TY - JOUR
T1 - AZD1222 effectiveness against severe COVID-19 in individuals with comorbidity or frailty
T2 - The RAVEN cohort study
AU - Meeraus, Wilhelmine
AU - Joy, Mark
AU - Ouwens, Mario
AU - Taylor, Kathryn S.
AU - Venkatesan, Sudhir
AU - Dennis, John
AU - Tran, Trung N.
AU - Dashtban, Ashkan
AU - Fan, Xuejuan
AU - Williams, Robert
AU - Morris, Tamsin
AU - Carty, Lucy
AU - Kar, Debasish
AU - Hoang, Uy
AU - Feher, Michael
AU - Forbes, Anna
AU - Jamie, Gavin
AU - Hinton, William
AU - Sanecka, Kornelia
AU - Byford, Rachel
AU - Anand, Sneha N.
AU - Hobbs, F. D.Richard
AU - Clifton, David A.
AU - Pollard, Andrew J.
AU - Taylor, Sylvia
AU - de Lusignan, Simon
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/2/29
Y1 - 2024/2/29
N2 - Objectives: Despite being prioritized during initial COVID-19 vaccine rollout, vulnerable individuals at high risk of severe COVID-19 (hospitalization, intensive care unit admission, or death) remain underrepresented in vaccine effectiveness (VE) studies. The RAVEN cohort study (NCT05047822) assessed AZD1222 (ChAdOx1 nCov-19) two-dose primary series VE in vulnerable populations. Methods: Using the Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub, linked to secondary care, death registration, and COVID-19 datasets in England, COVID-19 outcomes in 2021 were compared in vaccinated and unvaccinated individuals matched on age, sex, region, and multimorbidity. Results: Over 4.5 million AZD1222 recipients were matched (mean follow-up ∼5 months); 68% were ≥50 years, 57% had high multimorbidity. Overall, high VE against severe COVID-19 was demonstrated, with lower VE observed in vulnerable populations. VE against hospitalization was higher in the lowest multimorbidity quartile (91.1%; 95% CI: 90.1, 92.0) than the highest quartile (80.4%; 79.7, 81.1), and among individuals ≥65 years, higher in the ‘fit’ (86.2%; 84.5, 87.6) than the frailest (71.8%; 69.3, 74.2). VE against hospitalization was lowest in immunosuppressed individuals (64.6%; 60.7, 68.1). Conclusions: Based on integrated and comprehensive UK health data, overall population-level VE with AZD1222 was high. VEs were notably lower in vulnerable groups, particularly the immunosuppressed.
AB - Objectives: Despite being prioritized during initial COVID-19 vaccine rollout, vulnerable individuals at high risk of severe COVID-19 (hospitalization, intensive care unit admission, or death) remain underrepresented in vaccine effectiveness (VE) studies. The RAVEN cohort study (NCT05047822) assessed AZD1222 (ChAdOx1 nCov-19) two-dose primary series VE in vulnerable populations. Methods: Using the Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub, linked to secondary care, death registration, and COVID-19 datasets in England, COVID-19 outcomes in 2021 were compared in vaccinated and unvaccinated individuals matched on age, sex, region, and multimorbidity. Results: Over 4.5 million AZD1222 recipients were matched (mean follow-up ∼5 months); 68% were ≥50 years, 57% had high multimorbidity. Overall, high VE against severe COVID-19 was demonstrated, with lower VE observed in vulnerable populations. VE against hospitalization was higher in the lowest multimorbidity quartile (91.1%; 95% CI: 90.1, 92.0) than the highest quartile (80.4%; 79.7, 81.1), and among individuals ≥65 years, higher in the ‘fit’ (86.2%; 84.5, 87.6) than the frailest (71.8%; 69.3, 74.2). VE against hospitalization was lowest in immunosuppressed individuals (64.6%; 60.7, 68.1). Conclusions: Based on integrated and comprehensive UK health data, overall population-level VE with AZD1222 was high. VEs were notably lower in vulnerable groups, particularly the immunosuppressed.
KW - ChAdOx1 nCoV-19
KW - COVID-19
KW - COVID-19 vaccines
KW - SARS-CoV-2
UR - https://www.scopus.com/pages/publications/85188461826
U2 - 10.1016/j.jinf.2024.106129
DO - 10.1016/j.jinf.2024.106129
M3 - Article
C2 - 38431156
AN - SCOPUS:85188461826
SN - 0163-4453
VL - 88
JO - Journal of Infection
JF - Journal of Infection
IS - 4
M1 - 106129
ER -
