Using data to improve public health: COVID-19 secondment

COVID-19纵向健康与福祉国家核心研究（LH&W NCS）的核心任务之一是了解COVID-19感染的后果以及疫苗接种在减轻风险方面的作用。为了更好地了解对COVID-19感染和疫苗接种的免疫反应，从2021年3月至5月的11项纵向人群研究中收集了3万多名参与者的血清学数据（COVID-19抗体水平数据）。此外，更深入的免疫学数据收集了这些人群队列中的一个子集，即雅芳父母和儿童纵向研究(ALSPAC) - 20世纪90年代在布里斯托尔招募的出生队列。有许多关于血清阳性率（人群中具有COVID-19抗体的个体的频率）和免疫反应的研究，主要招募了诊断为COVID-19的出院患者或志愿者。然而，目前将血清学纳入现有人群队列的研究可以解决知识空白，包括：对较轻或无症状疾病的理解，缺乏适当的对照组进行比较，考虑到对以往血清学研究的选择性反应，对普遍性的担忧，以及了解感染或免疫反应的生物学决定因素（例如代谢和炎症状态）的大流行前客观数据有限。人口队列构成了研究免疫反应的丰富资源，因为它们代表了人口的关键部分（跨越年龄组、社会经济地位和种族——表1），研究结果显然具有普遍性，并且具有丰富的大流行前生物和社会人口数据。该项目的目的是分析纵向人群队列中的免疫学数据集，以调查对COVID-19感染或疫苗接种的差异免疫反应背后的生物和社会因素。我们将：(i)评估与疫苗接种后低抗体水平相关的大流行前和跨大流行的健康和社会人口因素；㈡调查自然感染后有症状和无症状病例之间的差异；（三）研究差异疫苗免疫反应的生物学解释。这项工作旨在帮助为疫苗接种战略和设计以及有关放松公共卫生控制措施的决定提供信息。

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.