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https://www.gov.uk/government/news/new-data-show-vaccines-reduce-severe-covid-19-in-older-adults Early effectiveness of COVID-19 vaccination with BNT162b2 mRNA vaccine and ChAdOx1 adenovirus vector vaccine on symptomatic disease, hospitalisations and mortality in older adults in the UK: a test negative case control study https://khub.net/documents/135939561/430986542/Early+effectiveness+of+COVID+vaccines.pdf/ffd7161c-b255-8e88-c2dc-88979fc2cc1b?t=1614617945615 Objectives Real-world effectiveness of the Pfizer/BioNTech BNT162b2 vaccine and … Astrazeneca ChAdOx1 vaccine against…. Confirmed COVID-19, hospitalisations and deaths To estimate effectiveness on the UK variant of concern. Setting Community COVID-19 PCR testing in England 8th December 2020 and 19th February 2021 All adults in England aged 70 years and older (over 7.5 million) All symptomatic COVID-19 testing in the community in over 70s Test negative case control design 174,731 PCR tests 156,930 of these (89.8%) linked to vaccination data 44,590 (28.4%) were positive tests 112,340 (71.6%) were negative Interventions One and two doses of BNT162b2 vaccine One dose of ChAdOx1 vaccine Main outcome measures Symptomatic PCR confirmed SARS-CoV-2 infection Hospitalisations and deaths with COVID-19. Symptomatic disease infection risk Results Individuals aged more than 80 years vaccinated with Pfizer BNT162b2 Higher odds of testing positive in the first 9 days after vaccination (odds ratio up to 1.48) Vaccine effects were noted from 10-13 days after vaccination Reaching an effectiveness of 70% from 28-34 days, then plateauing From 14 days after the second dose, vaccine effectiveness was 89% (Fewer than 10 over 80 sent to ITU every day in UK) Individuals aged more than70 years Pfizer BNT162b2 Vaccine effectiveness reached 61% from 28-34 days then plateaued AZ ChAdOx1 Vaccine effects, were seen from 14-20 days Reaching an effectiveness of 60% from 28-34 days Further increasing to 73% from day 35 onwards Risk of emergency hospitalisation and death results One dose of BNT162b2 Additional 43% lower risk of emergency hospitalisation Additional 51% lower risk of death One dose of ChAdOx1 Additional 37% lower risk of emergency hospitalisation Insufficient follow-up to assess the effect of ChAdOx1 on mortality Combined with the effect against symptomatic disease Single dose of either vaccine is approximately 80% effective at preventing hospitalisation Single dose of BNT162b2 is 85% effective at preventing death Single dose of ChAdOx1 unknown protective effect against death Conclusion Significant reduction in symptomatic SARS-CoV2 positive cases in older adults Even greater protection against severe disease Both vaccines show similar effects Protection was maintained for more than 6 weeks A second dose of BNT162b2 provides further protection against symptomatic disease Second doses of ChAdOx1 have not yet been rolled out in England There is a clear effect of the vaccines against the UK variant of concern Professor Jonathan Van-Tam Joint Committee on Vaccination and Immunisation not immunologically plausible the vaccine would work in younger age groups and not older ones. Dr Mary Ramsay, PHE's head of immunisation, said it could. If anything we would expect it to be a stronger protection from the vaccine Lower down in the age range is that people's chances of being hospitalised and dying are much lower France Oxford/AstraZeneca vaccine, can be given to people with underlying health conditions in the 65-74 age group 1.1m doses in country Germany Still not giving the AstraZeneca to the over-65s Now under discussion Large stocks of that vaccine waiting to be used (Belgium, Poland, Italy, Sweden) Professor Andrew Pollard, Oxford Vaccine group Findings were stunning 5,000 people dying every day in Europe, important to increase confidence in vaccines disappointing in some senses really high levels of protection support their decision making Oxford vaccine distributed to low-income countries, Covax scheme

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