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Bias assessment of a test-negative design study of COVID-19 vaccine effectiveness used in national policymaking.


ABSTRACT: National test-negative-case-control (TNCC) studies are used to monitor COVID-19 vaccine effectiveness in the UK. A questionnaire was sent to participants from the first published TNCC COVID-19 vaccine effectiveness study conducted by the UK Health Security Agency, to assess for potential biases and changes in behaviour related to vaccination. The original study included symptomatic adults aged ≥70 years testing for COVID-19 between 08/12/2020 and 21/02/2021. A questionnaire was sent to cases and controls tested from 1-21 February 2021. In this study, 8648 individuals responded to the questionnaire (36.5% response). Using information from the questionnaire to produce a combined estimate that accounted for all potential biases decreased the original vaccine effectiveness estimate after two doses of BNT162b2 from 88% (95% CI: 79-94%) to 85% (95% CI: 68-94%). Self-reported behaviour demonstrated minimal evidence of riskier behaviour after vaccination. These findings offer reassurance to policy makers and clinicians making decisions based on COVID-19 vaccine effectiveness TNCC studies.

SUBMITTER: Graham S 

PROVIDER: S-EPMC10325974 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Bias assessment of a test-negative design study of COVID-19 vaccine effectiveness used in national policymaking.

Graham Sophie S   Tessier Elise E   Stowe Julia J   Bernal Jamie Lopez JL   Parker Edward P K EPK   Nitsch Dorothea D   Miller Elizabeth E   Andrews Nick N   Walker Jemma L JL   McDonald Helen I HI  

Nature communications 20230706 1


National test-negative-case-control (TNCC) studies are used to monitor COVID-19 vaccine effectiveness in the UK. A questionnaire was sent to participants from the first published TNCC COVID-19 vaccine effectiveness study conducted by the UK Health Security Agency, to assess for potential biases and changes in behaviour related to vaccination. The original study included symptomatic adults aged ≥70 years testing for COVID-19 between 08/12/2020 and 21/02/2021. A questionnaire was sent to cases and  ...[more]

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