Changing patterns of SARS-CoV-2 infection through Delta and Omicron waves by vaccination status, previous infection and neighbourhood deprivation: A cohort analysis of 2.7M people



Green, Mark ORCID: 0000-0002-0942-6628, Hungerford, Daniel, Hughes, David ORCID: 0000-0002-1287-9994, Garcia-Fiñana, Marta, Turtle, Lance ORCID: 0000-0002-0778-1693, Cheyne, Christopher, Ashton, Matthew ORCID: 0000-0003-1959-5094, Leeming, Gary, Semple, Malcolm ORCID: 0000-0001-9700-0418, Singleton, Alex
et al (show 1 more authors) (2022) Changing patterns of SARS-CoV-2 infection through Delta and Omicron waves by vaccination status, previous infection and neighbourhood deprivation: A cohort analysis of 2.7M people. [Preprint]

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Abstract

<h4>Objective</h4> To examine if SARS-CoV-2 infections vary by vaccination status, if an individual had previously tested positive and by neighbourhood socioeconomic deprivation across the Delta and Omicron epidemic waves of SARS-CoV-2. <h4>Design</h4> Cohort study using electronic health records <h4>Setting</h4> Cheshire and Merseyside, England (3 rd June 2021 to 1 st March 2022) <h4>Participants</h4> 2.7M residents <h4>Main Outcome measure</h4> Registered positive test for SARS-CoV-2 <h4>Results</h4> Social inequalities in registered positive tests were dynamic during the study. Originally higher SARS-CoV-2 rates in the most socioeconomically deprived neighbourhoods changed to being higher in the least deprived neighbourhoods from the 1 st September 2021. While the introduction of Omicron initially reset inequalities, they continued to be dynamic and inconsistent. Individuals who were fully vaccinated (two doses) were associated with fewer registered positive tests (e.g., between 1 st September and 27 th November 2021: (i) individuals engaged in testing – Hazards Ratio (HR) = 0.48, 95% Confidence Intervals (CIs) = 0.47-0.50; (ii) individuals engaged with healthcare - HR = 0.34, 95% CIs = 0.33-0.34). Individuals with a previous registered positive test were also less likely to have a registered positive test (e.g., between 1 st September and 27 th November 2021: (i) individuals engaged in testing - HR = 0.16, 95% CIs = 0.15-0.18; (ii) individuals engaged with healthcare - HR = 0.14, 95% CIs = 0.13-0.16). However, Omicron is disrupting these associations due to immune escape resulting in smaller effect sizes for both measures. <h4>Conclusions</h4> Changing patterns of SARS-CoV-2 infections during the Delta and Omicron waves reveals a dynamic pandemic that continues to affect diverse communities in sometimes unexpected ways.

Item Type: Preprint
Uncontrolled Keywords: 4206 Public Health, 42 Health Sciences, Coronaviruses, Clinical Research, Infectious Diseases, Health Disparities, Minority Health, Emerging Infectious Diseases, Infection, 3 Good Health and Well Being
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 29 Apr 2022 11:51
Last Modified: 18 Jul 2024 18:45
DOI: 10.1101/2022.04.05.22273169
Open Access URL: https://www.medrxiv.org/content/10.1101/2022.04.05...
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3154018