kalimuddin, S., Leong, Y. S., Mah, T. K. L., Yuen, N., Tan, H. C., Zhang, S. L., Sim, J. X. Y., et al. (2022) · npj Vaccines · doi:10.1038/s41541-022-00590-x · Cited by 61 · see citing works
Burn, E., Li, X., Kostka, K., Stewart, H. M., Reich, C., Seager, S., Duarte‐Salles, T., Fernandez‐Bertolin, S., Aragón, M., Reyes, C., et al. (2022) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.5419 · Cited by 43 · see citing works
Low, J. G., de Alwis, R., Chen, S., Kalimuddin, S., Leong, Y. S., Mah, T. K. L., Yuen, N., Tan, H. C., Zhang, S. L., Sim, J. X. Y., et al. (2021) · doi:10.1101/2021.07.01.21259831 · Cited by 19 · see citing works
- Authors
- Vasileiou, E., Simpson, C. R., Shi, T., Kerr, S., Agrawal, U., Akbari, A., Bedston, S., Beggs, J., Bradley, D., Chuter, A., de Lusignan, S., Docherty, A. B., Ford, D., Hobbs, F. R., Joy, M., Katikireddi, S. V., Marple, J., McCowan, C., McGagh, D., McMenamin, J., Moore, E., Murray, J. L., Pan, J., Ritchie, L., Shah, S. A., Stock, S., Torabi, F., Tsang, R. S., Wood, R., Woolhouse, M., Robertson, C., & Sheikh, A.
- Affiliations
- University of Edinburgh (GB)
- Victoria University of Wellington (NZ)
- University of St Andrews (GB)
- Swansea University (GB)
- Queen's University Belfast (GB)
- University of Oxford (GB)
- MRC/CSO Social and Public Health Sciences Unit (GB)
- NHS Lothian (GB)
- Public Health Scotland (GB)
- University of Strathclyde (GB)
- University of Aberdeen (GB)
- Corresponding author
- Sheikh, Aziz
- ORCID
- Vasileiou, Eleftheria
- Simpson, Colin R
- Shi, Ting
- Kerr, Steven
- Agrawal, Utkarsh
- Akbari, Ashley
- Bedston, Stuart
- Beggs, Jillian
- Bradley, Declan
- Chuter, Antony
- Docherty, Annemarie B
- Ford, David
- Joy, Mark
- Katikireddi, Srinivasa Vittal
- McCowan, Colin
- McGagh, Dylan
- McMenamin, Jim
- Moore, Emily
- Pan, Jiafeng
- Ritchie, Lewis
- Shah, Syed Ahmar
- Stock, Sarah
- Torabi, Fatemeh
- Tsang, Ruby SM
- Wood, Rachael
- Woolhouse, Mark
- Robertson, Chris
- Sheikh, Aziz
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 397
- Issue
- 10285
- Pages
- 1646-1657
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC8064669
- OpenAlex
- W3158123254
- Cited by
- 549
- References
- 4
- Citations by year
- 2026: 8 · 2025: 29 · 2024: 37 · 2023: 80 · 2022: 203 · 2021: 192
- FWCI
- 40.54
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Lancet (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (publishedVersion, cc-by)
- Explore Bristol Research (publishedVersion, cc-by)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (acceptedVersion)
- St Andrews Research Repository (St Andrews Research Repository) (acceptedVersion, other-oa)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- St Andrews Research Repository (St Andrews Research Repository) (submittedVersion, cc-by)
- Funders
- MRC
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- COVID-19 vaccination, BNT162b2 mRNA vaccine, ChAdOx1 nCoV-19 vaccine, COVID-19 hospitalization, vaccine effectiveness, older adults, Scotland, SARS-CoV-2, first-dose vaccination, hospitalization reduction
- MeSH terms
- COVID-19, COVID-19 Vaccines, BNT162 Vaccine, ChAdOx1 nCoV-19, Adolescent, Adult, Aged, Aged, 80 and over, Female, Hospitalization, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Scotland, Social Class, Mass Vaccination, Young Adult, Pandemics
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