Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-022-02422-0 |
| _version_ | 1818158298828898304 |
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| author | The OpenSAFELY Collaborative Amelia Green Helen Curtis William Hulme Elizabeth Williamson Helen McDonald Krishnan Bhaskaran Christopher Rentsch Anna Schultze Brian MacKenna Viyaasan Mahalingasivam Laurie Tomlinson Alex Walker Louis Fisher Jon Massey Colm Andrews Lisa Hopcroft Caroline Morton Richard Croker Jessica Morley Amir Mehrkar Seb Bacon David Evans Peter Inglesby George Hickman Tom Ward Simon Davy Rohini Mathur John Tazare Rosalind Eggo Kevin Wing Angel Wong Harriet Forbes Chris Bates Jonathan Cockburn John Parry Frank Hester Sam Harper Ian Douglas Stephen Evans Liam Smeeth Ben Goldacre |
| author_facet | The OpenSAFELY Collaborative Amelia Green Helen Curtis William Hulme Elizabeth Williamson Helen McDonald Krishnan Bhaskaran Christopher Rentsch Anna Schultze Brian MacKenna Viyaasan Mahalingasivam Laurie Tomlinson Alex Walker Louis Fisher Jon Massey Colm Andrews Lisa Hopcroft Caroline Morton Richard Croker Jessica Morley Amir Mehrkar Seb Bacon David Evans Peter Inglesby George Hickman Tom Ward Simon Davy Rohini Mathur John Tazare Rosalind Eggo Kevin Wing Angel Wong Harriet Forbes Chris Bates Jonathan Cockburn John Parry Frank Hester Sam Harper Ian Douglas Stephen Evans Liam Smeeth Ben Goldacre |
| author_sort | The OpenSAFELY Collaborative |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-11T15:27:52Z |
| format | Article |
| id | doaj.art-5fb9fd19628a413e9a1d0e9303d74a1c |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-11T15:27:52Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-5fb9fd19628a413e9a1d0e9303d74a1c2022-12-22T01:00:09ZengBMCBMC Medicine1741-70152022-07-0120111410.1186/s12916-022-02422-0Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELYThe OpenSAFELY CollaborativeAmelia Green0Helen Curtis1William Hulme2Elizabeth Williamson3Helen McDonald4Krishnan Bhaskaran5Christopher Rentsch6Anna Schultze7Brian MacKenna8Viyaasan Mahalingasivam9Laurie Tomlinson10Alex Walker11Louis Fisher12Jon Massey13Colm Andrews14Lisa Hopcroft15Caroline Morton16Richard Croker17Jessica Morley18Amir Mehrkar19Seb Bacon20David Evans21Peter Inglesby22George Hickman23Tom Ward24Simon Davy25Rohini Mathur26John Tazare27Rosalind Eggo28Kevin Wing29Angel Wong30Harriet Forbes31Chris Bates32Jonathan Cockburn33John Parry34Frank Hester35Sam Harper36Ian Douglas37Stephen Evans38Liam Smeeth39Ben Goldacre40Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineTPP, TPP HouseTPP, TPP HouseTPP, TPP HouseTPP, TPP HouseTPP, TPP HouseLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of OxfordAbstract 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.https://doi.org/10.1186/s12916-022-02422-0COVID-19Vaccine breakthroughEHR data |
| spellingShingle | The OpenSAFELY Collaborative Amelia Green Helen Curtis William Hulme Elizabeth Williamson Helen McDonald Krishnan Bhaskaran Christopher Rentsch Anna Schultze Brian MacKenna Viyaasan Mahalingasivam Laurie Tomlinson Alex Walker Louis Fisher Jon Massey Colm Andrews Lisa Hopcroft Caroline Morton Richard Croker Jessica Morley Amir Mehrkar Seb Bacon David Evans Peter Inglesby George Hickman Tom Ward Simon Davy Rohini Mathur John Tazare Rosalind Eggo Kevin Wing Angel Wong Harriet Forbes Chris Bates Jonathan Cockburn John Parry Frank Hester Sam Harper Ian Douglas Stephen Evans Liam Smeeth Ben Goldacre Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY BMC Medicine COVID-19 Vaccine breakthrough EHR data |
| 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 | COVID-19 Vaccine breakthrough EHR data |
| url | https://doi.org/10.1186/s12916-022-02422-0 |
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