Real World Data Demonstrating Increased Reactogenicity in Adults Receiving Heterologous Compared to Homologous Prime-Boost COVID-19 Vaccination: March-May 2021, England

24 Pages Posted: 13 Jul 2021

See all articles by Annabel Powell

Annabel Powell

Public Health England - Immunisation and Countermeasures Division

Linda Power

Public Health England - Immunisation and Countermeasures Division

Samantha Westrop

Government of the United Kingdom - Immunisation and Countermeasures Division

Kelsey McOwat

Public Health England - Immunisation and Countermeasures Division

Helen Campbell

Government of the United Kingdom - Immunisation and Countermeasures Division

Ruth Simmons

Public Health England

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department

Kevin Brown

Public Health England

Shamez Ladhani

Public Health England - Immunisation and Countermeasures Division; University of London, St. George's, Paediatric Infectious Diseases Research Group

Gayatri Amirthalingam

Public Health England - Immunisation and Countermeasures Division

Date Written: July 6, 2021

Abstract

Adults receiving heterologous prime-boost COVID-19 immunisation schedules with mRNA (Pfizer-BioNTech) or adenoviral-vector (ChAdOx1-S/nCOV-19) vaccines had higher reactogenicity rates and were more likely to seek medical attention after their second dose than homologous schedules. Reactogenicity rates were generally higher among ≤50 than >50 year-olds and in adults with prior symptomatic or confirmed COVID-19. Adults receiving heterologous schedules because of severe first-dose reactions had lower reactogenicity after the second dose following ChAdOx1-S/Pfizer-BioNTech (93.4%[90.5-98.1] vs. 48%[41.0-57.7]) but not Pfizer-BioNTech/ChAdOx1-S (91.7%[77.5-98.2] vs. 75.0%[57.8-87.9]).

Note: Funding: This surveillance was internally funded by PHE and did not receive any specific grant funding from agencies in the public, commercial or not-for-profit sectors.

Declaration of Interests: The authors declare no conflict of interests

Ethics Approval Statement: PHE has legal permission, provided by Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002, to process patient confidential information for national surveillance of communicable diseases and as such, individual patient consent is not required to access records. Individual patient consent was obtained by those who completed the questionnaire.

Keywords: Reactogenicity, heterologous schedule, COVID-19 vaccine

Suggested Citation

Powell, Annabel and Power, Linda and Westrop, Samantha and McOwat, Kelsey and Campbell, Helen and Simmons, Ruth and Ramsay, Mary E. and Brown, Kevin and Ladhani, Shamez and Amirthalingam, Gayatri, Real World Data Demonstrating Increased Reactogenicity in Adults Receiving Heterologous Compared to Homologous Prime-Boost COVID-19 Vaccination: March-May 2021, England (July 6, 2021). Available at SSRN: https://ssrn.com/abstract=3880967 or http://dx.doi.org/10.2139/ssrn.3880967

Annabel Powell

Public Health England - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Linda Power

Public Health England - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Samantha Westrop

Government of the United Kingdom - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Kelsey McOwat

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Helen Campbell

Government of the United Kingdom - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Ruth Simmons

Public Health England ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department ( email )

United Kingdom

Kevin Brown

Public Health England ( email )

Wellington House,
133-155 Waterloo Rd,
London, SE1 8UG

Shamez Ladhani

Public Health England - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

University of London, St. George's, Paediatric Infectious Diseases Research Group

United Kingdom

Gayatri Amirthalingam (Contact Author)

Public Health England - Immunisation and Countermeasures Division ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

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