Real world data analysis provides critical insight on vaccination programme and supports evidence that single dose reduces infection

Analysis of north west London data from the beginning of the national Covid-19 vaccination programme has further supported the evidence that a single dose of the Covid-19 vaccine is effective in reducing infection with coronavirus for up to 60 days after vaccination.

The study is an example of how access to detailed, long-term patient data from across the North West London Integrated Care System (ICS) can be used to directly benefit patients and improve care. In this case, collaborative analysis of vaccination data by clinicians and researchers has been used to influence the ongoing delivery of the vaccination programme in north west London by offering real world evidence for consideration by the ‘Gold’ command group for vaccination, chaired by the Trust’s medical director Professor Julian Redhead, who is also a co-author of the paper.

The data analysed is from four acute, two mental health and two community trusts across eight clinical commissioning groups, alongside social care data from eight boroughs and primary care data from 360 GP practices.

The analysis of more than 2 million adults eligible for Covid-19 vaccination in north west London was undertaken by Imperial College Healthcare NHS Trust, in partnership with Imperial College London and looked at vaccine data between 8 December 2020 and 24 February 2021. The data showed no difference between the Pfizer or AstraZeneca vaccines - a single dose of either vaccine was effective in reducing the risk of testing positive up to around 60 days after vaccination. The data also showed a higher rate of declining the vaccine (16 per cent) in Black or Black British individuals and those living in the most deprived postcode areas (13 per cent).

Senior author Erik Mayer, transformation chief information officer at Imperial College Healthcare NHS Trust and clinical reader at Imperial College London said: “It’s been more critical than ever during the Covid-19 pandemic to understand the communities we care for and population data such as this has provided critical insight for the vaccination programme especially. The analysis could be used to direct resources as effectively as possible and reach groups the data suggested may be hesitant about taking up the vaccine with clear information to help inform decisions.

“The unique iCARE/WSIC population datasets provide a significant insight into our local populations and have the potential to be one of the most impactful resources we have for improving patient care and outcomes. I believe that through the NIHR Imperial iCARE, and its robustly governed dataset access, we provide a significant insight to help improve patient care and outcomes across NWL, nationally and globally.

Bob Klaber, director of strategy, research and innovation said: “This data-driven initiative has provided really helpful insights from which were able to plan a wide range of community engagement events to listen to local residents, and to understand any concerns or anxieties they had around Covid vaccines. As we think more widely about opportunities to deliver more preventative care, we will use this learning to work closely with our local communities and continue to share information with our local populations to help them to make informed decisions about their health wherever we can.”

Kavitha Saravanakumar, associate director of business intelligence, north west London clinical commissioning group said: “It’s great to also see this data supporting evidence across the world for the effectiveness of Covid-19 vaccines. This analysis looked at data from the beginning of the national vaccination programme, where north west London was one of the first to initiate a programme organised by the ICS. It is reassuring that one dose is still effective for those who are awaiting their second dose, which boosts and provides longevity of the protection.”

Published in the Journal of Medical Internet Research Public Health & Surveillance, the study also concluded that the risk of contracting Covid-19 at a vaccination hub was very low and the risk of contracting Covid-19 or becoming hospitalised with the disease was also very low among the vaccinated population.

In 2019, the NIHR Imperial Biomedical Research Centre (BRC), a translational research partnership between Imperial College Healthcare and Imperial College London, invested in a high-performance platform, called Imperial Clinical Analytics, Research & Evaluation (iCARE), that could help make the information held in the Trust’s electronic patient record and related clinical systems appropriately accessible for use in both research and direct patient care, while maintaining a clear and robust process for access that ensures the safety of the data.

When the pandemic struck in early 2020, the need for real time data within the Trust and across north-west London was critical in supporting the NHS response. iCARE adapted to support the response by hosting near to real time data feeds which had previously been unmanageable due to the size and complexity of data. Through the iCARE system, the study team were able to utilise large amounts of population data to better understand vaccination uptake and outcomes and inform the ongoing rollout of the vaccination programme. This helped the NHS to ensure that the opportunity for vaccination reached as many people in north-west London as possible.

Author and research informatics programme manager at the Trust, Ben Glampson, said: “By utilising the BRC’s iCARE platform and the established partnership between the Trust and Imperial College London, we could effectively provide real time input on the vaccine rollout that was based on data from real people. Our data also supports the findings from other academic studies which have suggested that the Covid-19 vaccine is effective against infection.”