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dc.contributor.authorAgrawal, Utkarsh
dc.contributor.authorKatikireddi, Srinivasa Vittal
dc.contributor.authorMcCowan, Colin
dc.contributor.authorMulholland, Rachel H
dc.contributor.authorAzcoaga-Lorenzo, Amaya
dc.contributor.authorAmele, Sarah
dc.contributor.authorFagbamigbe, Adeniyi Francis
dc.contributor.authorVasileiou, Eleftheria
dc.contributor.authorGrange, Zoe
dc.contributor.authorShi, Ting
dc.contributor.authorKerr, Steven
dc.contributor.authorMoore, Emily
dc.contributor.authorMurray, Josephine L K
dc.contributor.authorShah, Syed Ahmar
dc.contributor.authorRitchie, Lewis
dc.contributor.authorO'Reilly, Dermot
dc.contributor.authorStock, Sarah J
dc.contributor.authorBeggs, Jillian
dc.contributor.authorChuter, Antony
dc.contributor.authorTorabi, Fatemah
dc.contributor.authorAkbari, Ashley
dc.contributor.authorBedston, Stuart
dc.contributor.authorMcMenamin, Jim
dc.contributor.authorWood, Rachael
dc.contributor.authorTang, Ruby S M
dc.contributor.authorde Lusignan, Simon
dc.contributor.authorHobbs, F D Richard
dc.contributor.authorWoolhouse, Mark
dc.contributor.authorSimpson, Colin R
dc.contributor.authorRobertson, Chris
dc.contributor.authorSheikh, Aziz
dc.identifier.citationAgrawal , U , Katikireddi , S V , McCowan , C , Mulholland , R H , Azcoaga-Lorenzo , A , Amele , S , Fagbamigbe , A F , Vasileiou , E , Grange , Z , Shi , T , Kerr , S , Moore , E , Murray , J L K , Shah , S A , Ritchie , L , O'Reilly , D , Stock , S J , Beggs , J , Chuter , A , Torabi , F , Akbari , A , Bedston , S , McMenamin , J , Wood , R , Tang , R S M , de Lusignan , S , Hobbs , F D R , Woolhouse , M , Simpson , C R , Robertson , C & Sheikh , A 2021 , ' COVID-19 hospital admissions and deaths after BNT162b2 and ChAdOx1 nCoV-19 vaccinations in 2·57 million people in Scotland (EAVE II) : a prospective cohort study ' , The Lancet Respiratory Medicine , vol. In Press .
dc.identifier.otherRIS: urn:4D926564F7BF6CFAE40E12DF96B1F73D
dc.identifier.otherORCID: /0000-0002-9466-833X/work/100901624
dc.identifier.otherORCID: /0000-0003-3307-878X/work/100901643
dc.identifier.otherORCID: /0000-0002-1511-7944/work/115941603
dc.descriptionEAVE II is funded by the Medical Research Council (MR/R008345/1) with the support of BREATHE—The Health Data Research Hub for Respiratory Health [MC_PC_19004], which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. UA, CM, AA-L, and AFF acknowledge funding from Chief Scientist Office Rapid Research in COVID-19 programme (COV/SAN/20/06) and Health Data Research UK (measuring and understanding multimorbidity using routine data in the UK—HDR-9006; CFC0110). SVK acknowledges funding from a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2), and the Scottish Government's Chief Scientist Office (SPHSU17). SJS is funded by a Wellcome Trust Clinical Career Development Fellowship (209560/Z/17/Z).en
dc.description.abstractBackground  The UK COVID-19 vaccination programme has prioritised vaccination of those at the highest risk of COVID-19 mortality and hospitalisation. The programme was rolled out in Scotland during winter 2020–21, when SARS-CoV-2 infection rates were at their highest since the pandemic started, despite social distancing measures being in place. We aimed to estimate the frequency of COVID-19 hospitalisation or death in people who received at least one vaccine dose and characterise these individuals. Methods  We conducted a prospective cohort study using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) national surveillance platform, which contained linked vaccination, primary care, RT-PCR testing, hospitalisation, and mortality records for 5·4 million people (around 99% of the population) in Scotland. Individuals were followed up from receiving their first dose of the BNT162b2 (Pfizer–BioNTech) or ChAdOx1 nCoV-19 (Oxford–AstraZeneca) COVID-19 vaccines until admission to hospital for COVID-19, death, or the end of the study period on April 18, 2021. We used a time-dependent Poisson regression model to estimate rate ratios (RRs) for demographic and clinical factors associated with COVID-19 hospitalisation or death 14 days or more after the first vaccine dose, stratified by vaccine type. Findings Between Dec 8, 2020, and April 18, 2021, 2 572 008 individuals received their first dose of vaccine—841 090 (32·7%) received BNT162b2 and 1 730 918 (67·3%) received ChAdOx1. 1196 (<0·1%) individuals were admitted to hospital or died due to COVID-19 illness (883 hospitalised, of whom 228 died, and 313 who died due to COVID-19 without hospitalisation) 14 days or more after their first vaccine dose. These severe COVID-19 outcomes were associated with older age (≥80 years vs 18–64 years adjusted RR 4·75, 95% CI 3·85–5·87), comorbidities (five or more risk groups vs less than five risk groups 4·24, 3·34–5·39), hospitalisation in the previous 4 weeks (3·00, 2·47–3·65), high-risk occupations (ten or more previous COVID-19 tests vs less than ten previous COVID-19 tests 2·14, 1·62–2·81), care home residence (1·63, 1·32–2·02), socioeconomic deprivation (most deprived quintile vs least deprived quintile 1·57, 1·30–1·90), being male (1·27, 1·13–1·43), and being an ex-smoker (ex-smoker vs non-smoker 1·18, 1·01–1·38). A history of COVID-19 before vaccination was protective (0·40, 0·29–0·54). Interpretation COVID-19 hospitalisations and deaths were uncommon 14 days or more after the first vaccine dose in this national analysis in the context of a high background incidence of SARS-CoV-2 infection and with extensive social distancing measures in place. Sociodemographic and clinical features known to increase the risk of severe disease in unvaccinated populations were also associated with severe outcomes in people receiving their first dose of vaccine and could help inform case management and future vaccine policy formulation.
dc.relation.ispartofThe Lancet Respiratory Medicineen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleCOVID-19 hospital admissions and deaths after BNT162b2 and ChAdOx1 nCoV-19 vaccinations in 2·57 million people in Scotland (EAVE II) : a prospective cohort studyen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Population and Behavioural Science Divisionen
dc.contributor.institutionUniversity of St Andrews. Sir James Mackenzie Institute for Early Diagnosisen
dc.contributor.institutionUniversity of St Andrews. Education Divisionen
dc.description.statusPeer revieweden

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