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Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY

BACKGROUND: While the vaccines against COVID-19 are highly effective, COVID-19 vaccine breakthrough is possible despite being fully vaccinated. With SARS-CoV-2 variants still circulating, describing the characteristics of individuals who have experienced COVID-19 vaccine breakthroughs could be hugel...

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Autores principales: Green, Amelia, Curtis, Helen, Hulme, William, Williamson, Elizabeth, McDonald, Helen, Bhaskaran, Krishnan, Rentsch, Christopher, Schultze, Anna, MacKenna, Brian, Mahalingasivam, Viyaasan, Tomlinson, Laurie, Walker, Alex, Fisher, Louis, Massey, Jon, Andrews, Colm, Hopcroft, Lisa, Morton, Caroline, Croker, Richard, Morley, Jessica, Mehrkar, Amir, Bacon, Seb, Evans, David, Inglesby, Peter, Hickman, George, Ward, Tom, Davy, Simon, Mathur, Rohini, Tazare, John, Eggo, Rosalind, Wing, Kevin, Wong, Angel, Forbes, Harriet, Bates, Chris, Cockburn, Jonathan, Parry, John, Hester, Frank, Harper, Sam, Douglas, Ian, Evans, Stephen, Smeeth, Liam, Goldacre, Ben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9255436/
https://www.ncbi.nlm.nih.gov/pubmed/35791013
http://dx.doi.org/10.1186/s12916-022-02422-0
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author Green, Amelia
Curtis, Helen
Hulme, William
Williamson, Elizabeth
McDonald, Helen
Bhaskaran, Krishnan
Rentsch, Christopher
Schultze, Anna
MacKenna, Brian
Mahalingasivam, Viyaasan
Tomlinson, Laurie
Walker, Alex
Fisher, Louis
Massey, Jon
Andrews, Colm
Hopcroft, Lisa
Morton, Caroline
Croker, Richard
Morley, Jessica
Mehrkar, Amir
Bacon, Seb
Evans, David
Inglesby, Peter
Hickman, George
Ward, Tom
Davy, Simon
Mathur, Rohini
Tazare, John
Eggo, Rosalind
Wing, Kevin
Wong, Angel
Forbes, Harriet
Bates, Chris
Cockburn, Jonathan
Parry, John
Hester, Frank
Harper, Sam
Douglas, Ian
Evans, Stephen
Smeeth, Liam
Goldacre, Ben
author_facet Green, Amelia
Curtis, Helen
Hulme, William
Williamson, Elizabeth
McDonald, Helen
Bhaskaran, Krishnan
Rentsch, Christopher
Schultze, Anna
MacKenna, Brian
Mahalingasivam, Viyaasan
Tomlinson, Laurie
Walker, Alex
Fisher, Louis
Massey, Jon
Andrews, Colm
Hopcroft, Lisa
Morton, Caroline
Croker, Richard
Morley, Jessica
Mehrkar, Amir
Bacon, Seb
Evans, David
Inglesby, Peter
Hickman, George
Ward, Tom
Davy, Simon
Mathur, Rohini
Tazare, John
Eggo, Rosalind
Wing, Kevin
Wong, Angel
Forbes, Harriet
Bates, Chris
Cockburn, Jonathan
Parry, John
Hester, Frank
Harper, Sam
Douglas, Ian
Evans, Stephen
Smeeth, Liam
Goldacre, Ben
collection PubMed
description BACKGROUND: While the vaccines against COVID-19 are highly effective, COVID-19 vaccine breakthrough is possible despite being fully vaccinated. With SARS-CoV-2 variants still circulating, describing the characteristics of individuals who have experienced COVID-19 vaccine breakthroughs could be hugely important in helping to determine who may be at greatest risk. METHODS: With the approval of NHS England, we conducted a retrospective cohort study using routine clinical data from the OpenSAFELY-TPP database of fully vaccinated individuals, linked to secondary care and death registry data and described the characteristics of those experiencing COVID-19 vaccine breakthroughs. RESULTS: As of 1st November 2021, a total of 15,501,550 individuals were identified as being fully vaccinated against COVID-19, with a median follow-up time of 149 days (IQR: ​107–179). From within this population, a total of 579,780 (<4%) individuals reported a positive SARS-CoV-2 test. For every 1000 years of patient follow-up time, the corresponding incidence rate (IR) was 98.06 (95% CI 97.93–98.19). There were 28,580 COVID-19-related hospital admissions, 1980 COVID-19-related critical care admissions and 6435 COVID-19-related deaths; corresponding IRs 4.77 (95% CI 4.74–4.80), 0.33 (95% CI 0.32–0.34) and 1.07 (95% CI 1.06–1.09), respectively. The highest rates of breakthrough COVID-19 were seen in those in care homes and in patients with chronic kidney disease, dialysis, transplant, haematological malignancy or who were immunocompromised. CONCLUSIONS: While the majority of COVID-19 vaccine breakthrough cases in England were mild, some differences in rates of breakthrough cases have been identified in several clinical groups. While it is important to note that these findings are simply descriptive and cannot be used to answer why certain groups have higher rates of COVID-19 breakthrough than others, the emergence of the Omicron variant of COVID-19 coupled with the number of positive SARS-CoV-2 tests still occurring is concerning and as numbers of fully vaccinated (and boosted) individuals increases and as follow-up time lengthens, so too will the number of COVID-19 breakthrough cases. Additional analyses, to assess vaccine waning and rates of breakthrough COVID-19 between different variants, aimed at identifying individuals at higher risk, are needed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-022-02422-0.
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spelling pubmed-92554362022-07-06 Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY Green, Amelia Curtis, Helen Hulme, William Williamson, Elizabeth McDonald, Helen Bhaskaran, Krishnan Rentsch, Christopher Schultze, Anna MacKenna, Brian Mahalingasivam, Viyaasan Tomlinson, Laurie Walker, Alex Fisher, Louis Massey, Jon Andrews, Colm Hopcroft, Lisa Morton, Caroline Croker, Richard Morley, Jessica Mehrkar, Amir Bacon, Seb Evans, David Inglesby, Peter Hickman, George Ward, Tom Davy, Simon Mathur, Rohini Tazare, John Eggo, Rosalind Wing, Kevin Wong, Angel Forbes, Harriet Bates, Chris Cockburn, Jonathan Parry, John Hester, Frank Harper, Sam Douglas, Ian Evans, Stephen Smeeth, Liam Goldacre, Ben BMC Med Research Article BACKGROUND: While the vaccines against COVID-19 are highly effective, COVID-19 vaccine breakthrough is possible despite being fully vaccinated. With SARS-CoV-2 variants still circulating, describing the characteristics of individuals who have experienced COVID-19 vaccine breakthroughs could be hugely important in helping to determine who may be at greatest risk. METHODS: With the approval of NHS England, we conducted a retrospective cohort study using routine clinical data from the OpenSAFELY-TPP database of fully vaccinated individuals, linked to secondary care and death registry data and described the characteristics of those experiencing COVID-19 vaccine breakthroughs. RESULTS: As of 1st November 2021, a total of 15,501,550 individuals were identified as being fully vaccinated against COVID-19, with a median follow-up time of 149 days (IQR: ​107–179). From within this population, a total of 579,780 (<4%) individuals reported a positive SARS-CoV-2 test. For every 1000 years of patient follow-up time, the corresponding incidence rate (IR) was 98.06 (95% CI 97.93–98.19). There were 28,580 COVID-19-related hospital admissions, 1980 COVID-19-related critical care admissions and 6435 COVID-19-related deaths; corresponding IRs 4.77 (95% CI 4.74–4.80), 0.33 (95% CI 0.32–0.34) and 1.07 (95% CI 1.06–1.09), respectively. The highest rates of breakthrough COVID-19 were seen in those in care homes and in patients with chronic kidney disease, dialysis, transplant, haematological malignancy or who were immunocompromised. CONCLUSIONS: While the majority of COVID-19 vaccine breakthrough cases in England were mild, some differences in rates of breakthrough cases have been identified in several clinical groups. While it is important to note that these findings are simply descriptive and cannot be used to answer why certain groups have higher rates of COVID-19 breakthrough than others, the emergence of the Omicron variant of COVID-19 coupled with the number of positive SARS-CoV-2 tests still occurring is concerning and as numbers of fully vaccinated (and boosted) individuals increases and as follow-up time lengthens, so too will the number of COVID-19 breakthrough cases. Additional analyses, to assess vaccine waning and rates of breakthrough COVID-19 between different variants, aimed at identifying individuals at higher risk, are needed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-022-02422-0. BioMed Central 2022-07-05 /pmc/articles/PMC9255436/ /pubmed/35791013 http://dx.doi.org/10.1186/s12916-022-02422-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Green, Amelia
Curtis, Helen
Hulme, William
Williamson, Elizabeth
McDonald, Helen
Bhaskaran, Krishnan
Rentsch, Christopher
Schultze, Anna
MacKenna, Brian
Mahalingasivam, Viyaasan
Tomlinson, Laurie
Walker, Alex
Fisher, Louis
Massey, Jon
Andrews, Colm
Hopcroft, Lisa
Morton, Caroline
Croker, Richard
Morley, Jessica
Mehrkar, Amir
Bacon, Seb
Evans, David
Inglesby, Peter
Hickman, George
Ward, Tom
Davy, Simon
Mathur, Rohini
Tazare, John
Eggo, Rosalind
Wing, Kevin
Wong, Angel
Forbes, Harriet
Bates, Chris
Cockburn, Jonathan
Parry, John
Hester, Frank
Harper, Sam
Douglas, Ian
Evans, Stephen
Smeeth, Liam
Goldacre, Ben
Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY
title Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY
title_full Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY
title_fullStr Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY
title_full_unstemmed Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY
title_short Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY
title_sort describing the population experiencing covid-19 vaccine breakthrough following second vaccination in england: a cohort study from opensafely
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9255436/
https://www.ncbi.nlm.nih.gov/pubmed/35791013
http://dx.doi.org/10.1186/s12916-022-02422-0
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