Using data to improve public health: COVID-19 secondment

利用数据改善公共卫生：COVID-19 借调

• 批准号: MR/W021420/1
• 负责人: Edward Parker
• 金额: $ 9.21万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FW021420%2F1
• 关键词: Using; data; improve; public; health

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.

新冠肺炎疫苗的开发和实施一直是旨在减轻持续大流行影响的关键公共卫生战略之一。多种疫苗的安全性和有效性已在大型第三阶段临床试验中得到证实。然而，有关这些疫苗在现实世界中的使用仍然存在关键的不确定性，包括：(I)疫苗诱导的保护在不同亚群中的强度和持久性，包括严重新冠肺炎的特别风险人群；(Ii)给药间隔对疫苗效力的影响；以及(Iii)自然感染SARS-CoV-2可能在多大程度上增强疫苗诱导的保护(接种前或接种后)。解决这些不确定性对于制定有关增加新冠肺炎疫苗剂量的必要性、最佳时机和可能的影响的政策决策至关重要。我的借调将利用OpenSAFELY-一个用于分析英国境内电子健康记录数据的安全、开源的软件平台-来解决有关现实世界新冠肺炎疫苗实施和有效性的关键问题。我将与伦敦卫生与热带医学院和牛津大学的研究人员合作，评估新冠肺炎疫苗在关键风险群体中的覆盖率，包括受慢性肾脏疾病影响的个人(目标1)。然后，我将根据接受的初始剂量疫苗(例如，RNA疫苗与载体疫苗)和加强剂量，比较这些风险组的疫苗效力，特别强调异种“混合匹配”计划对疫苗性能的潜在影响(目标2)。最后，我将探讨几个关键因素对疫苗保护强度和持久性的影响，包括剂量间隔和自然感染(目标3)。在这样做的过程中，该项目将大规模应用真实世界的电子健康数据，以解决正在进行的新冠肺炎疫苗推出的重要证据空白。

项目成果

Challenges in estimating waning effectiveness of two doses of BNT162b2 and ChAdOx1 COVID-19 vaccines beyond six months: an OpenSAFELY cohort study using linked electronic health records

评估两剂 BNT162b2 和 ChAdOx1 COVID-19 疫苗六个月后有效性减弱的挑战：使用链接电子健康记录的 OpenSAFELY 队列研究

• DOI: 10.1101/2023.01.04.22283762
• 发表时间: 2023
• 作者: Horne E

Ethnic differences in the indirect impacts of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: An observational cohort study using OpenSAFELY

COVID-19 大流行对英格兰非 COVID 疾病临床监测和住院治疗的间接影响的种族差异：使用 OpenSAFELY 进行的一项观察性队列研究

• DOI: 10.1101/2023.01.04.23284174
• 发表时间: 2023
• 作者: Costello R

First dose COVID-19 vaccine coverage amongst adolescents and children in England: an analysis of 3.21 million patients' primary care records in situ using OpenSAFELY

英格兰青少年和儿童首剂 COVID-19 疫苗覆盖率：使用 OpenSAFELY 对 321 万患者的初级保健记录进行现场分析

• DOI: 10.12688/wellcomeopenres.18735.1
• 发表时间: 2023
• 期刊: Wellcome Open Research
• 作者: Hopcroft L

Waning effectiveness of BNT162b2 and ChAdOx1 covid-19 vaccines over six months since second dose: OpenSAFELY cohort study using linked electronic health records.

• DOI: 10.1136/bmj-2022-071249
• 发表时间: 2022-07-20
• 期刊: BMJ-BRITISH MEDICAL JOURNAL
• 影响因子: 105.7
• 作者: Horne, Elsie M. F.;Hulme, William J.;Keogh, Ruth H.;Palmer, Tom M.;Williamson, Elizabeth J.;Parker, Edward P. K.;Green, Amelia;Walker, Venexia;Walker, Alex J.;Curtis, Helen;Fisher, Louis;MacKenna, Brian;Croker, Richard;Hopcroft, Lisa;Park, Robin Y.;Massey, Jon;Morley, Jessica;Mehrkar, Amir;Bacon, Sebastian;Evans, David;Inglesby, Peter;Morton, Caroline E.;Hickman, George;Davy, Simon;Ward, Tom;Dillingham, Iain;Goldacre, Ben;Hernan, Miguel A.;Sterne, Jonathan A. C.
• 通讯作者: Sterne, Jonathan A. C.

Comparative effectiveness of two- and three-dose COVID-19 vaccination schedules involving AZD1222 and BNT162b2 in people with kidney disease: a linked OpenSAFELY and UK Renal Registry cohort study.

• DOI: 10.1016/j.lanepe.2023.100636
• 发表时间: 2023-05-03
• 期刊: LANCET REGIONAL HEALTH-EUROPE
• 影响因子: 20.9
• 作者: Parker, Edward P K;Horne, Elsie M F;Hulme, William J;Tazare, John;Zheng, Bang;Carr, Edward J;Loud, Fiona;Lyon, Susan;Mahalingasivam, Viyaasan;MacKenna, Brian;Mehrkar, Amir;Scanlon, Miranda;Santhakumaran, Shalini;Steenkamp, Retha;Goldacre, Ben;Sterne, Jonathan A C;Nitsch, Dorothea;Tomlinson, Laurie A
• 通讯作者: Tomlinson, Laurie A