| Verfasst von: | Lopez Bernal, Jamie |
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| | Andrews, Nick |
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| | Gower, Charlotte |
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| | Robertson, Chris |
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| | Stowe, Julia |
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| | Tessier, Elise |
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| | Simmons, Ruth |
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| | Cottrell, Simon |
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| | Roberts, Richard |
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| | O’Doherty, Mark |
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| | Brown, Kevin |
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| | Cameron, Claire |
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| | Stockton, Diane |
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| | McMenamin, Jim |
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| | Ramsay, Mary |
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| Titel: | 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 |
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| Verlagsort: | England |
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| Verlag: | BMJ Publishing Group LTD |
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| | BMJ Publishing Group Ltd |
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| Jahr: | 2021 |
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| Fussnoten: | ObjectType-Article-2 ; ObjectType-Feature-3 ; ObjectType-Undefined-1 ; SourceType-Scholarly Journals-1 ; content type line 23 |
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| Inhalt: | AbstractObjectiveTo 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.DesignTest negative case-control study.SettingCommunity testing for covid-19 in England.Participants156 930 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.InterventionsVaccination with BNT162b2 or ChAdOx1-S.Main outcome measuresPrimary outcomes were polymerase chain reaction confirmed symptomatic SARS-CoV-2 infections, admissions to hospital for covid-19, and deaths with covid-19.ResultsParticipants 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.ConclusionVaccination 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. |
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| ISSN: | 1756-1833 |
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| | 0959-8138 |
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| Titel Quelle: | BMJ (Online) |
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| Jahr Quelle: | 2021 |
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| Band/Heft Quelle: | 373, S. n1088-n1088 |
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| DOI: | doi:10.1136/bmj.n1088 |
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| URL: | http://www.ub.uni-heidelberg.de/cgi-bin/edok?dok=https%3A%2F%2Ffanyv88.com%3A443%2Fhttp%2Fdx.doi.org%2F10.1136%2Fbmj.n1088 |
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| | http://www.ub.uni-heidelberg.de/cgi-bin/edok?dok=https%3A%2F%2Ffanyv88.com%3A443%2Fhttps%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F33985964 |
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| | http://www.ub.uni-heidelberg.de/cgi-bin/edok?dok=https%3A%2F%2Ffanyv88.com%3A443%2Fhttps%2Fwww.proquest.com%2Fdocview%2F2526610995%2Fabstract%2F |
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| | http://www.ub.uni-heidelberg.de/cgi-bin/edok?dok=https%3A%2F%2Ffanyv88.com%3A443%2Fhttps%2Fsearch.proquest.com%2Fdocview%2F2528174994 |
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| | http://www.ub.uni-heidelberg.de/cgi-bin/edok?dok=https%3A%2F%2Ffanyv88.com%3A443%2Fhttps%2Fpubmed.ncbi.nlm.nih.gov%2FPMC8116636 |
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| | DOI: https://doi.org/10.1136/bmj.n1088 |
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| Sprache: | English |
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| Sach-SW: | Aged |
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| | Aged, 80 and over |
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| | Case-Control Studies |
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| | Clinical outcomes |
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| | Coronaviruses |
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| | COVID-19 |
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| | COVID-19 - diagnosis |
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| | COVID-19 - immunology |
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| | COVID-19 - mortality |
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| | COVID-19 - prevention & control |
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| | COVID-19 Testing - methods |
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| | COVID-19 vaccines |
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| | COVID-19 Vaccines - administration & dosage |
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| | COVID-19 Vaccines - immunology |
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| | Emergency medical care |
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| | England - epidemiology |
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| | Ethnicity |
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| | Female |
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| | Hospitalization |
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| | Hospitalization - statistics & numerical data |
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| | Humans |
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| | Laboratories |
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| | Male |
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| | Mortality |
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| | Mutation |
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| | Older people |
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| | Patient admissions |
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| | Polymerase chain reaction |
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| | Public health |
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| | SARS-CoV-2 - drug effects |
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| | SARS-CoV-2 - genetics |
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| | SARS-CoV-2 - immunology |
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| | Severe acute respiratory syndrome coronavirus 2 |
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| | Treatment Outcome |
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| | Vaccination - methods |
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| | Vaccination - statistics & numerical data |
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| | Vaccine efficacy |
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| | Vaccines |
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| Verknüpfungen: | → Sammelwerk |
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