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COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study
Open accessAbstract
Background BNT162b2 mRNA and ChAdOx1 nCOV-19 adenoviral vector vaccines have been rapidly rolled out in the UK from December, 2020. We aimed to determine the factors associated with vaccine coverage for both vaccines and documented the vaccine effectiveness of the BNT162b2 mRNA vaccine in a cohort of health-care workers undergoing regular asymptomatic testing. Methods The SIREN study is a prospective cohort study among staff (aged ≥18 years) working in publicly-funded hospitals in the UK. Participants were assigned into either the positive cohort (antibody positive or history of infection [indicated by previous positivity of antibody or PCR tests]) or the negative cohort (antibody negative with no previous positive test) at the beginning of the follow-up period. Baseline risk factors were collected at enrolment, symptom status was collected every 2 weeks, and vaccination status was collected through linkage to the National Immunisations Management System and questionnaires. Participants had fortnightly asymptomatic SARS-CoV-2 PCR testing and monthly antibody testing, and all tests (including symptomatic testing) outside SIREN were captured. Data cutoff for this analysis was Feb 5, 2021. The follow-up period was Dec 7, 2020, to Feb 5, 2021. The primary outcomes were vaccinated participants (binary ever vacinated variable; indicated by at least one vaccine dose recorded by at least one of the two vaccination data sources) for the vaccine coverage analysis and SARS-CoV-2 infection confirmed by a PCR test for the vaccine effectiveness analysis. We did a mixed-effect logistic regression analysis to identify factors associated with vaccine coverage. We used a piecewise exponential hazard mixed-effects model (shared frailty-type model) using a Poisson distribution to calculate hazard ratios to compare time-to-infection in unvaccinated and vaccinated participants and estimate the impact of the BNT162b2 vaccine on all PCR-positive infections (asymptomatic and symptomatic). This study is registered with ISRCTN, number ISRCTN11041050, and is ongoing. Findings 23 324 participants from 104 sites (all in England) met the inclusion criteria for this analysis and were enrolled. Included participants had a median age of 46·1 years (IQR 36·0-54·1) and 19 692 (84%) were female; 8203 (35%) were assigned to the positive cohort at the start of the analysis period, and 15 121 (65%) assigned to the negative cohort. Total follow-up time was 2 calendar months and 1 106 905 person-days (396 318 vaccinated and 710 587 unvaccinated). Vaccine coverage was 89% on Feb 5, 2021, 94% of whom had BNT162b2 vaccine. Significantly lower coverage was associated with previous infection, gender, age, ethnicity, job role, and Index of Multiple Deprivation score. During follow-up, there were 977 new infections in the unvaccinated cohort, an incidence density of 14 infections per 10 000 person-days; the vaccinated cohort had 71 new infections 21 days or more after their first dose (incidence density of eight infections per 10 000 person-days) and nine infections 7 days after the second dose (incidence density four infections per 10 000 person-days). In the unvaccinated cohort, 543 (56%) participants had typical COVID-19 symptoms and 140 (14%) were asymptomatic on or 14 days before their PCR positive test date, compared with 29 (36%) with typical COVID-19 symptoms and 15 (19%) asymptomatic in the vaccinated cohort. A single dose of BNT162b2 vaccine showed vaccine effectiveness of 70% (95% CI 55-85) 21 days after first dose and 85% (74-96) 7 days after two doses in the study population. Interpretation Our findings show that the BNT162b2 vaccine can prevent both symptomatic and asymptomatic infection in working-age adults. This cohort was vaccinated when the dominant variant in circulation was B1.1.7 and shows effectiveness against this variant. Funding Public Health England, UK Department of Health and Social Care, and the National Institute for Health Research.
Checked 2026-10-06 · 1 reference not checked yet
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40 Own result · 20 Own method · 12 Not checked yet · 7 Own interpretation · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the unvaccinated cohort, 543 (56%) participants had typical COVID-19 symptoms and 140 (14%) were asymptomatic on or 14 days before their PCR positive test date, compared with 29 (36%) with typical COVID-19 symptoms and 15 (19%) asymptomatic in the vaccinated cohort.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“and 85% (74–96) 7 days after two doses in the study population.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plaindirect- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: An immunological response to the vaccine dose is provoked by 21 days after the first dose and 7 days after the second dose.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Female | 2346 (11·9%) | 17 346 (88·1%) | 0·75 (0·67–0·85) | .. | 0·72 (0·63–0·82) | .. |”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plaincorrelationaln = 23 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“| Black | 162 (34·9%) | 302 (65·1%) | 0·22 (0·18–0·26) | .. | 0·26 (0·21–0·32) | .. |”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significantly lower coverage was associated with previous infection, gender, age, ethnicity, job role, and Index of Multiple Deprivation score.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Positive | 1278 (15·6%) | 6925 (84·4%) | 0·56 (0·51–0·6) | .. | 0·59 (0·54–0·64) | .. |”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plaincorrelationaln = 23 ·- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Vaccine coverage was 89% on Feb 5, 2021, 94% of whom had BNT162b2 vaccine.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plainn = 324- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A single dose of BNT162b2 vaccine showed vaccine effectiveness of 70% (95% CI 55–85) 21 days after first dose”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plaindirect- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: An immunological response to the vaccine dose is provoked by 21 days after the first dose and 7 days after the second dose.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Vaccine coverage was 89% on Feb 5, 2021, 94% of whom had BNT162b2 vaccine.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“vaccine effectiveness was 72% (95% CI 58–86) 21 days after first dose”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“| 1 (most deprived) | 436 (16·6%) | 2198 (83·4%) | 0·50 (0·44–0·57) | .. | 0·75 (0·65–0·87) | .. |”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“| 45–54 | 600 (8·4%) | 6566 (91·6%) | 2·09 (1·71–2·56) | .. | 2·22 (1·80–2·73) | .. |”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plaincorrelationaln = 23 ·- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and nine infections 7 days after the second dose (incidence density four infections per 10 000 person-days)”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the unvaccinated cohort, 543 (56%) participants had typical COVID-19 symptoms and 140 (14%) were asymptomatic on or 14 days before their PCR positive test date, compared with 29 (36%) with typical COVID-19 symptoms and 15 (19%) asymptomatic in the vaccinated cohort.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the vaccinated cohort had 71 new infections 21 days or more after their first dose (incidence density of eight infections per 10 000 person-days)”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During follow-up, there were 977 new infections in the unvaccinated cohort, an incidence density of 14 infections per 10 000 person-days”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The median length of time between first dose and second dose was 23 days (IQR 21–26; range 19–28).”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“19 384 (94%) received the BNT162b2 vaccine and 1252 (6%) received the ChAdOx1 vaccine”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plainn = 20- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with substantial protection from infection increasing from day 10 onwards and plateauing after 21 days”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the vaccinated group, 21 days after the first dose, there were 71 new infections (incidence density of eight per 10 000 person-days of follow-up)”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and nine new infections 7 days after the second dose (incidence density of four per 10 000 person-days of follow-up)”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants were less likely to have been vaccinated if they had a previous infection (adjusted odds ratio [aOR] 0·59, 95% CI 0·54–0·64), were female (0·72, 0·63–0·82), were aged under 35 (0·78, 0·64–0·96), were from Black, Asian or minority ethnic groups, especially if they were Black (0·26, 0·21–0·32)”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The study follows the Strengthening the Reporting of Observational studies in Epidemiology guidelines.15”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Methods > Statistical analysis
What the sources say
- Not checked yetcites [15] von Elm E Altman DG Egger M Pocock SJ Gøtzsche PC Vandenbroucke JP The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies Lancet 370 2007 1453 1457 18064739 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“We collected data on potential confounders, including site and participant demographics, to enable adjusted analysis.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Methods > Bias reduction
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In the paper
“To avoid misclassification of exposure, if a participant had an unreliable date of a second dose (eg, a second dose administered before a first dose or administered less than 19 days after the first dose) their follow-up time was censored at the date of the suspect second dose.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Methods > Bias reduction
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“We defined the end of follow-up in those who were not positive cases as the date of a negative test or Feb 5, 2021, if the test was after this date, to avoid immortal time bias.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Methods > Person-time at risk
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Before vaccine introduction, we calculated the precision of effectiveness estimates on an estimated cohort size of 40 000 participants, with 65% seronegativity at baseline, coverage averaging 75% in the follow-up period, and incidence in the follow-up period ranging from 0·5% to 5%.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Methods > Statistical analysis
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In the paper
“We restricted our analysis to one manufacturer only, where sufficient follow-up time had accrued.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Methods > Bias reduction
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“This study is registered with ISRCTN, number ISRCTN11041050.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Notably, to date, most data on vaccinated individuals in the UK are from people aged >75 years old, in whom vaccine effectiveness can be lower due to immunosenesence.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Discussion
What the sources say
- Not checked yetcites [26] Aiello A Farzaneh F Candore G Immunosenescence and its hallmarks: how to oppose aging strategically? A review of potential options for therapeutic intervention Front Immunol 10 2019 2247 PMC6773825 31608061
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“The final model resulted in a mean χ2 estimate of 1·04. Since the mean of χ2 variable is its degree of freedom, comparing the mean χ2 with its mean value 1 provides a quick check model. The estimated χ2 value of 1·04 is not too far from 1, which implies that there is no evidence against the final model.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Methods > Statistical analysis
hedged- Asserted: passes — The authors put it forward as true.
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- The authors state this as an assumption: The proportional hazards assumption holds in the piecewise exponential hazard model.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The testing frequency in our vaccinated population was slightly higher than in the unvaccinated population (10·4 days per test vs 14·3 days per test), making us more likely to pick up infections among the vaccinated, and, therefore, biasing our vaccine effectiveness results towards the null hypothesis.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Discussion
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Given the SIREN cohort is composed of working-age adults, the findings are more relevant for the general adult population, although the healthy worker effect bias might underestimate the disease impact compared with the general population.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Discussion
What the sources say
- Not checked yetcites [27] Shah D Healthy worker effect phenomenon Indian J Occup Environ Med 13 2009 77 79 20386623 PMC2847330
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“With fewer of the cohort vaccinated with the ChAdOx1 nCoV-19 vaccine, and the later roll-out resulting in less follow-up time accrued, we are unable to investigate the effectiveness of the ChAdOx1 nCoV-19 vaccine within this analysis.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Discussion
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A substudy of the Oxford–AstraZeneca COVID-19 vaccine did weekly swabbing and reported reduced viral load and PCR positivity in vaccinated participants; a signal that transmission might be reduced by this vaccine.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Discussion
What the sources say
- Not checked yetcites [28] Emary KRW Golubchik T Aley PK Efficacy of ChAdOx1 nCoV-19 (AZD1222) Vaccine Against SARS-CoV-2 VOC 202012/01 (B.1.1.7) Lancet 397 2021 1351 1362 33798499 PMC8009612
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Given the dominance of the B.1.1.7 variant in England during the study period, which accounted for 50% or more positive tests in Pillar 2 laboratories since the beginning of December, 2020, in the South East, London, and East of England, and in all regions by early January 2021”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Discussion
What the sources say
- Not checked yetcites [16] Public Health England Investigation of SARS-CoV-2 variants of concern in England. Technical briefing 6 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/961299/Variants_of_Concern_VOC_Technical_Briefing_6_England-1.pdf Feb 13, 2021
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“it is also possible that infections detected at a short interval after vaccination were acquired before vaccination, and, therefore, were misclassified as events within vaccinated follow-up, biasing vaccine effectiveness to the null hypothesis.”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“given our symptom status is ascertained by self-completed questionnaires sent at 14-day intervals, there is the possibility of recall bias”
§ COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The authors state this as an assumption.
The proportional hazards assumption holds in the piecewise exponential hazard model.
“The proportional hazards in this model is an assumption.”
The authors state this as an assumption.
The hospital trust random effect is normally distributed.
“The hospital trust random effect was assumed to be normal, and this implies that frailty (exp(hospital trusts)) distribution was log-normal.”
The paper relies on this without support.
The dominant SARS-CoV-2 variant in circulation during the study period was B1.1.7.
“This cohort was vaccinated when the dominant variant in circulation was B1.1.7 and shows effectiveness against this variant.”
The paper relies on this without support.
An immunological response to the vaccine dose is provoked by 21 days after the first dose and 7 days after the second dose.
“We calculated hazard ratios from 21 days after first dose and 7 days after second dose using a weighted average method, the point at which an immunological response to the vaccine dose should have been provoked.”
The paper relies on this without support.
At the time of the study, there was a scarcity of published research on whether vaccination reduces asymptomatic infection or transmission worldwide.
“To date, little has been published on the effect of vaccination on reducing asymptomatic infection or transmission globally.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Coronavirus disease 2019 (Covid-19) vaccines are highly effective against symptomatic disease and, more so, against severe disease and fatal outcomes caused by the original strain of SARS-CoV-2 as well as the alpha (B.1.1.7) variant that predominated in early 2021.”
From Effectiveness of COVID-19 vaccines against the Omicron (B.1.1.529) variant of concern (2021) · cites this paper as [12]
Experimental — accuracy not yet measuredIn the citing paper
“ChAdOx1 maintains efficacy against B.1.1.724,27 but has a major loss in efficacy against mild COVID-19 with the B.1.351 variant.26”
From Impact of SARS-CoV-2 variants on the total CD4+ and CD8+ T cell reactivity in infected or vaccinated individuals (2021) · cites this paper as [27]
In the citing paper
“There may also be differences among the populations that received each vaccine — for example, in younger age groups, health care workers are more likely to have received the BNT162b2 vaccine, whereas persons in clinical risk groups are more likely to have received the ChAdOx1 nCoV-19 vaccine.11”
From Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant (2021) · cites this paper as [11]
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Caveats on COVID-19 herd immunity threshold: the Spain case
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Switching vaccination among target groups to achieve improved long-lasting benefits
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Formal and informal science advice in emergencies: COVID-19 in the UK
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Higher vaccination rates predict reduction in SARS-CoV-2 transmission across the United States
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Covid-19: Moderna and Pfizer vaccines prevent infections as well as symptoms, CDC study finds
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SARS‐CoV‐2 vaccination in patients with inflammatory bowel disease
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Metadata
- Authors
- Hall, V. J., Foulkes, S., Saei, A., Andrews, N., Oguti, B., Charlett, A., Wellington, E., Stowe, J., Gillson, N., Atti, A., Islam, J., Karagiannis, I., Munro, K., Khawam, J., Chand, M. A., Brown, C. S., Ramsay, M., Lopez-Bernal, J., Hopkins, S., Andrews, N., Atti, A., Aziz, H., Brooks, T., Brown, C., Camero, D., Carr, C., Chand, M., Charlett, A., Crawford, H., Cole, M., Conneely, J., D'Arcangelo, S., Ellis, J., Evans, S., Foulkes, S., Gillson, N., Gopal, R., Hall, L., Hall, V., Harrington, P., Hopkins, S., Hewson, J., Hoschler, K., Ironmonger, D., Islam, J., Kall, M., Karagiannis, I., Kay, O., Khawam, J., King, E., Kirwan, P., Kyffin, R., Lackenby, A., Lattimore, M., Linley, E., Lopez-Bernal, J., Mabey, L., McGregor, R., Miah, S., Monk, E., Munro, K., Naheed, Z., Nissr, A., O'Connell, A., Oguti, B., Okafor, H., Organ, S., Osbourne, J., Otter, A., Patel, M., Platt, S., Pople, D., Potts, K., Ramsay, M., Robotham, J., Rokadiya, S., Rowe, C., Saei, A., Sebbage, G., Semper, A., Shrotri, M., Simmons, R., Soriano, A., Staves, P., Taylor, S., Taylor, A., Tengbe, A., Tonge, S., Vusirikala, A., Wallace, S., Wellington, E., Zambon, M., Corrigan, D., Sartaj, M., Cromey, L., Campbell, S., Braithwaite, K., Price, L., Haahr, L., Stewart, S., Lacey, E., Partridge, L., Stevens, G., Ellis, Y., Hodgson, H., Norman, C., Lacey, E., Larru, B., Mcwilliam, S., Roynon, A., Northfield, J., Winchester, S., Cieciwa, P., Pai, A., Bakker, P., Loughrey, C., Watt, A., Adair, F., Hawkins, A., Grant, A., Temple-Purcell, R., Howard, J., Slawson, N., Subudhi, C., Davies, S., Bexley, A., Penn, R., Wong, N., Boyd, G., Rajgopal, A., Arenas-Pinto, A., Matthews, R., Whileman, A., Laugharne, R., Ledger, J., Barnes, Jones, C., Osuji, N., Chitalia, N., Bailey, T., Akhtar, S., Harrison, G., Horne, S., Walker, N., Agwuh, K., Maxwell, V, Graves, J., Williams, S., O'Kelly, A., Ridley, P., Cowley, A., Johnstone, H., Swift, P., Democratis, J., Meda, M., Brake, S., Gunn, J., Selassi, A., Hams, S., Irvine, V, Chandrasekaran, B., Forsyth, C., Radmore, J., Thomas, C., Brown, K., Roberts, S., Burns, P., Gajee, K., Lewis, T., Byrne, T., Sanderson, F., Knight, S., Macnaughton, E., Burton, B., Smith, H., Chaudhuri, R., Aeron-Thomas, J., Hollinshead, K., Shorten, R., Swan, A., Shorten, R., Favager, C., Murira, J., Baillon, S., Hamer, S., Shah, A., Russell, J., Brennan, D., Dave, A., Chawla, A., Westwell, F., Adeboyeku, D., Papineni, P., Pegg, C., Williams, M., Ahmad, S., Horsley, A., Gabriel, C., Pagget, K., Cieciwa, P., Maloney, G., Ashcroft, J., Del Rosario, I., Crosby-Nwaobi, R., Flanagan, D., Dhasmana, D., Fowler, S., Cameron, E., Prentice, L., Sinclair, C., Irvine, V, Bateman, V, McLelland-Brooks, K., Ho, A., Murphy, M., Cochrane, A., Gibson, A., Patel, M., Black, K., Tempeton, K., Donaldson, S., Coke, L., Elumogo, N., Elliott, J., Padgett, D., Cross, A., Mirfenderesky, M., Joyce, S., Sinanovic, I., Howard, M., Lewis, T., Cowling, P., Brazil, M., Hanna, E., Abdelrazik, A., Brand, S., Sheridan, E., Wadams, B., Lloyd, A., Mouland, J., Giles, J., Pottinger, G., Coles, H., Joseph, M., Lee, M., Orr, S., Chenoweth, H., Browne, D., Auckland, C., Lear, R., Mahungu, T., Rodger, A., Warren, S., Brooking, D., Pai, S., Druyeh, R., Smith, E., Stone, S., Meisner, S., Delgado, D., Underhill, E., Keen, L., Aga, M., Domingos, P., Gormley, S., Kerrison, C., Birch, S., DeSilva, T., Allsop, L., Ambalkar, S., Beekes, M., Jose, S., Tomlinson, J., Painter, S., Price, C., Pepperell, J., James, K., Trinick, T., Moore, L., Day, J., Boulos, A., Knox, I., Defever, E., McCracken, D., Brown, K., Gray, K., Houston, A., Planche, T., Pritchard Jones, R., Wycherley, D., Bennett, S., Marrs, J., Nimako, K., Stewart, B., Bain, S., Kalakonda, N., Khanduri, S., Ashby, A., Holden, M., Mahabir, N., Harwood, J., Payne, B., Court, K., White, N., Longfellow, R., Hughes, L., Green, M., Halkes, M., Mercer, P., Roebuck, A., Wilson-Davies, E., Gallego, L., Lazarus, R., Aldridge, N., Berry, L., Game, F., Reynolds, T., Holmes, C., Wiselka, M., Higham, A., Booth, M., Duff, C., Alderton, J., Hilton, D., Powell, J., Jackson, A., Plant, A., Ahmed, N., Chin, T., Qazzafi, M., Moody, A., Tilley, R., Donaghy, T., O'Kane, M., Shipman, K., Sierra, R., Parmar, C., Mills, G., Harvey, D., Huang, Y., Birch, J., Robinson, L., Board, S., Broadley, A., Laven, C., Todd, N., Eyre, D., Jeffery, K., Dunachie, S., Duncan, C., Klenerman, P., Turtle, L., Baxendale, H., & Heeney, J.
- Affiliations
- Public Health England (GB)
- St Thomas' Hospital (GB)
- Guy's Hospital (GB)
- Corresponding author
- Aziz, H
- Carr, C
- Crawford, H
- Okafor, H
- Potts, K
- Rowe, C
- Braithwaite, K
- Hodgson, H
- Norman, C
- Loughrey, C
- Adair, F
- Subudhi, C
- Jones, C
- Agwuh, K
- Johnstone, H
- Forsyth, C
- Thomas, C
- Gajee, K
- Sanderson, F
- Smith, H
- Hollinshead, K
- Favager, C
- Westwell, F
- Pegg, C
- Gabriel, C
- Pagget, K
- Sinclair, C
- McLelland-Brooks, K
- Ho, A
- Black, K
- Tempeton, K
- Coles, H
- Chenoweth, H
- Auckland, C
- Kerrison, C
- Price, C
- James, K
- Gray, K
- Nimako, K
- Court, K
- Game, F
- Holmes, C
- Duff, C
- Shipman, K
- Parmar, C
- Laven, C
- Jeffery, K
- Duncan, C
- Baxendale, H
- ORCID
- Hall, Victoria Jane
- Stowe, Julia
- Chand, Meera A
- Brooks, T
- Cole, M
- Ellis, J
- Hewson, J
- Kall, M
- Kirwan, P
- Lackenby, A
- Linley, E
- Miah, S
- Monk, EJM
- Organ, S
- Otter, A
- Pople, D
- Robotham, J
- Rokadiya, S
- Semper, A
- Shrotri, M
- Simmons, R
- Vusirikala, A
- Wallace, S
- Zambon, M
- Braithwaite, K
- Price, L
- Haahr, L
- Stewart, S
- Partridge, L
- Hodgson, H
- Mcwilliam, S
- Winchester, S
- Watt, A
- Davies, S
- Penn, R
- Wong, N
- Rajgopal, A
- Laugharne, R
- Bailey, T
- Horne, S
- Walker, N
- Ridley, P
- Democratis, J
- Meda, M
- Chandrasekaran, B
- Thomas, C
- Knight, S
- Smith, H
- Murira, J
- Shah, A
- Chawla, A
- Papineni, P
- Ahmad, S
- Horsley, A
- Ashcroft, J
- Dhasmana, D
- Cochrane, A
- Gibson, A
- Elumogo, N
- Mirfenderesky, M
- Brand, S
- Coles, H
- Auckland, C
- Lear, R
- Rodger, A
- Brooking, D
- Smith, E
- Meisner, S
- Birch, S
- Pepperell, J
- Defever, E
- Planche, T
- Kalakonda, N
- Ashby, A
- Holden, M
- Payne, B
- Halkes, M
- Wilson-Davies, E
- Lazarus, R
- Aldridge, N
- Game, F
- Reynolds, T
- Holmes, C
- Wiselka, M
- Ahmed, N
- Shipman, K
- Sierra, R
- Parmar, C
- Mills, G
- Harvey, D
- Todd, N
- Jeffery, K
- Dunachie, S
- Duncan, C
- Klenerman, P
- Turtle, L
- Baxendale, H
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 397
- Issue
- 10286
- Pages
- 1725-1735
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC8064668
- OpenAlex
- W3159191704
- Cited by
- 767
- References
- 27
- Citations by year
- 2026: 18 · 2025: 34 · 2024: 55 · 2023: 109 · 2022: 270 · 2021: 278
- FWCI
- 56.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ResearchOnline (Glasgow Caledonian University) (submittedVersion, cc-by-nc-nd)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- United Kingdom Department of Health and Social Care
- Public Health England
- National Institute for Health Research
- 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, vaccination coverage, healthcare workers, hospital staff, vaccine effectiveness, COVID-19 pandemic, asymptomatic testing, time to infection, shared frailty model, England, SIREN study, nosocomial infections
- MeSH terms
- COVID-19 Vaccines, BNT162 Vaccine, England, Health Personnel, Humans, Occupational Diseases, Prospective Studies, RNA, Messenger, Cohort Studies, Occupational Exposure, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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