Risk of severe COVID-19 outcomes after autumn 2022 COVID-19 booster vaccinations: a pooled analysis of national prospective cohort studies involving 7.4 million adults in England, Northern Ireland, Scotland and Wales

• Published in: The Lancet regional health. Europe 2024-02, Vol.37, p.100816, Article 100816
• Main Authors: Bedston, Stuart, Almaghrabi, Fatima, Patterson, Lynsey, Agrawal, Utkarsh, Woolford, Lana, Anand, Sneha N., Joy, Mark, Crawford, Anna, Goudie, Rosalind, Byford, Rachel, Abbasizanjani, Hoda, Smith, Deb, Laidlaw, Lynn, Akbari, Ashley, Sullivan, Christopher, Bradley, Declan T., Lyons, Ronan A., de Lusignan, Simon, Hobbs, F.D. Richard, Robertson, Chris, Sheikh, Sir Aziz, Shi, Ting
• Format: Article
• Language: English
• Subjects: Booster dose; COVID-19; Hospital admission; Vaccine; Vaccine breakthrough
• ISSN: 2666-7762; 2666-7762
• DOI: 10.1016/j.lanepe.2023.100816

UK COVID-19 vaccination policy has evolved to offering COVID-19 booster doses to individuals at increased risk of severe Illness from COVID-19. Building on our analyses of vaccine effectiveness of first, second and initial booster doses, we aimed to identify individuals at increased risk of severe outcomes (i.e., COVID-19 related hospitalisation or death) post the autumn 2022 booster dose. We undertook a national population-based cohort analysis across all four UK nations through linked primary care, vaccination, hospitalisation and mortality data. We included individuals who received autumn 2022 booster doses of BNT162b2 (Comirnaty) or mRNA-1273 (Spikevax) during the period September 1, 2022 to December 31, 2022 to investigate the risk of severe COVID-19 outcomes. Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for the association between demographic and clinical factors and severe COVID-19 outcomes after the autumn booster dose. Analyses were adjusted for age, sex, body mass index (BMI), deprivation, urban/rural areas and comorbidities. Stratified analyses were conducted by vaccine type. We then conducted a fixed-effect meta-analysis to combine results across the four UK nations. Between September 1, 2022 and December 31, 2022, 7,451,890 individuals ≥18 years received an autumn booster dose. 3500 had severe COVID-19 outcomes (2.9 events per 1000 person-years). Being male (male vs female, aHR 1.41 (1.32–1.51)), older adults (≥80 years vs 18–49 years; 10.43 (8.06–13.50)), underweight (BMI