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

Gayatri Amirthalingam (), Jamie Lopez Bernal, Nick J. Andrews, Heather Whitaker, Charlotte Gower, Julia Stowe, Elise Tessier, Sathyavani Subbarao, Georgina Ireland, Frances Baawuah, Ezra Linley, Lenesha Warrener, Michelle O’Brien, Corinne Whillock, Paul Moss, Shamez N. Ladhani, Kevin E. Brown and Mary E. Ramsay
Additional contact information
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
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
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

Nature Communications, 2021, vol. 12, issue 1, 1-9

Abstract: 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.

Date: 2021
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DOI: 10.1038/s41467-021-27410-5

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