Using data to improve public health: COVID-19 secondment

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The development and implementation of COVID-19 vaccines has been among the key public health strategies aiming to mitigate the fallout of the ongoing pandemic. The safety and efficacy of multiple vaccines has been established in large Phase III clinical trials. However, key uncertainties remain regarding the real-world use of these vaccines, including: (i) the strength and durability of vaccine-induced protection in different subpopulations, including groups at particular risk of severe COVID-19; (ii) the influence of dosing interval on vaccine effectiveness; and (iii) the extent to which vaccine-induced protection might be augmented by natural SARS-CoV-2 infection (either before or after vaccination). Addressing these uncertainties will be essential to inform policy decisions regarding the necessity, optimal timing, and likely impact of additional COVID-19 vaccine doses.My secondment will harness OpenSAFELY - a secure, open-source software platform for the analysis of electronic health record data within the UK - to address key questions regarding real-world COVID-19 vaccine implementation and effectiveness. Working with researchers at the London School of Hygiene & Tropical Medicine and Oxford University, I will evaluate COVID-19 vaccine coverage in key risk groups, including individuals affected by chronic kidney disease (Objective 1). I will then compare vaccine effectiveness in these risk groups according to the vaccines received for initial doses (e.g. RNA vs vectored vaccines) and booster doses, with a particular emphasis on the potential impact of heterologous 'mix-and-match' schedules on vaccine performance (Objective 2). Finally, I will explore the impact of several key factors on the strength and durability of vaccine protection, including dose interval and natural infection (Objective 3). In doing so, the project will apply real-world electronic health data at scale to address important evidence gaps regarding the ongoing COVID-19 vaccine roll-out.