Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study

被引：444

作者：

Vasileiou, Eleftheria ^{[1
]}

Simpson, Colin R. ^{[1
,4
]}

Shi, Ting

Kerr, Steven ^{[1
]}

Agrawal, Utkarsh ^{[5
]}

Akbari, Ashley ^{[6
]}

Bedston, Stuart ^{[6
]}

Beggs, Jillian ^{[8
]}

Bradley, Declan ^{[9
,10
]}

Chuter, Antony ^{[1
,8
]}

de Lusignan, Simon ^{[11
]}

Docherty, Annemarie B. ^{[1
]}

Ford, David ^{[7
]}

Hobbs, F. D. Richard ^{[11
]}

Joy, Mark ^{[11
]}

Katikireddi, Srinivasa Vittal ^{[12
]}

Marple, James ^{[2
,3
]}

McCowan, Colin ^{[5
]}

McGagh, Dylan ^{[11
]}

McMenamin, Jim ^{[13
]}

Moore, Emily ^{[13
]}

Murray, Josephine L. K. ^{[13
]}

Pan, Jiafeng ^{[15
]}

Ritchie, Lewis ^{[16
]}

Shah, Syed Ahmar ^{[1
]}

Stock, Sarah ^{[1
]}

Torabi, Fatemeh ^{[6
]}

Tsang, Ruby S. M. ^{[11
]}

Wood, Rachael ^{[14
]}

Woolhouse, Mark ^{[1
]}

Robertson, Chris ^{[13
,15
]}

Sheikh, Aziz ^{[1
]}

机构：

[1] Univ Edinburgh, Usher Inst, Edinburgh EH8 9AG, Midlothian, Scotland

[2] Univ Edinburgh, Royal Infirm Edinburgh, NHS Lothian, Edinburgh, Midlothian, Scotland

[3] Univ Edinburgh, Anaesthesia Crit Care & Pain Med, Edinburgh, Midlothian, Scotland

[4] Victoria Univ Wellington, Wellington Fac Hlth, Sch Hlth, Wellington, New Zealand

[5] Univ St Andrews, Sch Med, St Andrews, Fife, Scotland

[6] Swansea Univ, Sch Med, Populat Data Sci, Swansea, W Glam, Wales

[7] Swansea Univ, Coll Med, Hlth Informat, Hlth Informat Grp, Swansea, W Glam, Wales

[8] Hlth Data Res Hub Resp Hlth, Edinburgh, Midlothian, Scotland

[9] Publ Hlth Agcy, Belfast, Antrim, North Ireland

[10] Queens Univ Belfast, Ctr Publ Hlth, Belfast, Antrim, North Ireland

[11] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Oxford, England

[12] Univ Glasgow, MRC CSO Social & Publ Hlth Sci Unit, Glasgow, Lanark, Scotland

[13] Publ Hlth Scotland, Glasgow, Lanark, Scotland

[14] Publ Hlth Scotland, Clin & Publ Hlth Intelligence Team, Edinburgh, Midlothian, Scotland

[15] Univ Strathclyde, Dept Math & Stat, Glasgow, Lanark, Scotland

[16] Univ Aberdeen, Sch Med & Dent, Acad Primary Care, Aberdeen, Scotland

来源：

LANCET | 2021年 / 397卷 / 10285期

基金：

英国科研创新办公室; 英国医学研究理事会; 美国国家卫生研究院;

关键词：

INFLUENZA VACCINE;

D O I：

10.1016/S0140-6736(21)00677-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.

引用

页码：1646 / 1657

页数：12