Trends and clinical characteristics of 57.9 million COVID-19 vaccine recipients: a federated analysis of patients' primary care records <i>in situ</i> using OpenSAFELY.

Peer-reviewed article
(2021 Sep) Br J Gen Pract

Authors

Curtis HJ, Inglesby P, Morton CE, MacKenna B, Green A, Hulme W, Walker AJ, Morley J, Mehrkar A, Bacon S, Hickman G, Bates C, Croker R, Evans D, Ward T, Cockburn J, Davy S, Bhaskaran K, Schultze A, Rentsch CT, Williamson EJ, Rowan A, Fisher L, McDonald HI, Tomlinson L, Mathur R, Drysdale H, Eggo RM, Wing K, Wong AY, Forbes H, Parry J, Hester F, Harper S, O'Hanlon S, Eavis A, Jarvis R, Avramov D, Griffiths P, Fowles A, Parkes N, Douglas IJ, Evans SJ, Smeeth L, Goldacre B, (The OpenSAFELY Collaborative).

Abstract

BACKGROUND

On 8 December 2020 NHS England administered the first COVID-19 vaccination.

AIM

To describe trends and variation in vaccine coverage in different clinical and demographic groups in the first 100 days of the vaccine rollout.

DESIGN AND SETTING

With the approval of NHS England, a cohort study was conducted of 57.9 million patient records in general practice in England, and within the infrastructure of the electronic health record software vendors EMIS and TPP using OpenSAFELY.

METHOD

Vaccine coverage across various subgroups of Joint Committee on Vaccination and Immunisation (JCVI) priority cohorts is described.

RESULTS

A total of 20 852 692 patients (36.0%) received a vaccine between 8 December 2020 and 17 March 2021. Of patients aged ≥80 years not in a care home (JCVI group 2) 94.7% received a vaccine, but with substantial variation by ethnicity (White 96.2%, Black 68.3%) and deprivation (least deprived 96.6%, most deprived 90.7%). Patients with pre-existing medical conditions were more likely to be vaccinated with two exceptions: severe mental illness (89.5%) and learning disability (91.4%). There were 275 205 vaccine recipients who were identified as care home residents (JCVI group 1; 91.2% coverage). By 17 March, 1 257 914 (6.0%) recipients had a second dose.

CONCLUSION

The NHS rapidly delivered mass vaccination. In this study a data-monitoring framework was deployed using publicly auditable methods and a secure processing model, using linked but pseudonymised patient-level NHS data for 57.9 million patients. Targeted activity may be needed to address lower vaccination coverage observed among certain key groups.