Clifford, Samuel; Waight, Pauline; Hackman, Jada; Hué, Stephane; Gower, Charlotte M; Kirsebom, Freja CM; Skarnes, Catriona; Letley, Louise; Lopez Bernal, Jamie; Andrews, Nick; +2 more... Flasche, Stefan; Miller, Elizabeth; (2023) Effectiveness of BNT162b2 and ChAdOx1 against SARS-CoV-2 household transmission: a prospective cohort study in England. Wellcome Open Research, 8. p. 96. ISSN 2398-502X DOI: https://doi.org/10.12688/wellcomeopenres.17995.1
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Abstract
<ns3:p><ns3:bold>Background:</ns3:bold> The ability of SARS-CoV-2 vaccines to protect against infection and onward transmission determines whether immunisation can control global circulation. We estimated the effectiveness of Pfizer-BioNTech mRNA vaccine (BNT162b2) and Oxford AstraZeneca adenovirus vector vaccine (ChAdOx1) vaccines against acquisition and transmission of the Alpha and Delta variants in a prospective household study in England.</ns3:p><ns3:p> <ns3:bold>Methods:</ns3:bold> Households were recruited based on adult purported index cases testing positive after reverse transcription-quantitative (RT-q)PCR testing of oral-nasal swabs. Purported index cases and their household contacts took oral-nasal swabs on days 1, 3 and 7 after enrolment and a subset of the PCR-positive swabs underwent genomic sequencing conducted on a subset. We used Bayesian logistic regression to infer vaccine effectiveness against acquisition and transmission, adjusted for age, vaccination history and variant.</ns3:p><ns3:p> <ns3:bold>Results: </ns3:bold>Between 2 February 2021 and 10 September 2021, 213 index cases and 312 contacts were followed up. After excluding households lacking genomic proximity (N=2) or with unlikely serial intervals (N=16), 195 households with 278 contacts remained, of whom 113 (41%) became PCR positive. Delta lineages had 1.53 times the risk (95% Credible Interval: 1.04 – 2.20) of transmission than Alpha; contacts older than 18 years old were 1.48 (1.20 – 1.91) and 1.02 (0.93 – 1.16) times more likely to acquire an Alpha or Delta infection than children. Effectiveness of two doses of BNT162b2 against transmission of Delta was 36% (-1%, 66%) and 49% (18%, 73%) for ChAdOx1, similar to their effectiveness for Alpha. Protection against infection with Alpha was higher than for Delta, 69% (9%, 95%)<ns3:italic> vs.</ns3:italic> 18% (-11%, 59%), respectively, for BNT162b2 and 24% (-41%, 72%) <ns3:italic>vs.</ns3:italic> 9% (-15%, 42%), respectively, for ChAdOx1.</ns3:p><ns3:p> <ns3:bold>Conclusions:</ns3:bold> BNT162b2 and ChAdOx1 reduce transmission of the Delta variant from breakthrough infections in the household setting, although their protection against infection within this setting is low.</ns3:p>
Item Type | Article |
---|---|
Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & Dynamics (2023-) Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) |
Research Centre |
Covid-19 Research Centre for the Mathematical Modelling of Infectious Diseases ?? 181801 ?? |
Elements ID | 199666 |
Official URL | http://dx.doi.org/10.12688/wellcomeopenres.17995.1 |
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