Freja Kirsebom Profile picture
Dec 10, 2021 11 tweets 2 min read Read on X
Our first initial estimates of vaccine effectiveness (VE) against symptomatic disease with the Omicron variant are now out. In short, VE remains high following a Pfizer booster after AZ or Pfizer, but is reduced after two doses.

More below 👇

1/11
We used a test negative case control design to estimate VE against symptomatic COVID-19 with the Omicron variant compared to Delta. The odds of vaccination in PCR positive cases was compared to the odds of vaccination in those who test negative.

2/11
Pillar 2 tests were classified as either Delta or Omicron from the period 27/11 – 6/12 based on sequencing and SGFT where sequencing wasn’t available. From 27/11, at least 80% of PCR tests which included the S-gene as a target and which had SGTF were the Omicron variant.

3/11
581 symptomatic Omicron cases were identified during the study period which could be linked to the vaccine record. Over the same period there were 56,439 eligible Delta cases and 130,867 test negative controls.

4/11
Among those who received AZ as the primary course, from two weeks after a Pfizer booster, VE increased to 71.4% (95%CI: 41.8 to 86.0%). Among those who had received Pfizer as the primary course, VE increased to 75.5% (95%CI: 56.1 to 86.3%) after the booster.

5/11
Our findings show that VE against symptomatic disease with the Omicron variant is lower than with the Delta variant, although moderate to high VE of 70-75% is seen in the early period after a booster.

6/11
Due to the small numbers of Omicron cases detected and the time-lag between infection and severe disease, we have not yet been able to determine how protective the vaccines are against severe outcomes.

7/11
However - previous experience with the Delta variant suggests that protection against hospitalisation after two doses is well maintained. We will be looking at this as soon as there is enough data!

8/11
These findings are based on small numbers of cases with the Omicron variant and our estimates are subject to significant uncertainty with wide confidence intervals. This will improve as more data become available.

9/11
Our findings support maximising coverage with booster doses in highly vaccinated populations. Further follow-up will be needed to assess VE against more severe outcomes (such as hospitalisation) as well as the duration of protection of the booster vaccine.

10/11
Full pre-print here: khub.net/documents/1359…

11/11

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More from @freja_kirsebom

Oct 2, 2023
First real-world data on the vaccine effectiveness (VE) of the Sanofi booster now out.

TLDR; the Sanofi booster provides good protection (30-50% on top of the protection remaining from a waned autumn booster) against hospitalisation in those aged 75+.

medrxiv.org/content/10.110…
The Sanofi/GSK AS03-adjuvanted (VidPrevtyn Beta) vaccine and the Pfizer-BioNTech mRNA BA.4-5 bivalent vaccine were offered to adults aged 75 years and over in England from 3rd April 2023.

This is the first time an adjuvanted COVID-19 vaccine has been given in the UK.
We used a test-negative case-control study design to estimate the incremental VE of the Sanofi/GSK and Pfizer BA.4-5 boosters against hospitalisation between 3 April and 27 August 2023 using national level electronic healthcare records in England.
Read 11 tweets
Dec 8, 2022
Vaccine effectiveness (VE) of the bivalent booster vaccines against COVID-19 hospitalisation in England -> first data now out in the UKHSA vaccine surveillance report

1/7

assets.publishing.service.gov.uk/government/upl…
Bivalent boosters with either Pfizer BioNTech or
Moderna targeting both the ancestral
strain and Omicron BA.1 were offered to those in clinical risk groups and those aged 50 years
and older from September 2022 in England.

2/7
The study period included tests from 5th Sept to 30th Oct 2022 to allow time for hospitalisation and to account for lags in receiving admission data. VE against hospitalisation was estimated for combined manufacturers and against all Omicron sub-lineages in circulation.

3/7
Read 7 tweets
Sep 2, 2022
Our latest pre-print where we estimate vaccine effectiveness (VE) against hospitalisation following infection with the Omicron sub-lineages BA.4 and BA.5 in England is now up:

medrxiv.org/content/10.110…
Here, we use a whole population test-negative case control study design. VE against hospitalisation with BA.4 and BA.5 is compared to BA.2 during a period of co-circulation.
Since there are now very few unvaccinated individuals, VE was estimated in those who had recently received a booster vaccine relative to those with waned immunity who had received their second dose 25 or more weeks ago.
Read 10 tweets
May 25, 2022
Now peer-reviewed and published @TheLancetInfDis, our study on vaccine effectiveness (VE) against symptomatic disease and hospitalisation for BA.2 compared to BA.1.

thelancet.com/journals/lanin…
Here, we find no reduction in VE against symptomatic disease for BA.2 as compared to BA.1.
Using a strict definition of hospitalisation to identify admissions with severe respiratory disease, we find VE is similar for BA.2 and BA.1, with some evidence of faster waning.
Read 6 tweets
Apr 28, 2022
The first real-world data on the vaccine effectiveness (VE) of the AstraZeneca booster against symptomatic disease and hospitalisation with Delta and Omicron - new pre-print from us this week.

khub.net/documents/1359…

1/14
The AZ booster is in use as part of numerous vaccine programmes globally, particularly in LMICs, due to the lower cost and the relative logistical ease of use. As such, there is a need to understand the duration & level of protection conferred in real world settings.

2/14
In the UK, a small number of individuals who had received at least one dose of AZ, received AZ as a booster where vaccination with mRNA vaccines was clinically contraindicated. In some cases it was also offered for logistical reasons e.g. to housebound individuals.

3/14
Read 14 tweets
Mar 24, 2022
Our most comprehensive analysis so far on the protection conferred by vaccines against hospitalisation over time is published today in the UKHSA Vaccine Surveillance report

assets.publishing.service.gov.uk/government/upl…
Since Omicron causes milder disease and all individuals who are hospitalised for any reason in the UK are tested for COVID-19, an increasing proportion of cases in hospital are likely to have COVID-19 as an incidental finding rather than as the primary reason for admission.
We therefore used multiple, specific definitions of hospitalisation since we previously found that using broad definitions of hospitalisation (anyone admitted via A&E within 14 days of a positive test) gave lower estimates that were likely more reflective of VE against infection.
Read 5 tweets

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