Using data to improve public health: COVID-19 secondment

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One of the core remits of the COVID-19 Longitudinal Health and Wellbeing National Core Study (LH&W NCS) is to understand the consequences of COVID-19 infection and the role of vaccination in mitigating risks. To gain a better understanding of immunological responses to COVID-19 infection and vaccination, serology data (data on COVID-19 antibody levels) was collected for over 30,000 participants from 11 longitudinal population studies between March and May 2021. In addition, even more in-depth immunological data was collected for a subset of one of these population cohorts, namely the Avon Longitudinal Study of Parents and Children (ALSPAC) - a birth cohort recruited in Bristol in the 1990s. There are many studies of seroprevalence (frequency of individuals with antibodies to COVID-19 in a population), and of immune response, largely recruiting patients discharged from hospital with a COVID-19 diagnosis, or volunteers. However, the current study embedding serology in existing population cohorts can address knowledge gaps including: understanding of milder or asymptomatic disease, lack of appropriate control groups for comparison, concerns regarding generalisability given the selective response to previous serological studies and limited objective pre-pandemic data to understand biological determinants of infection or immune response (e.g. metabolic and inflammatory status). The population cohorts form a rich resource in which to study immunological response as they represent key sectors of the population (spanning age groups, socioeconomic status and ethnicity - Table 1.), findings are demonstrably generalizable, and they have rich pre-pandemic biological and sociodemographic data. The aim of this project is to analyse immunological data sets within longitudinal population cohorts to investigate the biological and societal factors underlying the differential immunological responses to COVID-19 infection or vaccination. We will: (i) evaluate pre- and trans- pandemic health and sociodemographic factors associating with low antibody levels post vaccination; (ii) investigate differences between symptomatic and asymptomatic cases following natural infection; and (iii) examine biological explanations for differential vaccine immunological response. This work aims to help inform vaccination strategies and design as well as decisions regarding the easing of public health control measures.