Evidence map›Paper›PMID 36655537›Full record

Observational studyInternational journal of epidemiology2023

Comparative effectiveness of different primary vaccination courses on mRNA-based booster vaccines against SARs-COV-2 infections: a time-varying cohort analysis using trial emulation in the Virus Watch community cohort.

Vincent Grigori Nguyen, Alexei Yavlinsky, Sarah Beale, Susan Hoskins, Thomas E Byrne, Vasileios Lampos, Isobel Braithwaite, Wing Lam Erica Fong, Ellen Fragaszy, Cyril Geismar and 7 more

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 2 institutions in 1 country.

Vincent Grigori NguyenInstitute of Health Informatics, University College London, London, UK.ORCID 0000-0002-9776-6242
Alexei YavlinskyInstitute of Health Informatics, University College London, London, UK.
Sarah BealeInstitute of Health Informatics, University College London, London, UK.
Susan HoskinsInstitute of Epidemiology and Health Care, University College London, London, UK.
Thomas E ByrneInstitute of Health Informatics, University College London, London, UK.
Vasileios LamposDepartment of Computer Science, University College London, London, UK.
Isobel BraithwaiteInstitute of Health Informatics, University College London, London, UK.
Wing Lam Erica FongInstitute of Health Informatics, University College London, London, UK.
Ellen FragaszyInstitute of Health Informatics, University College London, London, UK.
Cyril GeismarInstitute of Health Informatics, University College London, London, UK.
Jana KovarInstitute of Epidemiology and Health Care, University College London, London, UK.
Annalan M D NavaratnamInstitute of Health Informatics, University College London, London, UK.
Parth PatelInstitute of Health Informatics, University College London, London, UK.
Madhumita ShrotriInstitute of Health Informatics, University College London, London, UK.
Sophie WeberInstitute of Health Informatics, University College London, London, UK.
Andrew C HaywardInstitute of Epidemiology and Health Care, University College London, London, UK.
Robert W AldridgeInstitute of Health Informatics, University College London, London, UK.
University College London · GBLondon School of Hygiene & Tropical Medicine · GB

Funding

Medical Research Council MC_PC 19070Medical Research Council MC_PC_19070Medical Research Council MR/N013867/1Medical Research Council MR/V028375/1Wellcome TrustWellcome Trust 206602
6 · The paper itself

Abstract

backgroundThe Omicron B.1.1.529 variant increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in doubly vaccinated individuals, particularly in the Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1) recipients. To tackle infections, the UK's booster vaccination programmes used messenger ribonucleic acid (mRNA) vaccines irrespective of an individual's primary course vaccine type, and prioritized the clinically vulnerable. These mRNA vaccines included the Pfizer-BioNTech COVID-19 vaccine (BNT162b2) the Moderna COVID-19 vaccine (mRNA-1273). There is limited understanding of the effectiveness of different primary vaccination courses on mRNA booster vaccines against SARs-COV-2 infections and how time-varying confounders affect these evaluations.

methodsTrial emulation was applied to a prospective community observational cohort in England and Wales to reduce time-varying confounding-by-indication driven by prioritizing vaccination based upon age, vulnerability and exposure. Trial emulation was conducted by meta-analysing eight adult cohort results whose booster vaccinations were staggered between 16 September 2021 and 05 January 2022 and followed until 23 January 2022. Time from booster vaccination until SARS-CoV-2 infection, loss of follow-up or end of study was modelled using Cox proportional hazard models and adjusted for age, sex, minority ethnic status, clinically vulnerability and deprivation.

resultsA total of 19 159 participants were analysed, with 11 709 ChAdOx1 primary courses and 7450 BNT162b2 primary courses. Median age, clinical vulnerability status and infection rates fluctuate through time. In mRNA-boosted adults, 7.4% (n = 863) of boosted adults with a ChAdOx1 primary course experienced a SARS-CoV-2 infection compared with 7.7% (n = 571) of those who had BNT162b2 as a primary course. The pooled adjusted hazard ratio (aHR) was 1.01 with a 95% confidence interval (CI) of: 0.90 to 1.13.

conclusionAfter an mRNA booster dose, we found no difference in protection comparing those with a primary course of BNT162b2 with those with a ChAdOx1 primary course. This contrasts with pre-booster findings where previous research shows greater effectiveness of BNT162b2 than ChAdOx1 in preventing infection.

Indexed as

COVID-192019-nCoV Vaccine mRNA-1273AdultBNT162 VaccineCOVID-19 VaccinesHumansProspective StudiesRNA, MessengerSARS-CoV-2Vaccination2019-nCoV Vaccine mRNA-1273BNT162 VaccineCOVID-19 VaccinesRNA, MessengerCOVID-19mRNA booster vaccinationSARS-CoV-2time-varying confounding-by-indicationtrial emulation

Identifiers

PMID36655537
PMCPMC10114109
OpenAlexW4317436803

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.