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1. Improving the representativeness of UK’s national COVID-19 Infection Survey through spatio-temporal regression and post-stratification

Author

Pouwels, Koen B., Eyre, David W., House, Thomas, Aspey, Ben, Matthews, Philippa C., Stoesser, Nicole, Newton, John N., Diamond, Ian, Studley, Ruth, Taylor, Nick G. H., Bell, John I., Farrar, Jeremy, Kolenchery, Jaison, Marsden, Brian D., Hoosdally, Sarah, Jones, E. Yvonne, Stuart, David I., Crook, Derrick W., Peto, Tim E. A., and Walker, A. Sarah

Published
2024
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6. Antibody responses and correlates of protection in the general population after two doses of the ChAdOx1 or BNT162b2 vaccines

Author

Wei, Jia, Pouwels, Koen B., Stoesser, Nicole, Matthews, Philippa C., Diamond, Ian, Studley, Ruth, Rourke, Emma, Cook, Duncan, Bell, John I., Newton, John N., Farrar, Jeremy, Howarth, Alison, Marsden, Brian D., Hoosdally, Sarah, Jones, E. Yvonne, Stuart, David I., Crook, Derrick W., Peto, Tim E. A., Walker, A. Sarah, and Eyre, David W.

Published
2022
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8. Daily testing for contacts of individuals with SARS-CoV-2 infection and attendance and SARS-CoV-2 transmission in English secondary schools and colleges: an open-label, cluster-randomised trial

Author

Young, Bernadette C, Eyre, David W, Kendrick, Saroj, White, Chris, Smith, Sylvester, Beveridge, George, Nonnenmacher, Toby, Ichofu, Fegor, Hillier, Joseph, Oakley, Sarah, Diamond, Ian, Rourke, Emma, Dawe, Fiona, Day, Ieuan, Davies, Lisa, Staite, Paul, Lacey, Andrea, McCrae, James, Jones, Ffion, Kelly, Joseph, Bankiewicz, Urszula, Tunkel, Sarah, Ovens, Richard, Chapman, David, Bhalla, Vineta, Marks, Peter, Hicks, Nick, Fowler, Tom, Hopkins, Susan, Yardley, Lucy, and Peto, Tim E A

Published
2021
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12. Identifying lineage effects when controlling for population structure improves power in bacterial association studies

Author

Earle, Sarah G, Wu, Chieh-Hsi, Charlesworth, Jane, Stoesser, Nicole, Gordon, N Claire, Walker, Timothy M, Spencer, Chris C A, Iqbal, Zamin, Clifton, David A, Hopkins, Katie L, Woodford, Neil, Smith, E Grace, Ismail, Nazir, Llewelyn, Martin J, Peto, Tim E, Crook, Derrick W, McVean, Gil, Walker, A Sarah, and Wilson, Daniel J

Subjects
Quantitative Biology - Genomics
Abstract

Bacteria pose unique challenges for genome-wide association studies (GWAS) because of strong structuring into distinct strains and substantial linkage disequilibrium across the genome. While methods developed for human studies can correct for strain structure, this risks considerable loss- of-power because genetic differences between strains often contribute substantial phenotypic variability. Here we propose a new method that captures lineage-level associations even when locus-specific associations cannot be fine-mapped. We demonstrate its ability to detect genes and genetic variants underlying resistance to 17 antimicrobials in 3144 isolates from four taxonomically diverse clonal and recombining bacteria: Mycobacterium tuberculosis, Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae. Strong selection, recombination and penetrance confer high power to recover known antimicrobial resistance mechanisms, and reveal a candidate association between the outer membrane porin nmpC and cefazolin resistance in E. coli. Hence our method pinpoints locus-specific effects where possible, and boosts power by detecting lineage-level differences when fine-mapping is intractable.

Published
2015

13. Impact of vaccination on new SARS-CoV-2 infections in the United Kingdom

Author

Pritchard, Emma, Matthews, Philippa C., Stoesser, Nicole, Eyre, David W., Gethings, Owen, Vihta, Karina-Doris, Jones, Joel, House, Thomas, VanSteenHouse, Harper, Bell, Iain, Bell, John I., Newton, John N., Farrar, Jeremy, Diamond, Ian, Rourke, Emma, Studley, Ruth, Crook, Derrick, Peto, Tim E. A., Walker, A. Sarah, and Pouwels, Koen B.

Published
2021
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14. Detecting changes in population trends in infection surveillance using community SARS-CoV-2 prevalence as an exemplar.

Author

Pritchard, Emma, Vihta, Karina-Doris, Eyre, David W, Hopkins, Susan, Peto, Tim E A, Matthews, Philippa C, Stoesser, Nicole, Studley, Ruth, Rourke, Emma, Diamond, Ian, Pouwels, Koen B, Walker, Ann Sarah, and Team, COVID-19 Infection Survey

Subjects
PUBLIC health surveillance, COMMUNITY health services, COMMUNICABLE diseases, RESEARCH funding, QUESTIONNAIRES, PROBABILITY theory, COVID-19 testing, POLYMERASE chain reaction, DISEASE prevalence, DESCRIPTIVE statistics, LONGITUDINAL method, EPIDEMICS, INFECTIOUS disease transmission, PUBLIC health, COMPARATIVE studies, COVID-19
Abstract

Detecting and quantifying changes in the growth rates of infectious diseases is vital to informing public health strategy and can inform policymakers' rationale for implementing or continuing interventions aimed at reducing their impact. Substantial changes in SARS-CoV-2 prevalence with the emergence of variants have provided an opportunity to investigate different methods for doing this. We collected polymerase chain reaction (PCR) results from all participants in the United Kingdom's COVID-19 Infection Survey between August 1, 2020, and June 30, 2022. Change points for growth rates were identified using iterative sequential regression (ISR) and second derivatives of generalized additive models (GAMs). Consistency between methods and timeliness of detection were compared. Of 8 799 079 study visits, 147 278 (1.7%) were PCR-positive. Change points associated with the emergence of major variants were estimated to occur a median of 4 days earlier (IQR, 0-8) when using GAMs versus ISR. When estimating recent change points using successive data periods, 4 change points (4/96) identified by GAMs were not found when adding later data or by ISR. Change points were detected 3-5 weeks after they occurred under both methods but could be detected earlier within specific subgroups. Change points in growth rates of SARS-CoV-2 can be detected in near real time using ISR and second derivatives of GAMs. To increase certainty about changes in epidemic trajectories, both methods could be used in parallel. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Antimicrobial resistance in commensal opportunistic pathogens isolated from non-sterile sites can be an effective proxy for surveillance in bloodstream infections

Author

Vihta, Karina-Doris, Gordon, Nicola Claire, Stoesser, Nicole, Quan, T. Phuong, Tyrrell, Carina S. B., Vongsouvath, Manivanh, Ashley, Elizabeth A., Chansamouth, Vilada, Turner, Paul, Ling, Clare L., Eyre, David W., White, Nicholas J., Crook, Derrick, Peto, Tim E. A., and Walker, Ann Sarah

Published
2021
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17. Trends over time in Escherichia coli bloodstream infections, urinary tract infections, and antibiotic susceptibilities in Oxfordshire, UK, 1998–2016: a study of electronic health records

Author

Vihta, Karina-Doris, Stoesser, Nicole, Llewelyn, Martin J, Quan, T Phuong, Davies, Tim, Fawcett, Nicola J, Dunn, Laura, Jeffery, Katie, Butler, Chris C, Hayward, Gail, Andersson, Monique, Morgan, Marcus, Oakley, Sarah, Mason, Amy, Hopkins, Susan, Wyllie, David H, Crook, Derrick W, Wilcox, Mark H, Johnson, Alan P, Peto, Tim E A, and Walker, A Sarah

Published
2018
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19. Persistence of SARS-CoV-2 antibodies over 18 months following infection: UK Biobank COVID-19 Serology Study

Author

Bešević, Jelena, primary, Lacey, Ben, additional, Callen, Howard, additional, Omiyale, Wemimo, additional, Conroy, Megan, additional, Feng, Qi, additional, Crook, Derrick W, additional, Doherty, Nicola, additional, Ebner, Daniel, additional, Eyre, David W, additional, Fry, Dan, additional, Horn, Edward, additional, Jones, E Yvonne, additional, Marsden, Brian D, additional, Peto, Tim E A, additional, Starkey, Fenella, additional, Stuart, David, additional, Welsh, Samantha, additional, Wood, Natasha, additional, Young, Alan, additional, Young, Allen, additional, Effingham, Mark, additional, Collins, Rory, additional, Holliday, Jo, additional, and Allen, Naomi, additional

Published
2023
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23. Insidious Risk of Severe Mycobacterium chimaera Infection in Cardiac Surgery Patients

Author

Chand, Meera, Lamagni, Theresa, Kranzer, Katharina, Hedge, Jessica, Moore, Ginny, Parks, Simon, Collins, Samuel, del Ojo Elias, Carlos, Ahmed, Nada, Brown, Tim, Smith, E. Grace, Hoffman, Peter, Kirwan, Peter, Mason, Brendan, Smith-Palmer, Alison, Veal, Philip, Lalor, Maeve K., Bennett, Allan, Walker, James, Yeap, Alicia, Martin, Antonio Isidro Carrion, Dolan, Gayle, Bhatt, Sonia, Skingsley, Andrew, Charlett, André, Pearce, David, Russell, Katherine, Kendall, Simon, Klein, Andrew A., Robins, Stephen, Schelenz, Silke, Newsholme, William, Thomas, Stephanie, Collyns, Tim, Davies, Eleri, McMenamin, Jim, Doherty, Lorraine, Peto, Tim E. A., Crook, Derrick, Zambon, Maria, and Phin, Nick

Published
2017

25. Persistence of SARS-CoV-2 antibodies over 18 months following infection: UK Biobank COVID- 19 Serology Study.

Author

Bešević, Jelena, Lacey, Ben, Callen, Howard, Omiyale, Wemimo, Conroy, Megan, Qi Feng, Crook, Derrick W., Doherty, Nicola, Ebner, Daniel, Eyre, David W., Fry, Dan, Horn, Edward, Jones, E. Yvonne, Marsden, Brian D., Peto, Tim E. A., Starkey, Fenella, Stuart, David, Welsh, Samantha, Wood, Natasha, and Young, Alan

Subjects
IMMUNOGLOBULIN analysis, COVID-19, IMMUNOGLOBULINS, TIME, CORONAVIRUS spike protein, MEDICAL screening, SEROLOGY, IMMUNITY, RESEARCH funding, SOCIODEMOGRAPHIC factors, LONGITUDINAL method
Published
2024
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26. Whole-genome sequencing for prediction of Mycobacterium tuberculosis drug susceptibility and resistance: a retrospective cohort study

Author

Walker, Timothy M, Kohl, Thomas A, Omar, Shaheed V, Hedge, Jessica, Del Ojo Elias, Carlos, Bradley, Phelim, Iqbal, Zamin, Feuerriegel, Silke, Niehaus, Katherine E, Wilson, Daniel J, Clifton, David A, Kapatai, Georgia, Ip, Camilla L C, Bowden, Rory, Drobniewski, Francis A, Allix-Béguec, Caroline, Gaudin, Cyril, Parkhill, Julian, Diel, Roland, Supply, Philip, Crook, Derrick W, Smith, E Grace, Walker, A Sarah, Ismail, Nazir, Niemann, Stefan, and Peto, Tim E A

Published
2015
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27. Assessment of Mycobacterium tuberculosis transmission in Oxfordshire, UK, 2007–12, with whole pathogen genome sequences: an observational study

Author

Walker, Timothy M, Lalor, Maeve K, Broda, Agnieszka, Ortega, Luisa Saldana, Morgan, Marcus, Parker, Lynne, Churchill, Sheila, Bennett, Karen, Golubchik, Tanya, Giess, Adam P, Del Ojo Elias, Carlos, Jeffery, Katie J, Bowler, Ian C J W, Laurenson, Ian F, Barrett, Anne, Drobniewski, Francis, McCarthy, Noel D, Anderson, Laura F, Abubakar, Ibrahim, Thomas, H Lucy, Monk, Philip, Smith, E Grace, Walker, A Sarah, Crook, Derrick W, Peto, Tim E A, and Conlon, Christopher P

Published
2014
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34. Covert dissemination of carbapenemase-producing Klebsiella pneumoniae (KPC) in a successfully controlled outbreak: long- and short-read whole-genome sequencing demonstrate multiple genetic modes of transmission

Author

Martin, Jessica, Phan, Hang T. T, Findlay, Jacqueline, Stoesser, Nicole, Pankhurst, Louise, Navickaite, Indre, De Maio, Nicola, Eyre, David W, Toogood, Giles, Orsi, Nicolas M, Kirby, Andrew, Young, Nicola, Turton, Jane F, Hill, Robert L. R, Hopkins, Katie L, Woodford, Neil, Peto, Tim E. A, Walker, A. Sarah, Crook, Derrick W, and Wilcox, Mark H

Published
2017
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36. Evolutionary dynamics of Staphylococcus aureus during progression from carriage to disease

Author

Young, Bernadette C., Golubchik, Tanya, Batty, Elizabeth M., Fung, Rowena, Larner-Svensson, Hanna, Votintseva, Antonina A., Miller, Ruth R., Godwin, Heather, Knox, Kyle, Everitt, Richard G., Iqbal, Zamin, Rimmer, Andrew J., Cule, Madeleine, Ip, Camilla L. C., Didelot, Xavier, Harding, Rosalind M., Donnelly, Peter, Peto, Tim E., Crook, Derrick W., Bowden, Rory, and Wilson, Daniel J.

Published
2012

42. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial

Author

Dondorp, Arjen M, Fanello, Caterina I, Hendriksen, Ilse CE, Gomes, Ermelinda, Seni, Amir, Chhaganlal, Kajal D, Bojang, Kalifa, Olaosebikan, Rasaq, Anunobi, Nkechinyere, Maitland, Kathryn, Kivaya, Esther, Agbenyega, Tsiri, Nguah, Samuel Blay, Evans, Jennifer, Gesase, Samwel, Kahabuka, Catherine, Mtove, George, Nadjm, Behzad, Deen, Jacqueline, Mwanga-Amumpaire, Juliet, Nansumba, Margaret, Karema, Corine, Umulisa, Noella, Uwimana, Aline, Mokuolu, Olugbenga A, Adedoyin, Olanrewaju T, Johnson, Wahab BR, Tshefu, Antoinette K, Onyamboko, Marie A, Sakulthaew, Tharisara, Ngum, Wirichada Pan, Silamut, Kamolrat, Stepniewska, Kasia, Woodrow, Charles J, Bethell, Delia, Wills, Bridget, Oneko, Martina, Peto, Tim E, von Seidlein, Lorenz, Day, Nicholas PJ, and White, Nicholas J

Published
2010
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43. Anti-spike antibody response to natural SARS-CoV-2 infection in the general population

Author

Wei, Jia, Matthews, Philippa C., Stoesser, Nicole, Maddox, Thomas, Lorenzi, Luke, Studley, Ruth, Bell, John I., Newton, John N., Farrar, Jeremy, Diamond, Ian, Rourke, Emma, Howarth, Alison, Marsden, Brian D., Hoosdally, Sarah, Jones, E. Yvonne, Stuart, David I., Crook, Derrick W., Peto, Tim E. A., Pouwels, Koen B., Walker, A. Sarah, Eyre, David W., Thomas, Tina, Cook, Duncan, Ayoubkhani, Daniel, Black, Russell, Felton, Antonio, Crees, Megan, Jones, Joel, Lloyd, Lina, Sutherland, Esther, Pritchard, Emma, Vihta, Karina-Doris, Doherty, George, Kavanagh, James, Chau, Kevin K., Hatch, Stephanie B., Ebner, Daniel, Ferreira, Lucas Martins, Christott, Thomas, Dejnirattisai, Wanwisa, Mongkolsapaya, Juthathip, Cameron, Sarah, Tamblin-Hopper, Phoebe, Wolna, Magda, Brown, Rachael, Cornall, Richard, Screaton, Gavin, Lythgoe, Katrina, Bonsall, David, Golubchik, Tanya, Fryer, Helen, Cox, Stuart, Paddon, Kevin, James, Tim, House, Thomas, Robotham, Julie, Birrell, Paul, Jordan, Helena, Sheppard, Tim, Athey, Graham, Moody, Dan, Curry, Leigh, Brereton, Pamela, Jarvis, Ian, Godsmark, Anna, Morris, George, Mallick, Bobby, Eeles, Phil, Hay, Jodie, VanSteenhouse, Harper, Lee, Jessica, White, Sean, Evans, Tim, Bloemberg, Lisa, Allison, Katie, Pandya, Anouska, Davis, Sophie, Conway, David I., MacLeod, Margaret, and Cunningham, Chris

Abstract

Understanding the trajectory, duration, and determinants of antibody responses after SARS-CoV-2 infection can inform subsequent protection and risk of reinfection, however large-scale representative studies are limited. Here we estimated antibody response after SARS-CoV-2 infection in the general population using representative data from 7,256 United Kingdom COVID-19 infection survey participants who had positive swab SARS-CoV-2 PCR tests from 26-April-2020 to 14-June-2021. A latent class model classified 24% of participants as ‘non-responders’ not developing anti-spike antibodies, who were older, had higher SARS-CoV-2 cycle threshold values during infection (i.e. lower viral burden), and less frequently reported any symptoms. Among those who seroconverted, using Bayesian linear mixed models, the estimated anti-spike IgG peak level was 7.3-fold higher than the level previously associated with 50% protection against reinfection, with higher peak levels in older participants and those of non-white ethnicity. The estimated anti-spike IgG half-life was 184 days, being longer in females and those of white ethnicity. We estimated antibody levels associated with protection against reinfection likely last 1.5-2 years on average, with levels associated with protection from severe infection present for several years. These estimates could inform planning for vaccination booster strategies.

Published
2021

45. Correction: Corrigendum: Rapid antibiotic-resistance predictions from genome sequence data for Staphylococcus aureus and Mycobacterium tuberculosis

Author

Bradley, Phelim, Gordon, N. Claire, Walker, Timothy M., Dunn, Laura, Heys, Simon, Huang, Bill, Earle, Sarah, Pankhurst, Louise J., Anson, Luke, de Cesare, Mariateresa, Piazza, Paolo, Votintseva, Antonina A., Golubchik, Tanya, Wilson, Daniel J., Wyllie, David H., Diel, Roland, Niemann, Stefan, Feuerriegel, Silke, Kohl, Thomas A., Ismail, Nazir, Omar, Shaheed V., Smith, E. Grace, Buck, David, McVean, Gil, Walker, A. Sarah, Peto, Tim E. A., Crook, Derrick W., and Iqbal, Zamin

Published
2016
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47. Omicron-Associated Changes in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Symptoms in the United Kingdom.

Author

Vihta, Karina-Doris, Pouwels, Koen B, Peto, Tim E A, Pritchard, Emma, House, Thomas, Studley, Ruth, Rourke, Emma, Cook, Duncan, Diamond, Ian, Crook, Derrick, Clifton, David A, Matthews, Philippa C, Stoesser, Nicole, Eyre, David W, Walker, Ann Sarah, and team, COVID-19 Infection Survey

Subjects
COVID-19, GENETIC mutation, FEVER, SEVERITY of illness index, DYSPNEA, DESCRIPTIVE statistics, COUGH, SMELL disorders, RESEARCH funding, POLYMERASE chain reaction, VACCINATION status, FATIGUE (Physiology), DATA analysis software, SARS disease, PHARYNGITIS
Abstract

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant has been replaced by the highly transmissible Omicron BA.1 variant, and subsequently by Omicron BA.2. It is important to understand how these changes in dominant variants affect reported symptoms, while also accounting for symptoms arising from other cocirculating respiratory viruses. Methods In a nationally representative UK community study, the COVID-19 Infection Survey, we investigated symptoms in polymerase chain reaction (PCR)–positive infection episodes versus PCR-negative study visits over calendar time, by age and vaccination status, comparing periods when the Delta, Omicron BA.1, and BA.2 variants were dominant. Results Between October 2020 and April 2022, a total of 120 995 SARS-CoV-2 PCR-positive episodes occurred in 115 886 participants, with 70 683 (58%) reporting symptoms. The comparator comprised 4 766 366 PCR-negative study visits (483 894 participants), with symptoms reported at 203 422 visits (4%). Symptom reporting in PCR-positive infections varied over time, with a marked reduction in loss of taste/smell as Omicron BA.1 dominated, which was maintained with BA.2 (44% symptomatic infections reporting loss of taste/45% symptomatic infections reporting loss of smell on 17 October 2021, 16%/13% 2 January 2022, 15%/12% 27 March 2022). Cough, fever, shortness of breath, myalgia, fatigue/weakness, and headache also decreased after Omicron BA.1 dominated, but sore throat increased, the latter to a greater degree than concurrent increases in PCR-negative visits. Fatigue/weakness increased again after BA.2 dominated, although to a similar degree to concurrent increases in PCR-negative visits. Symptoms were consistently more common in adults aged 18–65 years than in children or older adults. Conclusions Increases in sore throat (also common in the general community), along with a marked reduction in loss of taste/smell, make Omicron harder to detect with symptom-based testing algorithms, with implications for institutional and national testing policies. [ABSTRACT FROM AUTHOR]

Published
2023
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48. Health record hiccups—5,526 real-world time series with change points labelled by crowdsourced visual inspection.

Author

Quan, T Phuong, Lacey, Ben, Peto, Tim E A, and Walker, A Sarah

Subjects
TIME series analysis, QUALITY control, INSPECTION & review, HICCUPS, ELECTRONIC health records, DATA quality, TANNER graphs
Abstract

Background Large routinely collected data such as electronic health records (EHRs) are increasingly used in research, but the statistical methods and processes used to check such data for temporal data quality issues have not moved beyond manual, ad hoc production and visual inspection of graphs. With the prospect of EHR data being used for disease surveillance via automated pipelines and public-facing dashboards, automation of data quality checks will become increasingly valuable. Findings We generated 5,526 time series from 8 different EHR datasets and engaged >2,000 citizen-science volunteers to label the locations of all suspicious-looking change points in the resulting graphs. Consensus labels were produced using density-based clustering with noise, with validation conducted using 956 images containing labels produced by an experienced data scientist. Parameter tuning was done against 670 images and performance calculated against 286 images, resulting in a final sensitivity of 80.4% (95% CI, 77.1%–83.3%), specificity of 99.8% (99.7%–99.8%), positive predictive value of 84.5% (81.4%–87.2%), and negative predictive value of 99.7% (99.6%–99.7%). In total, 12,745 change points were found within 3,687 of the time series. Conclusions This large collection of labelled EHR time series can be used to validate automated methods for change point detection in real-world settings, encouraging the development of methods that can successfully be applied in practice. It is particularly valuable since change point detection methods are typically validated using synthetic data, so their performance in real-world settings cannot be assumed to be comparable. While the dataset focusses on EHRs and data quality, it should also be applicable in other fields. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Antibody responses to SARS-CoV-2 vaccines in 45,965 adults from the general population of the United Kingdom

Author

Wei, Jia, Stoesser, Nicole, Matthews, Philippa C., Ayoubkhani, Daniel, Studley, Ruth, Bell, Iain, Bell, John I., Newton, John N., Farrar, Jeremy, Diamond, Ian, Rourke, Emma, Howarth, Alison, Marsden, Brian D., Hoosdally, Sarah, Jones, E. Yvonne, Stuart, David I., Crook, Derrick W., Peto, Tim E. A., Pouwels, Koen B., Eyre, David W., Walker, A. Sarah, Lambert, Alex, Thomas, Tina, Black, Russell, Felton, Antonio, Crees, Megan, Jones, Joel, Lloyd, Lina, Sutherland, Esther, Pritchard, Emma, Vihta, Karina-Doris, Doherty, George, Kavanagh, James, Chau, Kevin K., Hatch, Stephanie B., Ebner, Daniel, Ferreira, Lucas Martins, Christott, Thomas, Dejnirattisai, Wanwisa, Mongkolsapaya, Juthathip, Cameron, Sarah, Tamblin-Hopper, Phoebe, Wolna, Magda, Brown, Rachael, Cornall, Richard, Screaton, Gavin, Lythgoe, Katrina, Bonsall, David, Golubchik, Tanya, Fryer, Helen, Cox, Stuart, Paddon, Kevin, James, Tim, House, Thomas, Robotham, Julie, Birrell, Paul, Jordan, Helena, Sheppard, Tim, Athey, Graham, Moody, Dan, Curry, Leigh, Brereton, Pamela, Jarvis, Ian, Godsmark, Anna, Morris, George, Mallick, Bobby, Eeles, Phil, Hay, Jodie, VanSteenhouse, Harper, and Lee, Jessica

Abstract

We report that in a cohort of 45,965 adults, who were receiving either the ChAdOx1 or the BNT162b2 SARS-CoV-2 vaccines, in those who had no prior infection with SARS-CoV-2, seroconversion rates and quantitative antibody levels after a single dose were lower in older individuals, especially in those aged >60 years. Two vaccine doses achieved high responses across all ages. Antibody levels increased more slowly and to lower levels with a single dose of ChAdOx1 compared with a single dose of BNT162b2, but waned following a single dose of BNT162b2 in older individuals. In descriptive latent class models, we identified four responder subgroups, including a ‘low responder’ group that more commonly consisted of people aged >75 years, males and individuals with long-term health conditions. Given our findings, we propose that available vaccines should be prioritized for those not previously infected and that second doses should be prioritized for individuals aged >60 years. Further data are needed to better understand the extent to which quantitative antibody responses are associated with vaccine-mediated protection.

Published
2021

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