Evidence map›Paper›PMID 37363796›Full record

ArticleThe Lancet regional health. Europe2023

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.

OpenSAFELY Collaborative, Edward P K Parker, Elsie M F Horne, William J Hulme, John Tazare, Bang Zheng, Edward J Carr, Fiona Loud, Susan Lyon, Viyaasan Mahalingasivam and 10 more

Open access · goldAbstract read
In one paragraph

Article in The Lancet regional health. Europe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
5.4field-weighted citation impact, top 3% 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

10 citing papers in PubMed, 28 citations in OpenAlex.

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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

20 authors at 7 institutions in 1 country.

OpenSAFELY Collaborative
Edward P K ParkerLondon School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Elsie M F HornePopulation Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
William J HulmeBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK.
John TazareLondon School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Bang ZhengLondon School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Edward J CarrThe Francis Crick Institute, London, NW1 1AT, UK.
Fiona LoudKidney Care UK, Alton, UK.
Susan LyonPatient Council, UK Kidney Association, Bristol, UK.
Viyaasan MahalingasivamLondon School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Brian MacKennaBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK.
Amir MehrkarBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK.
Miranda ScanlonKidney Research UK, Peterborough, UK.
Shalini SanthakumaranUK Renal Registry, Bristol, UK.
Retha SteenkampUK Renal Registry, Bristol, UK.
Ben GoldacrePopulation Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
Jonathan A C SternePopulation Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
Dorothea NitschLondon School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Laurie A TomlinsonLondon School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
LH&W NCS (or CONVALESCENCE) Collaborative
University of London · GBUniversity of Bristol · GBUniversity of Oxford · GBKidney Care UK · GBRenal Association · GBKidney Research UK · GBThe Francis Crick Institute · GB

Funding

Medical Research Council MC_PC_20030Medical Research Council MC_PC_20051Medical Research Council MC_PC_20059Medical Research Council MR/W016729/1Medical Research Council MR/W021420/1Medical Research Council MR/X006751/1Wellcome Trust
6 · The paper itself

Abstract

Background: Kidney disease is a key risk factor for COVID-19-related mortality and suboptimal vaccine response. Optimising vaccination strategies is essential to reduce the disease burden in this vulnerable population. We therefore compared the effectiveness of two- and three-dose schedules involving AZD1222 (AZ; ChAdOx1-S) and BNT162b2 (BNT) among people with kidney disease in England. Methods: With the approval of NHS England, we performed a retrospective cohort study among people with moderate-to-severe kidney disease. Using linked primary care and UK Renal Registry records in the OpenSAFELY-TPP platform, we identified adults with stage 3-5 chronic kidney disease, dialysis recipients, and kidney transplant recipients. We used Cox proportional hazards models to compare COVID-19-related outcomes and non-COVID-19 death after two-dose (AZ-AZ vs BNT-BNT) and three-dose (AZ-AZ-BNT vs BNT-BNT-BNT) schedules. Findings: After two doses, incidence during the Delta wave was higher in AZ-AZ (n = 257,580) than BNT-BNT recipients (n = 169,205; adjusted hazard ratios [95% CIs] 1.43 [1.37-1.50], 1.59 [1.43-1.77], 1.44 [1.12-1.85], and 1.09 [1.02-1.17] for SARS-CoV-2 infection, COVID-19-related hospitalisation, COVID-19-related death, and non-COVID-19 death, respectively). Findings were consistent across disease subgroups, including dialysis and transplant recipients. After three doses, there was little evidence of differences between AZ-AZ-BNT (n = 220,330) and BNT-BNT-BNT recipients (n = 157,065) for any outcome during a period of Omicron dominance. Interpretation: Among individuals with moderate-to-severe kidney disease, two doses of BNT conferred stronger protection than AZ against SARS-CoV-2 infection and severe disease. A subsequent BNT dose levelled the playing field, emphasising the value of heterologous RNA doses in vulnerable populations. Funding: National Core Studies, Wellcome Trust, MRC, and Health Data Research UK.

Indexed as

Chronic kidney diseaseCOVID-19EffectivenessNHS EnglandSARS-CoV-2Vaccination

Identifiers

PMID37363796
PMCPMC10155829
OpenAlexW4367856971

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.