Evidence map›Paper›PMID 34174190›Full record

ArticleThe Lancet. Infectious diseases2021

Effectiveness of BNT162b2 and ChAdOx1 nCoV-19 COVID-19 vaccination at preventing hospitalisations in people aged at least 80 years: a test-negative, case-control study.

Catherine Hyams, Robin Marlow, Zandile Maseko, Jade King, Lana Ward, Kazminder Fox, Robyn Heath, Anabella Tuner, Zsolt Friedrich, Leigh Morrison and 8 more

Erratum issuedOpen access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 93 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 5 pooled it
9.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 5 syntheses or guidelines pooled it, 149 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Trial
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Mechanistic models of humoral kinetics following COVID-19 vaccination.Journal of the Royal Society, Interface · 2025
    Article
  15. Article
  16. Article
  17. Review
  18. Observational
  19. Article
  20. Article

33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 1 country.

Catherine HyamsPopulation Health Sciences, University of Bristol, Bristol, UK; Academic Respiratory Unit, Southmead Hospital, Bristol, UK.
Robin MarlowPopulation Health Sciences, University of Bristol, Bristol, UK.
Zandile MasekoAcademic Respiratory Unit, Southmead Hospital, Bristol, UK.
Jade KingClinical Research and Imaging Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Lana WardNorth Bristol NHS Trust, Southmead Hospital, Bristol, UK.
Kazminder FoxClinical Research and Imaging Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Robyn HeathClinical Research and Imaging Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Anabella TunerClinical Research and Imaging Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Zsolt FriedrichNorth Bristol NHS Trust, Southmead Hospital, Bristol, UK.
Leigh MorrisonNorth Bristol NHS Trust, Southmead Hospital, Bristol, UK.
Gabriella RuffinoNorth Bristol NHS Trust, Southmead Hospital, Bristol, UK.
Rupert AnticoPopulation Health Sciences, University of Bristol, Bristol, UK.
David AdegbitePopulation Health Sciences, University of Bristol, Bristol, UK.
Zsuzsa Szasz-BenczurPopulation Health Sciences, University of Bristol, Bristol, UK.
Maria Garcia GonzalezPopulation Health Sciences, University of Bristol, Bristol, UK.
Jennifer OliverPopulation Health Sciences, University of Bristol, Bristol, UK.
Leon DanonEngineering Mathematics, University of Bristol, Bristol, UK.
Adam FinnPopulation Health Sciences, University of Bristol, Bristol, UK; Cellular and Molecular Medicine, University of Bristol, Bristol, UK. Electronic address: adam.finn@bristol.ac.uk.
University of Bristol · GBSouthmead Hospital · GBUniversity Hospitals Bristol and Weston NHS Foundation TrustNorth Bristol NHS Trust · GBUniversity Hospitals Bristol NHS Foundation Trust · GB

Funding

Medical Research Council MC_PC_19067
6 · The paper itself

Abstract

backgroundOn Dec 8, 2020, deployment of the first SARS-CoV-2 vaccination authorised for UK use (BNT162b2 mRNA vaccine) began, followed by an adenoviral vector vaccine ChAdOx1 nCoV-19 on Jan 4, 2021. Care home residents and staff, frontline health-care workers, and adults aged 80 years and older were vaccinated first. However, few data exist regarding the effectiveness of these vaccines in older people with many comorbidities. In this post-implementation evaluation of two COVID-19 vaccines, we aimed to determine the effectiveness of one dose in reducing COVID-19-related admissions to hospital in people of advanced age.

methodsThis prospective test-negative case-control study included adults aged at least 80 years who were admitted to hospital in two NHS trusts in Bristol, UK with signs and symptoms of respiratory disease. Patients who developed symptoms before receiving their vaccine or those who received their vaccine after admission to hospital were excluded, as were those with symptoms that started more than 10 days before hospital admission. We did logistic regression analysis, controlling for time (week), sex, index of multiple deprivations, and care residency status, and sensitivity analyses matched for time and sex using a conditional logistic model adjusting for index of multiple deprivations and care residency status. This study is registered with ISRCTN, number 39557.

findingsBetween Dec 18, 2020, and Feb 26, 2021, 466 adults were eligible (144 test-positive and 322 test-negative). 18 (13%) of 135 people with SARS-CoV-2 infection and 90 (34%) of 269 controls received one dose of BNT162b2. The adjusted vaccine effectiveness was 71·4% (95% CI 46·5-90·6). Nine (25%) of 36 people with COVID-19 infection and 53 (59%) of 90 controls received one dose of ChAdOx1 nCoV-19. The adjusted vaccine effectiveness was 80·4% (95% CI 36·4-94·5). When BNT162b2 effectiveness analysis was restricted to the period covered by ChAdOx1 nCoV-19, the estimate was 79·3% (95% CI 47·0-92·5).

interpretationOne dose of either BNT162b2 or ChAdOx1 nCoV-19 resulted in substantial risk reductions of COVID-19-related hospitalisation in people aged at least 80 years.

fundingPfizer.

Indexed as

Immunogenicity, VaccineAged, 80 and overAge FactorsBNT162 VaccineCase-Control StudiesChAdOx1 nCoV-19COVID-19COVID-19 Nucleic Acid TestingCOVID-19 VaccinesEnglandFemaleHospitalizationHumansImmunization ScheduleIncidenceMaleBNT162 VaccineChAdOx1 nCoV-19COVID-19 Vaccines

Identifiers

PMID34174190
PMCPMC8221734
OpenAlexW3176340533

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.