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Estimating the effectiveness of first dose of COVID-19 vaccine against mortality in England: a quasi-experimental study

Estimating the effectiveness of first dose of COVID-19 vaccine against mortality in England: a quasi-experimental study
Estimating the effectiveness of first dose of COVID-19 vaccine against mortality in England: a quasi-experimental study
Estimating real-world vaccine effectiveness is vital to assess the COVID-19 vaccination programme and to inform the ongoing policy response. However, estimating vaccine effectiveness using observational data is inherently challenging because of the non-randomised design and potential for unmeasured confounding. We used a Regression Discontinuity Design (RDD) to estimate vaccine effectiveness against COVID-19 mortality in England using. the fact that people aged 80 or over were prioritised for the vaccine roll-out. The prioritisation led to a large discrepancy in vaccination rates in people 80–84 compared to those 75–79 at the beginning of the vaccination campaign. We found a corresponding difference in COVID-19 mortality, but not in non-COVID-19 mortality, suggesting that our approach appropriately addresses the issue of unmeasured confounding factors. Our results suggest that the first vaccine dose reduced the risk of COVID-19 death by 52.6% (95% Cl 26.6–84.2) in those aged 80, supporting existing evidence that a first dose of a COVID-19 vaccine has a strong protective effect against COVID-19 mortality in older adults. The RDD estimate of vaccine effectiveness is only slightly lower to previously published studies using different methods, suggesting that these estimates are unlikely to be substantially affected by unmeasured confounding factors.
0002-9262
Bermingham, Charlotte
097f6236-9ec0-41c4-afc0-3cb8881640f1
Morgan, Jasper
06cc0fec-7f9e-412d-926a-ad851c69f1f4
Ayoubkhani, Daniel
cfd1b0e2-6685-4edb-a53f-299582b89280
Glickman, Myer
61b66cbc-a403-4cd6-b7b5-eb18fccae968
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Sheikh, Aziz
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Sterne, Jonathan
05fbcb78-68a6-4461-815e-e1f555602bd5
Walker, A. Sarah
e07841ba-91e9-4b85-971b-b95c299afa3a
Nafilyan, Vahé
bae04e8d-af87-4def-965c-3d59e2017a9b
Bermingham, Charlotte
097f6236-9ec0-41c4-afc0-3cb8881640f1
Morgan, Jasper
06cc0fec-7f9e-412d-926a-ad851c69f1f4
Ayoubkhani, Daniel
cfd1b0e2-6685-4edb-a53f-299582b89280
Glickman, Myer
61b66cbc-a403-4cd6-b7b5-eb18fccae968
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Sheikh, Aziz
5b7eb24b-0820-4bd6-8304-cc46bbe561a8
Sterne, Jonathan
05fbcb78-68a6-4461-815e-e1f555602bd5
Walker, A. Sarah
e07841ba-91e9-4b85-971b-b95c299afa3a
Nafilyan, Vahé
bae04e8d-af87-4def-965c-3d59e2017a9b

Bermingham, Charlotte, Morgan, Jasper, Ayoubkhani, Daniel, Glickman, Myer, Islam, Nazrul, Sheikh, Aziz, Sterne, Jonathan, Walker, A. Sarah and Nafilyan, Vahé (2022) Estimating the effectiveness of first dose of COVID-19 vaccine against mortality in England: a quasi-experimental study. American Journal of Epidemiology, [kwac157]. (doi:10.1101/2021.07.12.21260385).

Record type: Article

Abstract

Estimating real-world vaccine effectiveness is vital to assess the COVID-19 vaccination programme and to inform the ongoing policy response. However, estimating vaccine effectiveness using observational data is inherently challenging because of the non-randomised design and potential for unmeasured confounding. We used a Regression Discontinuity Design (RDD) to estimate vaccine effectiveness against COVID-19 mortality in England using. the fact that people aged 80 or over were prioritised for the vaccine roll-out. The prioritisation led to a large discrepancy in vaccination rates in people 80–84 compared to those 75–79 at the beginning of the vaccination campaign. We found a corresponding difference in COVID-19 mortality, but not in non-COVID-19 mortality, suggesting that our approach appropriately addresses the issue of unmeasured confounding factors. Our results suggest that the first vaccine dose reduced the risk of COVID-19 death by 52.6% (95% Cl 26.6–84.2) in those aged 80, supporting existing evidence that a first dose of a COVID-19 vaccine has a strong protective effect against COVID-19 mortality in older adults. The RDD estimate of vaccine effectiveness is only slightly lower to previously published studies using different methods, suggesting that these estimates are unlikely to be substantially affected by unmeasured confounding factors.

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2021.07.12.21260385v2.full - Author's Original
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kwac157 - Accepted Manuscript
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Accepted/In Press date: 30 August 2022
Published date: 5 September 2022

Identifiers

Local EPrints ID: 470560
URI: http://eprints.soton.ac.uk/id/eprint/470560
ISSN: 0002-9262
PURE UUID: 56c214ef-603c-4c99-a368-17d300265fd7
ORCID for Nazrul Islam: ORCID iD orcid.org/0000-0003-3982-4325

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Date deposited: 13 Oct 2022 16:31
Last modified: 24 Nov 2022 03:05

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Contributors

Author: Charlotte Bermingham
Author: Jasper Morgan
Author: Daniel Ayoubkhani
Author: Myer Glickman
Author: Nazrul Islam ORCID iD
Author: Aziz Sheikh
Author: Jonathan Sterne
Author: A. Sarah Walker
Author: Vahé Nafilyan

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