Researchers identify groups of vaccinated patients most at risk for severe Covid

Certain groups of immunocompromised people, as well as residents of nursing homes, are among those identified as still at “high risk” of serious consequences from Covid despite vaccination, new research has shown.

The researchers said they hope the results will inform discussions between doctors and patients about their risk as well as the prioritization of boosters and therapies.

It comes as the The protection program put in place to protect those who are clinically extremely vulnerable to Covid has officially closed this week.

A new Covid risk tool developed at the University of Oxford calculates “cumulative risk scores” for the risk of hospitalization or death of different groups from 14 days after the second dose of vaccine “when immunity substantial is expected, ”the university said.

The algorithm is an updated version of the QCovid risk tool developed last year to inform vaccination prioritization and takes into account factors such as age, gender, ethnicity and background rate of Covid infection, he added.

Announcing the results today, the University of Oxford said the new tool identified a “high risk” for “those who are immunocompromised as a result of chemotherapy, a recent bone marrow transplant or from a solid organ or from HIV / AIDS “.

People with “neurological disorders, including dementia and Parkinson’s disease, residents of nursing homes and those with chronic conditions, including Down syndrome”, are also at “high risk”, he said. -he adds.

An article published in the BMJ today presented the results of the study, which analyzed a representative sample of more than 6.9 million adults vaccinated in the UK – of which 5.2 million had received a double injection.

The sample included 2,031 Covid deaths and 1,929 Covid-related hospitalizations, of which 81 deaths and 71 admissions occurred 14 days or more after the second jab, the university said.

He added that the researchers hope the data can be used to help those most at risk make “more informed decisions about shielding” and “prioritize” them for further vaccine trials, booster shots or preventive therapies.

Julia Hippisley-Cox, professor of clinical epidemiology and general medicine at the University of Oxford and co-author of the article, said the tool is designed to help the NHS identify patients for ‘intervention targeted ”beyond vaccination.

She added: “This new tool can also inform discussions between physicians and patients about the level of risk to facilitate shared decision making.

“Individual risk will always depend on individual choices as well as the current prevalence of the disease, but we hope this new tool will contribute to shared decision-making and more personalized risk assessment. “

Aziz Sheikh, co-author of the article and professor of primary care research and development at the University of Edinburgh, added that the tool can help identify those “who might benefit from interventions such as doses of booster vaccine or new treatments such as monoclonal antibodies “. .

However, the researchers said the study “may have been limited” by factors such as exposure, as data such as occupation is not often recorded in the records of general practitioners or hospitals, and does not. not distinguish between types of vaccination.

They added: “There were relatively few hospitalizations or deaths related to Covid-19 in the group that received the second dose of any vaccine, meaning the study did not have the statistical power to determine whether the groups listed above are more, or less, at risk after a second dose of vaccine compared to after the first dose. ‘

The study was funded by the National Institute for Health Research (NIHR) and used data from general practice, as well as related national datasets for vaccination, Covid testing, deaths and hospital episodes.

The government this week accepted the JCVI’s final opinion that cohorts 1-9 of the first phase of the Covid vaccination campaign should have a booster six months after their second dose – with GPs have said to prioritize recalls in nursing homes.

Third injections for immunocompromised patients were already recommended, with general practitioners helping to identify patients eligible to receive the vaccine starting this week.

Meanwhile, researchers warned this month that deprivation factors should be included in Covid admission risk scores.