Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study
Objective To estimate the real world effectiveness of the Pfizer-BioNTech BNT162b2 and Oxford-AstraZeneca ChAdOx1-S vaccines against confirmed covid-19 symptoms (including the UK variant of concern B.1.1.7), admissions to hospital, and deaths.
Design Test negative case-control study.
Setting Community testing for covid-19 in England.
Participants 156â930 adults aged 70 years and older who reported symptoms of covid-19 between 8 December 2020 and 19 February 2021 and were successfully linked to vaccination data in the National Immunisation Management System.
Interventions Vaccination with BNT162b2 or ChAdOx1-S.
Main outcome measures Primary outcomes were polymerase chain reaction confirmed symptomatic SARS-CoV-2 infections, admissions to hospital for covid-19, and deaths with covid-19.
Results Participants aged 80 years and older vaccinated with BNT162b2 before 4 January 2021 had a higher odds of testing positive for covid-19 in the first nine days after vaccination (odds ratio up to 1.48, 95% confidence interval 1.23 to 1.77), indicating that those initially targeted had a higher underlying risk of infection. Vaccine effectiveness was therefore compared with the baseline post-vaccination period. Vaccine effects were noted 10 to 13 days after vaccination, reaching a vaccine effectiveness of 70% (95% confidence interval 59% to 78%), then plateauing. From 14 days after the second dose a vaccination effectiveness of 89% (85% to 93%) was found compared with the increased baseline risk. Participants aged 70 years and older vaccinated from 4 January (when ChAdOx1-S delivery commenced) had a similar underlying risk of covid-19 to unvaccinated individuals. With BNT162b2, vaccine effectiveness reached 61% (51% to 69%) from 28 to 34 days after vaccination, then plateaued. With ChAdOx1-S, effects were seen from 14 to 20 days after vaccination, reaching an effectiveness of 60% (41% to 73%) from 28 to 34 days, increasing to 73% (27% to 90%) from day 35 onwards. On top of the protection against symptomatic disease, a further 43% (33% to 52%) reduced risk of emergency hospital admission and 51% (37% to 62%) reduced risk of death was observed in those who had received one dose of BNT162b2. Participants who had received one dose of ChAdOx1-S had a further 37% (3% to 59%) reduced risk of emergency hospital admission. Follow-up was insufficient to assess the effect of ChAdOx1-S on mortality. Combined with the effect against symptomatic disease, a single dose of either vaccine was about 80% effective at preventing admission to hospital with covid-19 and a single dose of BNT162b2 was 85% effective at preventing death with covid-19.
Conclusion Vaccination with either one dose of BNT162b2 or ChAdOx1-S was associated with a significant reduction in symptomatic covid-19 in older adults, and with further protection against severe disease. Both vaccines showed similar effects. Protection was maintained for the duration of follow-up (6 weeks). A second dose of BNT162b2 was associated with further protection against symptomatic disease. A clear effect of the vaccines against the B.1.1.7 variant was found.
The Red/Blue Divide in COVID-19 Vaccination Rates Continues: An Update | KFF
This analysis is an update to a previous analysis conducted in September 2021. Using county-level data, we analyzed trends in COVID-19 vaccination rates in counties that voted for President Trump in the 2020 election compared to counties that voted for President Biden. We find higher vaccination rates for counties that voted for Biden. However, rates among those fully vaccinated that have received a booster are similar between the two groups.
COVID vaccine boosters: the most important questions
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COVID vaccines protect against Delta, but their effectiveness wanes
Massive UK study of COVID-19 cases shows that people who are jabbed have good immunity at first, but quickly become more vulnerable to the fast-spreading Delta variant.
Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study
COVID-19 vaccines show excellent efficacy in clinical trials and effectiveness in real-world data, but some people still become infected with SARS-CoV-2 after vaccination. This study aimed to identify risk factors for post-vaccination SARS-CoV-2 ...
COVID-19 vaccine uptake data reported to and by Indigenous Services Canada now excludes uptake in Inuit and territorial communities as data updates from territorial and regional governments have not been publicly available since mid-2022.
Want to Research Something? This Is How You Get Money for It
Have you ever seen Black Hawk helicopters fly above the McGill campus? Me neither. Yet, there is a persistent conspiracy theory that might as well invoke their presence. Because our Office regularly portrays vaccines as effective and safeânot 100% safe, because nothing isâthose who deny their worth need to explain why weâre so âwrong.â It turns out that one professor on campus once received a grant from the Bill and Melinda Gates Foundation. Bill Gates funds vaccine research and distribution: ergo, our Office is in the pocket of Bill Gates. How is this enforced? I imagine that Black Hawk helicopters must have circled campus the day the grant was approved, with military personnel rappelling down, knocking on doors, and handing thousands of staff members and professors our new vaccine talking points. Without understanding how research is financed, this theory is actually appealing to a lot of people, and it may make these same people crack a smile when they see the Trump regime hacking and slashing at science funding in the United States. But receiving research financing is far from lazily applying for government handouts; itâs a core activity of a scientistâs life, and the success rates are low. What a grant proposal looks like Science costs money, and itâs not just because silly human beings need salaries. Each time an experiment in, letâs say, molecular biology is performed, reagents get consumed, meaning enzymes, buffers, stains, molecular building blocks, and more. And these reagents donât float in the air; they require consumables like plastic tubes and pipet tips, and scientists need disposable gloves to avoid contaminating their solutions or inadvertently transferring enzymes from their skin into tubes where they will destroy the RNA theyâre trying to isolate. (I will be focusing on the biomedical sciences, as this is what Iâm most familiar with.) Sometimes, new equipment needs to be purchased as well: centrifuges, vortex mixers, machines that amplify DNA, micropipettes, and even simple things like plastic racks to hold tubes in place. Thereâs also a line in any research budget for overheads, to which we will return. The basic process for the head of a laboratoryâcommonly referred to as the principal investigator or P.I., no relation to Tom Selleckâto ask for money is to write a grant proposal. Typical grants last a few years: a recent competition held by Canadaâs largest public funder of health research, CIHR, conferred grants of an average duration of four and a half years. And applying for this money is a lengthy, arduous exercise that, for major grants, often takes a year to plan, execute, and submit. The grant proposal can itself be preceded by a letter of intent, where the P.I. submits a summary of what they plan to do and the collaborators they have assembled for the project. If the letter is accepted, the massive document that is the grant proposal begins to be created. Everyone with a major role to play in this proposed research has to list their past publications, degrees, and awardsâessentially, they must convince the evaluators that they are the right people for the job. The P.I. will also write a long explanation of what we know about the topic and what has led to the burning research question they want to answer. For a grant proposal on studying how two key proteins interact in people who have a particular type of skin cancer, for example, this introduction would cover important statistics about skin cancer in general and this type of cancer specifically; the underlying biological mechanism that lead to this type of skin cancer; what is known about each one of these key proteins and the systems or signalling cascades they are part of; and how they are tied to skin cancer. And every single claim needs to be adequately referenced. The researchersâ hypothesis has to be spelled out, alongside a detailed description of the specific experiments they want to carry out: the techniques to be used, the samples to be tested, the controls to be included. This needs to be justified as being part of the P.I.âs overarching research program, and a budget has to be included detailing where the money would go in terms of salaries, consumables, reagents, equipment, and overheads. Different granting agencies have specific requirements and templates to be used, so additional documents often have to be filled out. Writing a grant proposal is thus a giant effort in literature research, academic writing, and coordination, articulated over months. The granting agency will then convene a panel of scientists to grade the proposals it has received, since it typically doesnât have the money to approve them all. Reviewers thus have to pour over these proposalsâas unpaid labour, I should point outâand ask themselves important questions. Is the rationale sound? Are the objectives well defined and the methods appropriate? Are the researchers likely to finish the project in time? Have they identified likely challenges and do they propose solutions to them? Is the institution where this will take place well equipped to carry out this project? These evaluations are done by people, and people are flawed. Moreover, two grant proposals may end up in a tie. Which one should get the money? Since the late 1990s, the idea of a lottery system has been put forward, either as a complete replacement for people manually evaluating grant proposals or as an add-on to the process, where proposals that pass evaluation are put into a basket to determine the winners, or where ties are broken by the use of chance. Partial lottery systems are still rare and there is a lack of consensus on whether or not they ultimately benefit scientists (and the public, whose trust is predicated on the system being perceived as fair). So, what are the chances of getting funded? When we look at the numbers coming out of major North American granting agencies, we get a sobering lesson: research is very competitive. From the late 1990s to the early 2000s, success rates for applications to the NIH (the United Statesâ largest federal fund for health research) hovered around 30%, meaning that a little under one in three applications was funded. Since then, rates have gone down to 20%, meaning one in five. In Canada, the equivalent CIHR has seen a comparable decline in its percentage of funded applications: from 33% in 2000 to less than 20% in recent years. Getting your research financed through public agencies has always been hard. Under Trumpâs kakistocratic regime, things are about to worsen. The decimation of the worldâs biggest health research funding body A leaked budget for the fiscal year starting this October reveals that the White House wants to chop the NIHâs budget from about 47 billion dollars down to 27. Already, the NIH has cancelled hundreds of active research grantsâmoney it had accepted to disburse to researchers prior to Trumpâs re-election and which it is now cutting off. An analysis published by the journal Nature revealed that, as of April 7, 29% of NIH grants related to HIV/AIDS had seen their federal financing revoked. Half of all grants which mentioned LGBT issues had been cancelled, as well as nearly half of grants that alluded to vaccine hesitancy. In the name of right-wing ideology, NIH grants to over 12 American universities in Trumpâs crosshairs have allegedly been withheld in a possible attempt to pressure these universities into abandoning diversity, equity and inclusion initiatives. The sudden cancellation of on-going grants has led a group of scientists to sue the NIH, while many researchers take to the media to remind the public that the NIH is the worldâs biggest funder of biomedical research by a wide margin: in 2022, it doled out 33 billion US dollars in grants, followed in second place by the London-based charity Wellcome with 1.2 billion US dollars. Zooming in on HIV, tuberculosis, and malariaâmajor infectious killers worldwideâthe NIH gave out 1.4 billion US dollars for their research in 2023. In second place? The Gates Foundation, with half of a billion dollars. The private sector simply does not measure up. Which is not to say that nonprofits and foundations donât play a role in funding research. In fact, academics are more and more encouraged to partner with private organizations to help finance their projects. But these organizationsâwhich funded most research in the U.S. prior to the Second World Warâtend to be very selective in what they want to put money into, and if a project has no immediate commercialization prospect, its P.I. will likely be told âno.â Whatâs more, private funders typically do not give money for overheads, and the NIHâs coverage of overheads has also been slashed from 40% of the total budget being submitted to 15%. Also known as indirect costs, overheads acknowledge that a scientistâs laboratory does not exist in a vacuum. Research centres have clerical and administrative staff, as well as fiscal managers and directors. They have computers and printers, and they use up electricity and running water. Like any building, they sometimes have to be renovated and their grounds have to be maintained. Moreover, they offer core services that multiple researchers end up using. As a grad student and later research assistant, I had access to centralized facilities that could sort cells for me, or do mass spectrometry, or do whole-genome sequencing. These instruments cost a fortune and they require trained scientists to run them and diagnose errors. It doesnât make sense for each lab to have them, so they are typically shared as core facilities. Overheads pay for that, too. Biomedical research is not the only discipline being drawn and quartered. The Department of Energy has likewise capped its allowable overhead coverage for research projects at 15%; the National Oceanographic and Atmospheric Administration sees its proposed budget hampered by 1.6 billion dollars; and the National Science Foundation has termi...
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An Evidence-Based Approach to Covid-19 Vaccination | NEJM
This article from the FDA compares broad U.S. recommendations on Covid vaccination
with those from other countries and announces the adoption of an evidence-based approach
to such recommendations.