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Effectiveness of First Dose of COVID-19 Vaccines Against Hospital Admissions in Scotland: National Prospective Cohort Study of 5.4 Million People

21 Pages Posted: 19 Feb 2021

See all articles by Eleftheria Vasileiou

Eleftheria Vasileiou

University of Edinburgh - Asthma UK Centre for Applied Research

Colin R. Simpson

Victoria University of Wellington - School of Health

Chris Robertson

University of Strathclyde - Department of Mathematics & Statistics

Ting Shi

University of Edinburgh - Centre for Global Health

Steven Kerr

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics

Utkarsh Agrawal

University of St. Andrews - School of Medicine

Ashley Akbari

Swansea University - Health Data Research UK

Stuart Bedston

Swansea University - Population Data Science

Jillian Beggs

BREATHE – The Health Data Research Hub for Respiratory Health

Declan Bradley

Queen’s University Belfast - Public Health Agency

Antony Chuter

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics

Simon de Lusignan

University of Oxford; Royal College of General Practitioners - Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC); University of Surrey - Department of Clinical & Experimental Medicine

Annemarie Docherty

University of Edinburgh - Centre for Medical Informatics

David Ford

Swansea University - Health Informatics Group

Richard Hobbs

University of Oxford - Nuffield Department of Primary Care Health Sciences; University of Birmingham

Mark Joy

University of Oxford - Nuffield Department of Primary Care Health Sciences

Srinivasa Vittal Katikireddi

University of Glasgow - Institute of Health and Wellbeing

James Marple

The University of Edinburgh - Royal Infirmary of Edinburgh

Colin McCowan

University of St Andrews - School of Medicine

Dylan McGagh

Nuffield Department of Primary Care Health Sciences, University of Oxford

Jim McMenamin

Public Health Scotland

Emily Moore

Public Health Scotland

Josephine-L.K Murray

Public Health Scotland

Jiafeng Pan

University of Strathclyde - Department of Mathematics & Statistics

Lewis Ritchie

University of Aberdeen - Academic Primary Care

Syed Ahmar Shah

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics

Sarah Stock

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics

Fatemeh Torabi

Swansea University - Population Data Science

Ruby S. M. Tsang

University of Oxford - Nuffield Department of Primary Care Health Sciences

Rachael Wood

Public Health Scotland - Clinical and Public Health Intelligence Team

Mark Woolhouse

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics

Aziz Sheikh

University of Edinburgh - Asthma UK Centre for Applied Research

More...

Abstract

Background: The BNT162b2 mRNA (Pfizer-BioNTech) and ChAdOx1 (Oxford-AstraZeneca) COVID-19 vaccines have demonstrated high efficacy against infection in phase 3 clinical trials and are now being used in national vaccination programmes in the UK and several other countries. There is an urgent need to study the ‘real-world’ effects of these vaccines. The aim of our study was to estimate the effectiveness of the first dose of these COVID-19 vaccines in preventing hospital admissions.

Methods: We conducted a prospective cohort study using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) database comprising of linked vaccination, primary care, Real-Time Polymerase Chain Reaction (RT-PCR) testing, hospitalisation and mortality records for 5.4 million people in Scotland (covering ~99% of population). A time-dependent Cox model and Poisson regression models were fitted to estimate effectiveness against COVID-19 related hospitalisation (defined as 1- Adjusted Hazard Ratio) following the first dose of vaccine.

Findings: The first dose of the BNT162b2 vaccine was associated with a vaccine effect of 85% (95% confidence interval [CI] 76 to 91) for COVID-19 related hospitalisation at 28-34 days post-vaccination. Vaccine effect at the same time interval for the ChAdOx1 vaccine was 94% (95% CI 73 to 99). Results of combined vaccine effect for prevention of COVID-19 related hospitalisation were comparable when restricting the analysis to those aged ≥80 years (81%; 95% CI 65 to 90 at 28-34 days post-vaccination).

Interpretation: A single dose of the BNT162b2 mRNA and ChAdOx1 vaccines resulted in substantial reductions in the risk of COVID-19 related hospitalisation in Scotland.

Funding: UK Research and Innovation (Medical Research Council); Research and Innovation Industrial Strategy Challenge Fund; Health Data Research UK.

Conflict of Interest: AS is a member of the Scottish Government Chief Medical Officer’s COVID-19Advisory Group and the New and Emerging Respiratory Virus Threats (NERVTAG) Risk Stratification Subgroup. CRS declares funding from the MRC, NIHR, CSO and New Zealand Ministry for Business, Innovation and Employment and Health Research Council during the conduct of this study. SVK is co-chair of the Scottish Government’s Expert Reference Group on COVID-19 and ethnicity, is a member of the Scientific Advisory Group on Emergencies (SAGE) subgroup on ethnicity and acknowledges funding from a NRS Senior Clinical Fellowship, MRC and CSO. All other authors report no conflicts of interest.

Ethical Approval: Approvals were obtained from the National Research Ethics Service Committee, Southeast Scotland 02 (reference number: 12/SS/0201) and Public Benefit and Privacy Panel for Health and Social Care (reference number: 1920-0279).

Suggested Citation

Vasileiou, Eleftheria and Simpson, Colin R. and Robertson, Chris and Shi, Ting and Kerr, Steven and Agrawal, Utkarsh and Akbari, Ashley and Bedston, Stuart and Beggs, Jillian and Bradley, Declan and Chuter, Antony and de Lusignan, Simon and Docherty, Annemarie and Ford, David and Hobbs, F.D. Richard and Joy, Mark and Katikireddi, Srinivasa Vittal and Marple, James and McCowan, Colin and McGagh, Dylan and McMenamin, Jim and Moore, Emily and Murray, Josephine-L.K and Pan, Jiafeng and Ritchie OBE FRSE, Professor Sir Lewis and Shah, Syed Ahmar and Stock, Sarah and Torabi, Fatemeh and Tsang, Ruby S. M. and Wood, Rachael and Woolhouse, Mark and Sheikh, Aziz, Effectiveness of First Dose of COVID-19 Vaccines Against Hospital Admissions in Scotland: National Prospective Cohort Study of 5.4 Million People. Available at SSRN: https://ssrn.com/abstract=3789264 or http://dx.doi.org/10.2139/ssrn.3789264

Eleftheria Vasileiou (Contact Author)

University of Edinburgh - Asthma UK Centre for Applied Research ( email )

Edinburgh
United Kingdom

Colin R. Simpson

Victoria University of Wellington - School of Health

P.O. Box 600
Wellington, 6140
New Zealand

Chris Robertson

University of Strathclyde - Department of Mathematics & Statistics ( email )

26 Richmond Street
Glasgow G1 1XH
United Kingdom

Ting Shi

University of Edinburgh - Centre for Global Health

Old College
South Bridge
Edinburgh, Scotland EH8 9JY
United Kingdom

Steven Kerr

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics

Teviot Place
Edinburgh, EH8 9AG
United Kingdom

Utkarsh Agrawal

University of St. Andrews - School of Medicine

United Kingdom

Ashley Akbari

Swansea University - Health Data Research UK

United Kingdom

Stuart Bedston

Swansea University - Population Data Science

Singleton Park
Swansea, SA2 8PP
United Kingdom

Jillian Beggs

BREATHE – The Health Data Research Hub for Respiratory Health ( email )

Declan Bradley

Queen’s University Belfast - Public Health Agency ( email )

Ireland

Antony Chuter

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics ( email )

Teviot Place
Edinburgh, EH8 9AG
United Kingdom

Simon De Lusignan

University of Oxford ( email )

Eagle House,
Walton Well Road,
Oxford, OX2 6ED
United Kingdom

HOME PAGE: http://https://orchid.phc.ox.ac.uk

Royal College of General Practitioners - Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) ( email )

30 Euston Square
London
United Kingdom

University of Surrey - Department of Clinical & Experimental Medicine ( email )

Guildford
United Kingdom

Annemarie Docherty

University of Edinburgh - Centre for Medical Informatics ( email )

David Ford

Swansea University - Health Informatics Group

Singleton Park
Swansea, Wales SA2 8PP
United Kingdom

F.D. Richard Hobbs

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

University of Birmingham ( email )

Mark Joy

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Srinivasa Vittal Katikireddi

University of Glasgow - Institute of Health and Wellbeing ( email )

Glasgow
United Kingdom

James Marple

The University of Edinburgh - Royal Infirmary of Edinburgh ( email )

51 Little France Cres
Edinburgh, EH16 4SA
United Kingdom

Colin McCowan

University of St Andrews - School of Medicine

St Andrews, KY16 9AL
United Kingdom

Dylan McGagh

Nuffield Department of Primary Care Health Sciences, University of Oxford ( email )

Jim McMenamin

Public Health Scotland

Glasgow, Scotland
United Kingdom

Emily Moore

Public Health Scotland

Josephine-L.K Murray

Public Health Scotland ( email )

Jiafeng Pan

University of Strathclyde - Department of Mathematics & Statistics ( email )

26 Richmond Street
Glasgow G1 1XH
United Kingdom

Professor Sir Lewis Ritchie OBE FRSE

University of Aberdeen - Academic Primary Care

Dunbar Street
Aberdeen, AB24 3QY
United Kingdom

Syed Ahmar Shah

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics ( email )

Teviot Place
Edinburgh, EH8 9AG
United Kingdom

Sarah Stock

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics

Teviot Place
Edinburgh, EH8 9AG
United Kingdom

Fatemeh Torabi

Swansea University - Population Data Science

Singleton Park
Swansea, Wales SA2 8PP
United Kingdom

Ruby S. M. Tsang

University of Oxford - Nuffield Department of Primary Care Health Sciences

Mansfield Road
Oxford, OX1 4AU
United Kingdom

Rachael Wood

Public Health Scotland - Clinical and Public Health Intelligence Team

Scotland
United Kingdom

Mark Woolhouse

University of Edinburgh - Usher Institute of Population Health Sciences and Informatics

Teviot Place
Edinburgh, EH8 9AG
United Kingdom

Aziz Sheikh

University of Edinburgh - Asthma UK Centre for Applied Research ( email )

Edinburgh
United Kingdom

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