Estimating the Effectiveness of First Dose of COVID-19 Vaccine Against Mortality in England: A Quasi-Experimental Study

被引:4
|
作者
Bermingham, Charlotte [2 ]
Morgan, Jasper [2 ]
Ayoubkhani, Daniel [2 ]
Glickman, Myer [2 ]
Islam, Nazrul [3 ]
Sheikh, Aziz [4 ,5 ]
Sterne, Jonathan [6 ]
Walker, A. Sarah [7 ]
Nafilyan, Vahe [1 ,2 ,8 ]
机构
[1] Off Natl Stat, Govt Bldg, Newport NP10 8XG, Gwent, Wales
[2] Off Natl Stat, Newport, Gwent, Wales
[3] Univ Oxford, Big Data Inst, Nuffield Dept Populat Hlth, Oxford, England
[4] Univ Edinburgh, Usher Inst, Edinburgh, Scotland
[5] UK Breathe Hub, Hlth Data Res, London, England
[6] Univ Bristol, Bristol Med Sch, Bristol, England
[7] Univ Oxford, Nuffield Dept Med, Oxford, England
[8] London Sch Hyg & Trop Med, Dept Med Stat, London, England
关键词
COVID-19; quasi-experiment; regression discontinuity; vaccination; vaccine effectiveness;
D O I
10.1093/aje/kwac157
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Estimating real-world vaccine effectiveness is vital to assessing the coronavirus disease 2019 (COVID-19) vaccination program and informing the ongoing policy response. However, estimating vaccine effectiveness using observational data is inherently challenging because of the nonrandomized design and potential for unmeasured confounding. We used a regression discontinuity design to estimate vaccine effectiveness against COVID-19 mortality in England using the fact that people aged 80 years or older were prioritized for the vaccine rollout. The prioritization led to a large discrepancy in vaccination rates among people aged 80-84 years compared with those aged 75-79 at the beginning of the vaccination campaign. We found a corresponding difference in COVID-19 mortality but not in non-COVID-19 mortality, suggesting that our approach appropriately addressed the issue of unmeasured confounding factors. Our results suggest that the first vaccine dose reduced the risk of COVID-19 death by 52.6% (95% confidence limits: 15.7, 73.4) in those aged 80 years, supporting existing evidence that a first dose of a COVID-19 vaccine had a strong protective effect against COVID-19 mortality in older adults. The regression discontinuity model's estimate of vaccine effectiveness is only slightly lower than those of previously published studies using different methods, suggesting that these estimates are unlikely to be substantially affected by unmeasured confounding factors.
引用
收藏
页码:267 / 275
页数:9
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