{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T19:00:59Z","timestamp":1778612459888,"version":"3.51.4"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["Health Protection Research Unit (HPRU) in Immunisation"],"award-info":[{"award-number":["Health Protection Research Unit (HPRU) in Immunisation"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["Health Protection Research Unit (HPRU) in Immunisation"],"award-info":[{"award-number":["Health Protection Research Unit (HPRU) in Immunisation"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["Health Protection Research Unit (HPRU) in Immunisation"],"award-info":[{"award-number":["Health Protection Research Unit (HPRU) in Immunisation"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["Health Protection Research Unit (HPRU) in Immunisation"],"award-info":[{"award-number":["Health Protection Research Unit (HPRU) in Immunisation"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["Health Protection Research Unit (HPRU) in Immunisation"],"award-info":[{"award-number":["Health Protection Research Unit (HPRU) in Immunisation"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["Health Protection Research Unit (HPRU) in Immunisation"],"award-info":[{"award-number":["Health Protection Research Unit (HPRU) in Immunisation"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["Health Protection Research Unit (HPRU) in Immunisation"],"award-info":[{"award-number":["Health Protection Research Unit (HPRU) in Immunisation"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Data Research UK","award":["MR\/S003975\/1"],"award-info":[{"award-number":["MR\/S003975\/1"]}]},{"name":"Medical Research Council","award":["MC_PC 19065"],"award-info":[{"award-number":["MC_PC 19065"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Characterising the size and distribution of the population at risk of severe COVID-19 is vital for effective policy and planning. Older age, and underlying health conditions, are associated with higher risk of death from COVID-19. This study aimed to describe the population at risk of severe COVID-19 due to underlying health conditions across the United Kingdom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used anonymised electronic health records from the Clinical Practice Research Datalink GOLD to estimate the point prevalence on 5 March 2019 of the at-risk population following national guidance. Prevalence for any risk condition and for each individual condition is given overall and stratified by age and region with binomial exact confidence intervals. We repeated the analysis on 5 March 2014 for full regional representation and to describe prevalence of underlying health conditions in pregnancy. We additionally described the population of cancer survivors, and assessed the value of linked secondary care records for ascertaining COVID-19 at-risk status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On 5 March 2019, 24.4% of the UK population were at risk due to a record of at least one underlying health condition, including 8.3% of school-aged children, 19.6% of working-aged adults, and 66.2% of individuals aged 70\u2009years or more. 7.1% of the population had multimorbidity. The size of the at-risk population was stable over time comparing 2014 to 2019, despite increases in chronic liver disease and diabetes and decreases in chronic kidney disease and current asthma. Separately, 1.6% of the population had a new diagnosis of cancer in the past 5 y.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The population at risk of severe COVID-19 (defined as either aged \u226570\u2009years, or younger with an underlying health condition) comprises 18.5 million individuals in the UK, including a considerable proportion of school-aged and working-aged individuals. Our national estimates broadly support the use of Global Burden of Disease modelled estimates in other countries. We provide age- and region- stratified prevalence for each condition to support effective modelling of public health interventions and planning of vaccine resource allocation. The high prevalence of health conditions among older age groups suggests that age-targeted vaccination strategies may efficiently target individuals at higher risk of severe COVID-19.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-021-10427-2","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T09:02:58Z","timestamp":1615453378000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["UK prevalence of underlying conditions which increase the risk of severe COVID-19 disease: a point prevalence study using electronic health records"],"prefix":"10.1186","volume":"21","author":[{"given":"Jemma L.","family":"Walker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Grint","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Strongman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalind M.","family":"Eggo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Peppa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Minassian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn E.","family":"Mansfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher T.","family":"Rentsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian J.","family":"Douglas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohini","family":"Mathur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel Y. S.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer K.","family":"Quint","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Andrews","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie Lopez","family":"Bernal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Anthony","family":"Scott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Ramsay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam","family":"Smeeth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0576-2015","authenticated-orcid":false,"given":"Helen I.","family":"McDonald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"10427_CR1","doi-asserted-by":"crossref","unstructured":"O'Driscoll M, Ribeiro Dos Santos G, Wang L, Cummings DAT, Azman AS, Paireau J, Fontanet A, Cauchemez S, Salje H. Age-specific mortality and immunity patterns of SARS-CoV-2. Nature. 2021;590(7844):140\u20135.","DOI":"10.1038\/s41586-020-2918-0"},{"key":"10427_CR2","doi-asserted-by":"crossref","unstructured":"Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, MacKenna B, Tomlinson L, Douglas IJ, Rentsch CT, Mathur R, Wong AYS, Grieve R, Harrison D, Forbes H, Schultze A, Croker R, Parry J, Hester F, Harper S, Perera R, Evans SJW, Smeeth L, Goldacre B. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584(7821):430\u20136.","DOI":"10.1038\/s41586-020-2521-4"},{"key":"10427_CR3","doi-asserted-by":"crossref","unstructured":"de Lusignan S, Dorward J, Correa A, Jones N, Akinyemi O, Amirthalingam G, Andrews N, Byford R, Dabrera G, Elliot A, Ellis J, Ferreira F, Lopez Bernal J, Okusi C, Ramsay M, Sherlock J, Smith G, Williams J, Howsam G, Zambon M, Joy M, Hobbs FDR. Risk factors for SARS-CoV-2 among patients in the Oxford Royal College of General Practitioners Research and Surveillance Centre primary care network: a cross-sectional study. Lancet Infect Dis. 2020;20(9):1034\u201342.","DOI":"10.1016\/S1473-3099(20)30371-6"},{"key":"10427_CR4","doi-asserted-by":"publisher","first-page":"m3731","DOI":"10.1136\/bmj.m3731","volume":"371","author":"AK Clift","year":"2020","unstructured":"Clift AK, Coupland CAC, Keogh RH, Diaz-Ordaz K, Williamson E, Harrison EM, et al. Living risk prediction algorithm (QCOVID) for risk of hospital admission and mortality from coronavirus 19 in adults: national derivation and validation cohort study. BMJ. 2020;371:m3731.","journal-title":"BMJ."},{"key":"10427_CR5","doi-asserted-by":"crossref","unstructured":"Mudatsir M, Fajar J, Wulandari L, Soegiarto G, Ilmawan M, Purnamasari Y, et al. Predictors of COVID-19 severity: a systematic review and meta-analysis [version 1; peer review: 2 approved]. F1000Research. 2020;9(1107).","DOI":"10.12688\/f1000research.26186.1"},{"key":"10427_CR6","doi-asserted-by":"publisher","first-page":"m1985","DOI":"10.1136\/bmj.m1985","volume":"369","author":"AB Docherty","year":"2020","unstructured":"Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, et al. Features of 20\u2009133 UK patients in hospital with covid-19 using the ISARIC WHO clinical characterisation protocol: prospective observational cohort study. BMJ. 2020;369:m1985.","journal-title":"BMJ."},{"key":"10427_CR7","unstructured":"NHS. People at higher risk from coronavirus 2020 [26\/06\/2020]. Available from: https:\/\/web.archive.org\/web\/20200716054208\/https:\/\/www.nhs.uk\/conditions\/coronavirus-covid-19\/people-at-higher-risk\/whos-at-higher-risk-from-coronavirus\/."},{"key":"10427_CR8","unstructured":"Public Health England. Immunisation against Infectious Disease (the Green Book). Chapter 19: Influenza. https:\/\/www.gov.uk\/government\/publications\/influenza-the-green-book-chapter-19. Accessed 26 Feb 2021."},{"key":"10427_CR9","doi-asserted-by":"crossref","unstructured":"Jordan RE, Adab P. Who is most likely to be infected with SARS-CoV-2?. Lancet Infect Dis. 2020;20(9):995\u20136.","DOI":"10.1016\/S1473-3099(20)30395-9"},{"key":"10427_CR10","unstructured":"Department of Health and Social Care. JCVI: updated interim advice on priority groups for COVID-19 vaccination 2020 [updated 25 September 2020]. Available from: https:\/\/web.archive.org\/web\/20201002071610\/https:\/\/www.gov.uk\/government\/publications\/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-25-september-2020\/jcvi-updated-interim-advice-on-priority-groups-for-covid-19-vaccination."},{"key":"10427_CR11","unstructured":"World Health Organization. Roadmap for prioritising population groups for vaccines against COVID-19 2020. https:\/\/www.who.int\/news-room\/q-a-detail\/coronavirus-disease-(covid-19)-vaccine-access-and-allocation. Accessed 26 Feb 2021."},{"key":"10427_CR12","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12979-019-0164-9","volume":"16","author":"SN Crooke","year":"2019","unstructured":"Crooke SN, Ovsyannikova IG, Poland GA, Kennedy RB. Immunosenescence and human vaccine immune responses. Immun Ageing. 2019;16:25.","journal-title":"Immun Ageing"},{"key":"10427_CR13","doi-asserted-by":"crossref","unstructured":"Clark A, Jit M, Warren-Gash C, Guthrie B, Wang HHX, Mercer SW, et al. Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: a modelling study. Lancet Glob Health. 2020;8(8):e1003\u2013e1017.","DOI":"10.1016\/S2214-109X(20)30264-3"},{"key":"10427_CR14","doi-asserted-by":"publisher","first-page":"50","DOI":"10.11606\/s1518-8787.2020054002596","volume":"54","author":"LFM Rezende","year":"2020","unstructured":"Rezende LFM, Thome B, Schveitzer MC, Souza-J\u00fanior PRB, Szwarcwald CL. Adults at high-risk of severe coronavirus disease-2019 (Covid-19) in Brazil. Rev Saude Publica. 2020;54:50.","journal-title":"Rev Saude Publica"},{"key":"10427_CR15","unstructured":"Koma W, Neuman T, Claxton G, Rae M, Kates J, Michaud J. How many adults are at risk of serious illness if infected with coronavirus? Updated data. 2020 Available from: https:\/\/www.kff.org\/coronavirus-covid-19\/issue-brief\/how-many-adults-are-at-risk-of-serious-illness-if-infected-with-coronavirus\/."},{"issue":"10238","key":"10427_CR16","doi-asserted-by":"publisher","first-page":"1715","DOI":"10.1016\/S0140-6736(20)30854-0","volume":"395","author":"A Banerjee","year":"2020","unstructured":"Banerjee A, Pasea L, Harris S, Gonzalez-Izquierdo A, Torralbo A, Shallcross L, et al. Estimating excess 1-year mortality associated with the COVID-19 pandemic according to underlying conditions and age: a population-based cohort study. Lancet. 2020;395(10238):1715\u201325.","journal-title":"Lancet."},{"issue":"3","key":"10427_CR17","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1093\/ije\/dyv098","volume":"44","author":"E Herrett","year":"2015","unstructured":"Herrett E, Gallagher AM, Bhaskaran K, Forbes H, Mathur R, van Staa T, et al. Data resource profile: clinical practice research Datalink (CPRD). Int J Epidemiol. 2015;44(3):827\u201336.","journal-title":"Int J Epidemiol"},{"issue":"1","key":"10427_CR18","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/j.1365-2125.2009.03537.x","volume":"69","author":"E Herrett","year":"2010","unstructured":"Herrett E, Thomas SL, Schoonen WM, Smeeth L, Hall AJ. Validation and validity of diagnoses in the general practice research database: a systematic review. Br J Clin Pharmacol. 2010;69(1):4\u201314.","journal-title":"Br J Clin Pharmacol"},{"issue":"4","key":"10427_CR19","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1093\/ije\/dyx015","volume":"46","author":"A Herbert","year":"2017","unstructured":"Herbert A, Wijlaars L, Zylbersztejn A, Cromwell D, Hardelid P. Data Resource Profile: Hospital Episode Statistics Admitted Patient Care (HES APC). Int J Epidemiol. 2017;46(4):1093.","journal-title":"Int J Epidemiol"},{"issue":"7","key":"10427_CR20","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1002\/pds.4811","volume":"28","author":"C Minassian","year":"2019","unstructured":"Minassian C, Williams R, Meeraus WH, Smeeth L, Campbell OMR, Thomas SL. Methods to generate and validate a pregnancy register in the UK clinical practice research Datalink primary care database. Pharmacoepidemiol Drug Saf. 2019;28(7):923\u201333.","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"7","key":"10427_CR21","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1002\/pds.1115","volume":"14","author":"JD Lewis","year":"2005","unstructured":"Lewis JD, Bilker WB, Weinstein RB, Strom BL. The relationship between time since registration and measured incidence rates in the general practice research database. Pharmacoepidemiol Drug Saf. 2005;14(7):443\u201351.","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"10427_CR22","unstructured":"Office for National Statistics. Population estimates for the UK, England and Wales, Scotland and Northern Ireland: mid-2019. 2020. Available from: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/populationandmigration\/populationestimates\/bulletins\/annualmidyearpopulationestimates\/mid2019estimates."},{"key":"10427_CR23","unstructured":"Public Health England. Cardiovascular Disease, Diabetes and Kidney Disease 2020 [26\/06\/2020]. Available from: https:\/\/fingertips.phe.org.uk\/profile-group\/cardiovascular-disease-diabetes-kidney-disease."},{"key":"10427_CR24","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1183\/13993003.02130-2018","volume":"53","author":"CI Bloom","year":"2019","unstructured":"Bloom CI, Saglani S, Feary J, Jarvis D, Quint JK. Changing prevalence of current asthma and inhaled corticosteroid treatment in the UK: population-based cohort 2006\u20132016. Eur Respir J. 2019;53:4.","journal-title":"Eur Respir J"},{"key":"10427_CR25","volume-title":"The epidemiology of infections among older people with diabetes mellitus and chronic kidney disease","author":"HI McDonald","year":"2015","unstructured":"McDonald HI. The epidemiology of infections among older people with diabetes mellitus and chronic kidney disease. London: London School of Hygiene & Tropical Medicine; 2015."},{"issue":"3","key":"10427_CR26","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1016\/j.jhep.2018.05.011","volume":"69","author":"L Pimpin","year":"2018","unstructured":"Pimpin L, Cortez-Pinto H, Negro F, Corbould E, Lazarus JV, Webber L, et al. Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies. J Hepatol. 2018;69(3):718\u201335.","journal-title":"J Hepatol"},{"key":"10427_CR27","unstructured":"Williamson E, Walker AJ, Bhaskaran KJ, Bacon S, Bates C, Morton CE, et al. [Preprint] OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv. 2020:2020.05.06.20092999."},{"key":"10427_CR28","doi-asserted-by":"publisher","first-page":"m2107","DOI":"10.1136\/bmj.m2107","volume":"369","author":"M Knight","year":"2020","unstructured":"Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ. 2020;369:m2107.","journal-title":"BMJ."},{"issue":"9907","key":"10427_CR29","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1016\/S0140-6736(13)62071-1","volume":"382","author":"K Wellings","year":"2013","unstructured":"Wellings K, Jones KG, Mercer CH, Tanton C, Clifton S, Datta J, et al. The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of sexual attitudes and lifestyles (Natsal-3). Lancet. 2013;382(9907):1807\u201316.","journal-title":"Lancet."},{"issue":"5","key":"10427_CR30","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1016\/S2213-2600(20)30167-3","volume":"8","author":"DMG Halpin","year":"2020","unstructured":"Halpin DMG, Faner R, Sibila O, Badia JR, Agusti A. Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection? Lancet Respir Med. 2020;8(5):436\u20138.","journal-title":"Lancet Respir Med"},{"key":"10427_CR31","unstructured":"Public Health England. Surveillance of influenza and other respiratory viruses in the UK: Winter 2019 to 2020. 2020. Available from: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/895233\/Surveillance_Influenza_and_other_respiratory_viruses_in_the_UK_2019_to_2020_FINAL.pdfW."}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-10427-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12889-021-10427-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-10427-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T17:16:51Z","timestamp":1724606211000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-021-10427-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,11]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10427"],"URL":"https:\/\/doi.org\/10.1186\/s12889-021-10427-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.08.24.20179192","asserted-by":"object"}]},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,11]]},"assertion":[{"value":"30 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Approval was received from the Independent Scientific Advisory Committee of the Medicines and Healthcare Products Regulatory Agency (ISAC number: 20_062A) and the Ethics Committee of the London School of Hygiene and Tropical Medicine (reference 21851). The ISAC protocol was made available to reviewers.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JLW, DJG, NA, JAS, LS, MR, HM received grants from the NIHR HPRU in Immunisation to support the submitted work. RME received grants from HDR UK (MR\/S003975\/1) and UK MRC (MC_PC 19065). JKQ reports grants and personal fees from AZ, grants from Asthma UK, grants and personal fees from BI, grants and personal fees from Bayer, grants and personal fees from Insmed, grants and personal fees from GSK, grants from The Health Foundation, grants from MRC, grants from British Lung Foundation, outside the submitted work; RM reports personal fees from AMGEN, outside the submitted work; JAS reports grants from National Institute for Health Research, during the conduct of the study; grants from MRC, grants from Wellcome Trust, grants from GAVI The Vaccine Alliance, grants from Bill & Melinda Gates Foundation, outside the submitted work; LS reports grants from Wellcome, grants from MRC, grants from NIHR, grants from GSK, grants from BHF, grants from Diabetes UK, outside the submitted work; and Is a Trustee of the British Heart Foundation. The PHE Immunisation and Countermeasures Department provides vaccine manufacturers with post-marketing surveillance reports which the companies are required to submit to the UK Licensing authority in compliance with their Risk Management Strategy. A cost recovery charge is made for these reports.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"484"}}