4.8 Article

Exponential growth, high prevalence of SARS-CoV-2, and vaccine effectiveness associated with the Delta variant

Journal

SCIENCE
Volume 374, Issue 6574, Pages 1463-+

Publisher

AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/science.abl9551

Keywords

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Funding

  1. Medical Research Council (MRC) Centre for Environment and Health [MR/L01341X/1, MR/S019669/1]
  2. Health Data Research UK (HDR UK)
  3. National Institute for Health Research (NIHR) Imperial Biomedical Research Centre
  4. NIHR Health Protection Research Unit(HPRU) in Chemical and Radiation Threats and Hazards
  5. NIHR HPRU in Environmental Exposures and Health
  6. British Heart Foundation Centre for Research Excellence at Imperial College London [RE/18/4/34215]
  7. UK Dementia Research Institute at Imperial [MC_PC_17114]
  8. MRC Centre for Global Infectious Disease Analysis
  9. US Centers for Disease Control and Prevention [U01CK0005-01-02]
  10. NIHR Professorship
  11. NIHR Senior Investigator Award
  12. Wellcome Trust [205456/Z/16/Z, 200861/Z/16/Z, 200187/Z/15/Z]
  13. Huo Family Foundation
  14. BBSRC Institute Strategic Programme Microbes in the Food Chain [BB/R012504/1, BBS/E/F/000PR10352]
  15. MRC part of UK Research & Innovation (UKRI)
  16. Department of Health and Social Care in England
  17. COVID-19 Genomics UK (COG-UK) Consortium
  18. NIHR
  19. Genome Research Ltd.
  20. Biotechnology and Biological Sciences Research Council (BBSRC)
  21. NIHR HPRU in Modelling and Health Economics

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During early summer 2021, the Real-time Assessment of Community Transmission-1 (REACT-1) study in England found that infections were rising due to the Delta variant, with unvaccinated individuals having three times the prevalence of infection compared to double-vaccinated individuals. Despite vaccination, the vaccine effectiveness for double-vaccinated individuals was estimated to be around 50% to 60% during this period. Increased social mixing in the presence of the Delta variant had the potential to generate sustained growth in infections, even with high levels of vaccination.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections were rising during early summer 2021 in many countries as a result of the Delta variant. We assessed reverse transcription polymerase chain reaction swab positivity in the Real-time Assessment of Community Transmission-1 (REACT-1) study in England. During June and July 2021, we observed sustained exponential growth with an average doubling time of 25 days, driven by complete replacement of the Alpha variant by Delta and by high prevalence at younger, less-vaccinated ages. Prevalence among unvaccinated people [1.21% (95% credible interval 1.03%, 1.41%)] was three times that among double-vaccinated people [0.40%(95% credible interval 0.34%, 0.48%)]. However, after adjusting for age and other variables, vaccine effectiveness for double-vaccinated people was estimated at between similar to 50% and similar to 60% during this period in England. Increased socialmixing in the presence of Delta had the potential to generate sustained growth in infections, even at high levels of vaccination.

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