Pfizer-BioNTech and Oxford AstraZeneca COVID-19 vaccine effectiveness and immune response among individuals in clinical risk groups.
Whitaker HJ., Tsang RS., Byford R., Andrews NJ., Sherlock J., Pillai PS., Williams J., Button E., Campbell H., Sinnathamby M., Victor W., Anand S., Linley E., Hewson J., DArchangelo S., Otter AD., Ellis J., Hobbs RF., Howsam G., Zambon M., Ramsay M., Brown KE., de Lusignan S., Amirthalingam G., Bernal JL.
BACKGROUND: COVID-19 vaccines approved in the UK are highly effective in general population cohorts, however, data on effectiveness among individuals with clinical conditions that place them at increased risk of severe disease are limited. METHODS: We used GP electronic health record data, sentinel virology swabbing and antibody testing within a cohort of 712 general practices across England to estimate vaccine antibody response and vaccine effectiveness against medically attended COVID-19 among individuals in clinical risk groups using cohort and test-negative case control designs. FINDINGS: There was no reduction in S-antibody positivity in most clinical risk groups, however reduced S-antibody positivity and response was significant in the immunosuppressed group. Reduced vaccine effectiveness against clinical disease was also noted in the immunosuppressed group; after a second dose, effectiveness was moderate (Pfizer: 59.6%, 95%CI 18.0-80.1%; AstraZeneca 60.0%, 95%CI -63.6-90.2%). INTERPRETATION: In most clinical risk groups, immune response to primary vaccination was maintained and high levels of vaccine effectiveness were seen. Reduced antibody response and vaccine effectiveness were seen after 1 dose of vaccine among a broad immunosuppressed group, and second dose vaccine effectiveness was moderate. These findings support maximising coverage in immunosuppressed individuals and the policy of prioritisation of this group for third doses.