Risk of covid-19 related death and hospital admission after covid-19 vaccination

[bennevisplace]

An enormous prospective cohort study in vaccinated UK adults, producing hazard ratios for many different population groups.

Blood cancer patients do surprisingly well compared with other at-risk groups.

bmj.com/content/374/bmj.n2244

[AussieNeil Partner Administrator]

Noted 3 days earlier in an addition to the COVID-19 Mythbuster post. COVID-19 vaccinations do work and rather well at that!

healthunlocked.com/cllsuppo...

[chillsome]

This is great news! Thanks

[bennevisplace in reply to chillsome]

It does show that vaccines have been generally highly effective, but the modest hazard ratio for blood cancer patients is not a licence to relax and drop your guard, see other comments here.

[chillsome in reply to bennevisplace]

Yes that's true and also in reading the data we have to take into account that, as a group, we are probably being more careful than the general population.

[Art3mis1]

I’ll be very interested to see the full, peer reviewed report to understand how it dealt with the human factors in the data. Most extremely clinically vulnerable people in the UK were wisely shielding during this time, so transmission, even post vaccination, would have been affected by the this factor. If they weren’t ‘out in society’ mingling, the risk to the ECV group was lower (they were basically isolating). I know that this detail probably won’t have been captured in the data made available to the study, but I hope that it notes and caveats the limitations of the findings.

The reason I am raising this, is in a consultants letter in April ‘21 from my Mums consultant to her GP he highlighted that she ‘hadn’t taken any antibiotics or had any infections’ in the preceding 12 months - very rare as this included the winter months, and indeed factually correct. BUT OUT OF CONTEXT as not so rare, as she’d been shielding and haven’t mixed with society for 12 months! The GP has used this information, to discount concerns about her CLL (“she is clearly much better”) and the risk from COVID citing that she has been infection free from Nov 20 - Apr 21. But this was because she was shut in the house with no visitors for pretty much all of this time! Grrrrrrrr

[Psmithuk in reply to Art3mis1]

I wonder if this is why the governments think we are safe enough not to need the shielding we have been following. It’s been on my mind for a while - of course we are less likely to catch Covid when we don’t see anyone, and keep away from shops and indoor meetings!Cx

[bennevisplace in reply to Psmithuk]

Yep.

[bennevisplace in reply to Art3mis1]

I believe this is all we're going to get by way of peer reviewed report, From the footnotes:

The lead author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

Dissemination to participants and related patient and public communities: Patients will be invited to advise on disseminating the results.

Provenance and peer review: Not commissioned; externally peer reviewed.

You make a good point about shielding probably having lowered the relative risk of the blood cancer cohort. It's stated in the Introduction, and bears repeating here:

"The risk of a severe outcome in vaccinated groups includes the risk of exposure, the risk of a breakthrough infection if exposed, and the risk of a breakthrough infection becoming severe".

Post vaccination, we are at increased risk if we fail to manage our risk of exposure.

[Pinkdark2018]

This study covered a period when lockdowns were in place and fails to take into account the groups who were shielding effectively, including blood cancer patients. Also, analysis only includes 4 deaths in people who had received both doses so has little relationship to the current situation. Infection rates now are higher than for most of the period covered and protective behaviour has been completely abandoned so the risks currently are completely different. It is also worth mentioning that they state blood cancer not individual subsets of blood cancer.

[bennevisplace in reply to Pinkdark2018]

Valid points.

[stewie]

I agree we still need to be careful but it's so much better than a year ago , vaccines which may give some of us some protection or make the disease less severe , different treatments now on offer and the new antiviral drug being approved , I'm working in the NHS client/patient facing role ,so difficult for me to be really careful All the best

Stewie