Trends and clinical characteristics of COVID-19 vaccine recipients: A federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY

The OpenSAFELY Collaborative

doi:10.3399/BJGP.2021.0376

Trends and clinical characteristics of COVID-19 vaccine recipients: A federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY

The OpenSAFELY Collaborative

Research output: Contribution to journal › Article › peer-review

50 Citations (SciVal)

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, in situ 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 in situ 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.

Original language	English
Pages (from-to)	E51-E62
Journal	British Journal of General Practice
Volume	72
Issue number	714
DOIs	https://doi.org/10.3399/BJGP.2021.0376
Publication status	Published - 31 Dec 2021
Externally published	Yes

Bibliographical note

Funding Information:
All authors have completed the International Committee of Medical Journal Editors uniform disclosure form at www.icmje.org/ coi_disclosure.pdf and declare the following: over the past 5 years Ben Goldacre has received research funding from the Laura and John Arnold Foundation, the NIHR, the NIHR School of Primary Care Research, the NIHR Oxford Biomedical Research Centre, the Mohn Westlake Foundation, NIHR Applied Research Collaboration Oxford and Thames Valley, the Wellcome Trust, the Good Thinking Foundation, Health Data Research UK, the Health Foundation, and the World Health Organization; he also receives personal income from speaking and writing for lay audiences on the misuse of science. Krishnan Bhaskaran holds a Sir Henry Dale fellowship jointly funded by Wellcome and the Royal Society (reference: 107731/Z/15/Z). Helen I McDonald is funded by the NIHR Health Protection Research Unit in Immunisation, a partnership between Public Health England and London School of Hygiene and Tropical Medicine. Angel YS Wong holds a fellowship from the British Heart Foundation. Elizabeth J Williamson holds grants from the Medical Research Council. Rohini Mathur holds a Sir Henry Wellcome Fellowship funded by the Wellcome Trust (reference: 201375/Z/16/Z). Harriet Forbes holds a UKRI fellowship. Ian J Douglas has received unrestricted research grants and holds shares in GlaxoSmithKline. All other authors have declared no competing interests.

Funding Information:
This work was jointly funded by UK Research and Innovation (UKRI) (COV0076; MR/V015737/1), National Institute for Health Research (NIHR) and Asthma UK-British Lung Foundation, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme. EMIS and TPP provided technical expertise and infrastructure within their data environments pro bono in the context of a national emergency. The OpenSAFELY software platform is supported by a Wellcome Discretionary Award. Ben Goldacre’s work on clinical informatics is supported by the NIHR Oxford Biomedical Research Centre and the NIHR Applied Research Collaboration Oxford and Thames Valley. Funders had no role in the study design, collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The views expressed are those of the authors and not necessarily those of the NIHR, NHS England, Public Health England, or the Department of Health and Social Care.

Publisher Copyright:
© The Authors

Keywords

COVID-19
Ethnic groups
General practice
NHS England
SARS-CoV-2
Vaccination

ASJC Scopus subject areas

Family Practice

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3399/BJGP.2021.0376Licence: CC BY

Cite this

@article{8c2cc4ca097441cda8a4f8854f0e4375,

title = "Trends and clinical characteristics of COVID-19 vaccine recipients: A federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY",

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, in situ 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 in situ 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.",

keywords = "COVID-19, Ethnic groups, General practice, NHS England, SARS-CoV-2, Vaccination",

author = "{The OpenSAFELY Collaborative} and Curtis, {Helen J.} and Peter Inglesby and Morton, {Caroline E.} and Brian MacKenna and Amelia Green and William Hulme and Walker, {Alex J.} and Jessica Morley and Amir Mehrkar and Seb Bacon and George Hickman and Chris Bates and Richard Croker and David Evans and Tom Ward and Jonathan Cockburn and Simon Davy and Krishnan Bhaskaran and Anna Schultze and Rentsch, {Christopher T.} and Williamson, {Elizabeth J.} and Anna Rowan and Louis Fisher and McDonald, {Helen I.} and Laurie Tomlinson and Rohini Mathur and Henry Drysdale and Eggo, {Rosalind M.} and Kevin Wing and Wong, {Angel Y.S.} and Harriet Forbes and John Parry and Frank Hester and Sam Harper and Shaun O'Hanlon and Alex Eavis and Richard Jarvis and Dima Avramov and Paul Griffiths and Aaron Fowles and Nasreen Parkes and Douglas, {Ian J.} and Evans, {Stephen J.W.} and Liam Smeeth and Ben Goldacre",

note = "Funding Information: All authors have completed the International Committee of Medical Journal Editors uniform disclosure form at www.icmje.org/ coi_disclosure.pdf and declare the following: over the past 5 years Ben Goldacre has received research funding from the Laura and John Arnold Foundation, the NIHR, the NIHR School of Primary Care Research, the NIHR Oxford Biomedical Research Centre, the Mohn Westlake Foundation, NIHR Applied Research Collaboration Oxford and Thames Valley, the Wellcome Trust, the Good Thinking Foundation, Health Data Research UK, the Health Foundation, and the World Health Organization; he also receives personal income from speaking and writing for lay audiences on the misuse of science. Krishnan Bhaskaran holds a Sir Henry Dale fellowship jointly funded by Wellcome and the Royal Society (reference: 107731/Z/15/Z). Helen I McDonald is funded by the NIHR Health Protection Research Unit in Immunisation, a partnership between Public Health England and London School of Hygiene and Tropical Medicine. Angel YS Wong holds a fellowship from the British Heart Foundation. Elizabeth J Williamson holds grants from the Medical Research Council. Rohini Mathur holds a Sir Henry Wellcome Fellowship funded by the Wellcome Trust (reference: 201375/Z/16/Z). Harriet Forbes holds a UKRI fellowship. Ian J Douglas has received unrestricted research grants and holds shares in GlaxoSmithKline. All other authors have declared no competing interests. Funding Information: This work was jointly funded by UK Research and Innovation (UKRI) (COV0076; MR/V015737/1), National Institute for Health Research (NIHR) and Asthma UK-British Lung Foundation, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme. EMIS and TPP provided technical expertise and infrastructure within their data environments pro bono in the context of a national emergency. The OpenSAFELY software platform is supported by a Wellcome Discretionary Award. Ben Goldacre{\textquoteright}s work on clinical informatics is supported by the NIHR Oxford Biomedical Research Centre and the NIHR Applied Research Collaboration Oxford and Thames Valley. Funders had no role in the study design, collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The views expressed are those of the authors and not necessarily those of the NIHR, NHS England, Public Health England, or the Department of Health and Social Care. Publisher Copyright: {\textcopyright} The Authors",

year = "2021",

month = dec,

day = "31",

doi = "10.3399/BJGP.2021.0376",

language = "English",

volume = "72",

pages = "E51--E62",

journal = "British Journal of General Practice",

issn = "0960-1643",

publisher = "Royal College of General Practitioners",

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TY - JOUR

T1 - Trends and clinical characteristics of COVID-19 vaccine recipients

T2 - A federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY

AU - The OpenSAFELY Collaborative

AU - Curtis, Helen J.

AU - Inglesby, Peter

AU - Morton, Caroline E.

AU - MacKenna, Brian

AU - Green, Amelia

AU - Hulme, William

AU - Walker, Alex J.

AU - Morley, Jessica

AU - Mehrkar, Amir

AU - Bacon, Seb

AU - Hickman, George

AU - Bates, Chris

AU - Croker, Richard

AU - Evans, David

AU - Ward, Tom

AU - Cockburn, Jonathan

AU - Davy, Simon

AU - Bhaskaran, Krishnan

AU - Schultze, Anna

AU - Rentsch, Christopher T.

AU - Williamson, Elizabeth J.

AU - Rowan, Anna

AU - Fisher, Louis

AU - McDonald, Helen I.

AU - Tomlinson, Laurie

AU - Mathur, Rohini

AU - Drysdale, Henry

AU - Eggo, Rosalind M.

AU - Wing, Kevin

AU - Wong, Angel Y.S.

AU - Forbes, Harriet

AU - Parry, John

AU - Hester, Frank

AU - Harper, Sam

AU - O'Hanlon, Shaun

AU - Eavis, Alex

AU - Jarvis, Richard

AU - Avramov, Dima

AU - Griffiths, Paul

AU - Fowles, Aaron

AU - Parkes, Nasreen

AU - Douglas, Ian J.

AU - Evans, Stephen J.W.

AU - Smeeth, Liam

AU - Goldacre, Ben

N1 - Funding Information: All authors have completed the International Committee of Medical Journal Editors uniform disclosure form at www.icmje.org/ coi_disclosure.pdf and declare the following: over the past 5 years Ben Goldacre has received research funding from the Laura and John Arnold Foundation, the NIHR, the NIHR School of Primary Care Research, the NIHR Oxford Biomedical Research Centre, the Mohn Westlake Foundation, NIHR Applied Research Collaboration Oxford and Thames Valley, the Wellcome Trust, the Good Thinking Foundation, Health Data Research UK, the Health Foundation, and the World Health Organization; he also receives personal income from speaking and writing for lay audiences on the misuse of science. Krishnan Bhaskaran holds a Sir Henry Dale fellowship jointly funded by Wellcome and the Royal Society (reference: 107731/Z/15/Z). Helen I McDonald is funded by the NIHR Health Protection Research Unit in Immunisation, a partnership between Public Health England and London School of Hygiene and Tropical Medicine. Angel YS Wong holds a fellowship from the British Heart Foundation. Elizabeth J Williamson holds grants from the Medical Research Council. Rohini Mathur holds a Sir Henry Wellcome Fellowship funded by the Wellcome Trust (reference: 201375/Z/16/Z). Harriet Forbes holds a UKRI fellowship. Ian J Douglas has received unrestricted research grants and holds shares in GlaxoSmithKline. All other authors have declared no competing interests. Funding Information: This work was jointly funded by UK Research and Innovation (UKRI) (COV0076; MR/V015737/1), National Institute for Health Research (NIHR) and Asthma UK-British Lung Foundation, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme. EMIS and TPP provided technical expertise and infrastructure within their data environments pro bono in the context of a national emergency. The OpenSAFELY software platform is supported by a Wellcome Discretionary Award. Ben Goldacre’s work on clinical informatics is supported by the NIHR Oxford Biomedical Research Centre and the NIHR Applied Research Collaboration Oxford and Thames Valley. Funders had no role in the study design, collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The views expressed are those of the authors and not necessarily those of the NIHR, NHS England, Public Health England, or the Department of Health and Social Care. Publisher Copyright: © The Authors

PY - 2021/12/31

Y1 - 2021/12/31

N2 - 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, in situ 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 in situ 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.

AB - 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, in situ 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 in situ 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.

KW - COVID-19

KW - Ethnic groups

KW - General practice

KW - NHS England

KW - SARS-CoV-2

KW - Vaccination

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U2 - 10.3399/BJGP.2021.0376

DO - 10.3399/BJGP.2021.0376

M3 - Article

C2 - 34750106

AN - SCOPUS:85123226730

SN - 0960-1643

VL - 72

SP - E51-E62

JO - British Journal of General Practice

JF - British Journal of General Practice

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ER -

Trends and clinical characteristics of COVID-19 vaccine recipients: A federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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