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Serological responses and vaccine effectiveness for extended COVID-19 vaccine schedules in England

Author

Listed:
  • Gayatri Amirthalingam

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Jamie Lopez Bernal

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Nick J. Andrews

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Heather Whitaker

    (Statistics, Modelling and Economics Department, UK Health Security Agency)

  • Charlotte Gower

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Julia Stowe

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Elise Tessier

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Sathyavani Subbarao

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Georgina Ireland

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Frances Baawuah

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency
    Brondesbury Medical Centre, Kilburn)

  • Ezra Linley

    (Sero-Epidemiolgy Unit, UK Health Security Agency)

  • Lenesha Warrener

    (Virus Reference Department, UK Health Security Agency)

  • Michelle O’Brien

    (Brondesbury Medical Centre, Kilburn)

  • Corinne Whillock

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Paul Moss

    (University of Birmingham)

  • Shamez N. Ladhani

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency
    St. George’s University of London)

  • Kevin E. Brown

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

  • Mary E. Ramsay

    (Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency)

Abstract

The UK prioritised delivery of the first dose of BNT162b2 (Pfizer/BioNTech) and AZD1222 (AstraZeneca) vaccines by extending the interval between doses up to 12 weeks. In 750 participants aged 50–89 years, we here compare serological responses after BNT162b2 and AZD1222 vaccination with varying dose intervals, and evaluate these against real-world national vaccine effectiveness (VE) estimates against COVID-19 in England. We show that antibody levels 14–35 days after dose two are higher in BNT162b2 recipients with an extended vaccine interval (65–84 days) compared with those vaccinated with a standard (19–29 days) interval. Following the extended schedule, antibody levels were 6-fold higher at 14–35 days post dose 2 for BNT162b2 than AZD1222. For both vaccines, VE was higher across all age-groups from 14 days after dose two compared to one dose, but the magnitude varied with dose interval. Higher dose two VE was observed with >6 week interval between BNT162b2 doses compared to the standard schedule. Our findings suggest higher effectiveness against infection using an extended vaccine schedule. Given global vaccine constraints these results are relevant to policymakers.

Suggested Citation

  • Gayatri Amirthalingam & Jamie Lopez Bernal & Nick J. Andrews & Heather Whitaker & Charlotte Gower & Julia Stowe & Elise Tessier & Sathyavani Subbarao & Georgina Ireland & Frances Baawuah & Ezra Linley, 2021. "Serological responses and vaccine effectiveness for extended COVID-19 vaccine schedules in England," Nature Communications, Nature, vol. 12(1), pages 1-9, December.
    • Handle: RePEc:nat:natcom:v:12:y:2021:i:1:d:10.1038_s41467-021-27410-5
    DOI: 10.1038/s41467-021-27410-5
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    1. Elizabeth J. Williamson & Alex J. Walker & Krishnan Bhaskaran & Seb Bacon & Chris Bates & Caroline E. Morton & Helen J. Curtis & Amir Mehrkar & David Evans & Peter Inglesby & Jonathan Cockburn & Helen, 2020. "Factors associated with COVID-19-related death using OpenSAFELY," Nature, Nature, vol. 584(7821), pages 430-436, August.
    2. Dami A. Collier & Isabella A. T. M. Ferreira & Prasanti Kotagiri & Rawlings P. Datir & Eleanor Y. Lim & Emma Touizer & Bo Meng & Adam Abdullahi & Anne Elmer & Nathalie Kingston & Barbara Graves & Emma, 2021. "Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2," Nature, Nature, vol. 596(7872), pages 417-422, August.
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    Cited by:

    1. Madhumita Shrotri & Ellen Fragaszy & Vincent Nguyen & Annalan M. D. Navaratnam & Cyril Geismar & Sarah Beale & Jana Kovar & Thomas E. Byrne & Wing Lam Erica Fong & Parth Patel & Anna Aryee & Isobel Br, 2022. "Spike-antibody responses to COVID-19 vaccination by demographic and clinical factors in a prospective community cohort study," Nature Communications, Nature, vol. 13(1), pages 1-10, December.
    2. Francisco Tsz Tsun Lai & Min Fan & Caige Huang & Celine Sze Ling Chui & Eric Yuk Fai Wan & Xue Li & Carlos King Ho Wong & Ching-Lung Cheung & Ian Chi Kei Wong & Esther Wai Yin Chan, 2023. "Effectiveness of BNT162b2 after extending the primary series dosing interval in children and adolescents aged 5–17," Nature Communications, Nature, vol. 14(1), pages 1-6, December.

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