The Lancet Regional Health - Europe

BackgroundUnderstanding underlying mechanisms of heterogeneity in test-seeking and reporting behaviour can help to protect the vulnerable and guide equity-driven interventions. Using COVID-19 testing data for England and data from community prevalence surveillance surveys (REACT-1 and ONS-CIS) from October 2020 to March 2022, we investigated the relationship between sociodemographic factors and testing behaviours in England. MethodsWe used mass testing data for lateral flow device (LFD; data fo...

BackgroundThe UK was the first country to start national COVID-19 vaccination programmes, initially administering doses 3-weeks apart. However, early evidence of high vaccine effectiveness after the first dose and the emergence of the Alpha variant prompted the UK to extend the interval between doses to 12-weeks. In this study, we quantify the impact of delaying the second vaccine dose on the epidemic in England. MethodsWe used a previously described model of SARS-CoV-2 transmission and calibra...

ObjectiveTo assess the early vaccine administration coverage and vaccine effectiveness and outcome data across an integrated care system of eight CCGs leveraging a unique population-level care dataset DesignRetrospective cohort study. SettingIndividuals eligible for COVID 19 vaccination in North West London based on linked primary and secondary care data. Participants2,183,939 individuals eligible for COVID 19 vaccination ResultsDuring the NWL vaccine programme study time period 5.88% of ind...

ObjectiveTo estimate the percentage of individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) over time in the community in England and to quantify risk factors. DesignRepeated cross-sectional surveys of population-representative households with longitudinal follow-up if consent given. SettingEngland Participants34,992 Individuals aged 2 years and over from 16,722 private residential households. Data were collected in a pilot phase of the survey between 26 Apri...

BackgroundNegative attitudes towards vaccines and an uncertainty or unwillingness to receive vaccinations are major barriers to managing the COVID-19 pandemic in the long-term. We estimate predictors of four domains of negative attitudes towards vaccines and identify groups most at risk of uncertainty and unwillingness to receive a COVID-19 vaccine in a large sample of UK adults. MethodsData were from 32,361 adults in the UCL COVID-19 Social Study. Ordinary least squares regression analyses exa...

Background: The availability of a COVID-19 vaccine has been heralded as key to controlling the COVID-19 pandemic. COVID-19 vaccination programme success will rely on public willingness to be vaccinated. Methods: We used a multi-methods approach - involving an online cross-sectional survey and semi-structured interviews - to investigate parents' and guardians' views on the acceptability of a future COVID-19 vaccine. 1252 parents and guardians (aged 16+ years) who reported living in England with a...

BackgroundCOVID-19 vaccines have been the central pillar of the public health response to the pandemic, intended to enable us to live with Covid. It is important to understand COVID-19 vaccines attitudes and decisions in order to maximise uptake through an empathetic lens. ObjectiveTo explore the factors that influenced peoples COVID-19 vaccines decisions and how attitudes towards the vaccines had changed in an eventful year. Design and participantsThis is a follow up study that took place in...

BackgroundAll patients in England within vaccine priority groups were offered a COVID-19 vaccine by mid-April 2021. Clinical record systems contain codes to denote when such an offer has been declined by a patient (although these can in some cases be entered for a variety of other reasons including vaccination delay, or other administrative issues). We set out to describe the patterns of usage of codes for COVID-19 vaccines being declined. MethodsWith the approval of NHS England and using the f...

AimTo evaluate associations of plasma 25(OH)D status with the likelihood of coronavirus disease (COVID-19) infection and hospitalization. MethodsThe study population included the 14,000 members of Leumit Health Services who were tested for COVID-19 infection from February 1st to April 30th 2020, and who had at least one previous blood test for plasma 25(OH)D level. "Suboptimal" or "low" plasma 25(OH)D level was defined as plasma 25-hydroxyvitamin D, or 25(OH)D, concentration below 30 ng/mL. Re...

BackgroundIndividuals of South Asian ancestry experience higher risk of cardiometabolic disease compared with most other groups, and the impact of acculturation on this risk warrants further study. MethodsWe studied individuals of South Asian (n=8,420) and European (n=441,696) ancestry free of baseline cardiometabolic disease in the UK Biobank prospective cohort. South Asians were divided into 3 acculturation groups based on time lived in UK: born in UK (n=801); born abroad, in UK >5yrs (n=7213...

BackgroundWith the global pandemic of coronavirus disease 2019 (Covid-19) there has been disruption to normal clinical activity in response to the increased demand on health services. There are reports of a reduction in non-Covid-19 emergency presentations. Consequentially, there are concerns that deaths from non-Covid-19 causes could increase. We examined recent reported population-based mortality rates, compared with expected rates, and compared any excess in deaths with the number of deaths a...

Preliminary reports suggest that the Coronavirus Disease 2019 (COVIDa^19) pandemic has led to disproportionate morbidity and mortality among historically disadvantaged populations. The extent to which these disparities are related to socioeconomic versus biologic factors is largely unknown. We investigate the racial and socioeconomic associations of COVIDa^19 hospitalization among 418,794 participants of the UK Biobank, of whom 549 (0.13%) had been hospitalized. Both black participants (odds rat...

BackgroundUnderstanding of the true asymptomatic rate of infection of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. MethodsWe undertook enzyme linked immunosorbent assay characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein o...

BackgroundCOVID-19 is associated with subsequent mental illness in both hospital- and population-based studies. Evidence regarding effects of COVID-19 vaccination on mental health consequences of COVID-19 is limited. MethodsWith the approval of NHS England, we used linked electronic health records (OpenSAFELY-TPP) to conduct analyses in a pre-vaccination cohort (17,619,987 people) followed during the wild-type/Alpha variant eras (January 2020-June 2021), and vaccinated and unvaccinated cohor...

BackgroundUnderstanding of the role of ethnicity and socioeconomic position in the risk of developing SARS-CoV-2 infection is limited. We investigated this in the UK Biobank study. MethodsThe UK Biobank study recruited 40-70 year olds in 2006-2010 from the general population, collecting information about self-defined ethnicity and socioeconomic variables (including area-level socioeconomic deprivation and educational attainment). SARS-CoV-2 test results from Public Health England were linked to...

ObjectiveTo create case definitions for confirmed COVID diagnoses, COVID vaccination status, and three separate definitions of high risk of severe COVID, as well as to assess whether the implementation of these definitions in a cohort reflected the sociodemographic and clinical characteristics of COVID epidemiology in England. DesignRetrospective cohort study SettingElectronic healthcare records from primary care (Clinical Practice Research Datalink, or CPRD) linked to secondary care data (Hos...

ObjectiveTo determine clinical and ethnodemographic correlates of serological responses against the SARS-CoV-2 spike glycoprotein following mild-to-moderate COVID-19. DesignA retrospective cohort study of healthcare workers who had self-isolated due to COVID-19. SettingUniversity Hospitals Birmingham NHS Foundation Trust, UK (UHBFT). Participants956 health care workers were recruited by open invitation via UHBFT trust email and social media. InterventionParticipants volunteered a venous bloo...

ObjectivesTo quantify healthcare resource utilisation (HCRU) and costs to the National Health Service (NHS) associated with acute COVID-19 in adults in England. DesignPopulation-based retrospective cohort study, using Clinical Practice Research Datalink (CPRD) Aurum primary care electronic medical records linked when available to Hospital Episode Statistics (HES) secondary care administrative data. SettingPatients registered to primary care practices in England. Population1,706,368 adults wit...

COVID-19 point prevalence PCR community testing allows disease burden estimation. In a sample of London residents, point prevalence decreased from 2.2% (95%CI 1.4;3.5) in early April (reflecting infection around lockdown implementation) to 0.2% (95%CI 0.03-1.6) in early May (reflecting infection 3-5 weeks into lockdown). Extrapolation from reports of confirmed cases suggest that 5-7.6% of total infections were confirmed by testing during this period. These data complement seroprevalence surveys ...

ImportanceThe emergence of the COVID-19 vaccination has been critical in changing the course of the COVID-19 pandemic, with estimates suggesting vaccinations have prevented millions of deaths worldwide. To ensure protection remains high in vulnerable groups booster vaccinations in the UK have been targeted based on age and clinical vulnerabilities. ObjectiveWe sought to identify adults who had received a booster vaccination as part of the autumn 2022 campaign in England yet remained at increase...