Duration of Protection against Mild and Severe Disease by Covid-19 Vaccines.

Adolescent Adult Age Factors Aged BNT162 Vaccine COVID-19 / mortality Case-Control Studies ChAdOx1 nCoV-19 Female Hospitalization / statistics & numerical data Humans Immunization, Secondary Immunogenicity, Vaccine Male Middle Aged Patient Acuity Risk Factors SARS-CoV-2 Time Factors United Kingdom / epidemiology Vaccine Efficacy

Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
27 01 2022
Historique:
pubmed: 13 1 2022
medline: 3 2 2022
entrez: 12 1 2022
Statut: ppublish

Résumé

Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), have been used since December 2020 in the United Kingdom. Real-world data have shown the vaccines to be highly effective against Covid-19 and related severe disease and death. Vaccine effectiveness may wane over time since the receipt of the second dose of the ChAdOx1-S (ChAdOx1 nCoV-19) and BNT162b2 vaccines. We used a test-negative case-control design to estimate vaccine effectiveness against symptomatic Covid-19 and related hospitalization and death in England. Effectiveness of the ChAdOx1-S and BNT162b2 vaccines was assessed according to participant age and status with regard to coexisting conditions and over time since receipt of the second vaccine dose to investigate waning of effectiveness separately for the B.1.1.7 (alpha) and B.1.617.2 (delta) variants. Vaccine effectiveness against symptomatic Covid-19 with the delta variant peaked in the early weeks after receipt of the second dose and then decreased by 20 weeks to 44.3% (95% confidence interval [CI], 43.2 to 45.4) with the ChAdOx1-S vaccine and to 66.3% (95% CI, 65.7 to 66.9) with the BNT162b2 vaccine. Waning of vaccine effectiveness was greater in persons 65 years of age or older than in those 40 to 64 years of age. At 20 weeks or more after vaccination, vaccine effectiveness decreased less against both hospitalization, to 80.0% (95% CI, 76.8 to 82.7) with the ChAdOx1-S vaccine and 91.7% (95% CI, 90.2 to 93.0) with the BNT162b2 vaccine, and death, to 84.8% (95% CI, 76.2 to 90.3) and 91.9% (95% CI, 88.5 to 94.3), respectively. Greater waning in vaccine effectiveness against hospitalization was observed in persons 65 years of age or older in a clinically extremely vulnerable group and in persons 40 to 64 years of age with underlying medical conditions than in healthy adults. We observed limited waning in vaccine effectiveness against Covid-19-related hospitalization and death at 20 weeks or more after vaccination with two doses of the ChAdOx1-S or BNT162b2 vaccine. Waning was greater in older adults and in those in a clinical risk group.

Sections du résumé

BACKGROUND
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), have been used since December 2020 in the United Kingdom. Real-world data have shown the vaccines to be highly effective against Covid-19 and related severe disease and death. Vaccine effectiveness may wane over time since the receipt of the second dose of the ChAdOx1-S (ChAdOx1 nCoV-19) and BNT162b2 vaccines.
METHODS
We used a test-negative case-control design to estimate vaccine effectiveness against symptomatic Covid-19 and related hospitalization and death in England. Effectiveness of the ChAdOx1-S and BNT162b2 vaccines was assessed according to participant age and status with regard to coexisting conditions and over time since receipt of the second vaccine dose to investigate waning of effectiveness separately for the B.1.1.7 (alpha) and B.1.617.2 (delta) variants.
RESULTS
Vaccine effectiveness against symptomatic Covid-19 with the delta variant peaked in the early weeks after receipt of the second dose and then decreased by 20 weeks to 44.3% (95% confidence interval [CI], 43.2 to 45.4) with the ChAdOx1-S vaccine and to 66.3% (95% CI, 65.7 to 66.9) with the BNT162b2 vaccine. Waning of vaccine effectiveness was greater in persons 65 years of age or older than in those 40 to 64 years of age. At 20 weeks or more after vaccination, vaccine effectiveness decreased less against both hospitalization, to 80.0% (95% CI, 76.8 to 82.7) with the ChAdOx1-S vaccine and 91.7% (95% CI, 90.2 to 93.0) with the BNT162b2 vaccine, and death, to 84.8% (95% CI, 76.2 to 90.3) and 91.9% (95% CI, 88.5 to 94.3), respectively. Greater waning in vaccine effectiveness against hospitalization was observed in persons 65 years of age or older in a clinically extremely vulnerable group and in persons 40 to 64 years of age with underlying medical conditions than in healthy adults.
CONCLUSIONS
We observed limited waning in vaccine effectiveness against Covid-19-related hospitalization and death at 20 weeks or more after vaccination with two doses of the ChAdOx1-S or BNT162b2 vaccine. Waning was greater in older adults and in those in a clinical risk group.

Identifiants

DOI: 10.1056/NEJMoa2115481 PMID: 35021002 PMC: PMC8781262
pubmed: 35021002
doi: 10.1056/NEJMoa2115481
pmc: PMC8781262
doi:

Substances chimiques

ChAdOx1 nCoV-19 B5S3K2V0G8
BNT162 Vaccine N38TVC63NU

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

340-350

Subventions

Organisme : Medical Research Council
ID : MR/W02067X/1
Pays : United Kingdom

Informations de copyright

Copyright © 2022 Massachusetts Medical Society.

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Auteurs

Nick Andrews (N)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Elise Tessier (E)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Julia Stowe (J)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Charlotte Gower (C)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Freja Kirsebom (F)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Ruth Simmons (R)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Eileen Gallagher (E)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Simon Thelwall (S)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Natalie Groves (N)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Gavin Dabrera (G)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.
ORCID: 0000-0003-4606-5945

Richard Myers (R)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Colin N J Campbell (CNJ)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Gayatri Amirthalingam (G)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Matt Edmunds (M)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Maria Zambon (M)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Kevin Brown (K)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.
ORCID: 0000-0002-1568-683X

Susan Hopkins (S)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Meera Chand (M)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Shamez N Ladhani (SN)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Mary Ramsay (M)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

Jamie Lopez Bernal (J)

From the United Kingdom Health Security Agency (N.A., E.T., J.S., C.G., F.K., R.S., E.G., S.T., N.G., G.D., R.M., C.N.J.C., G.A., M.E., M.Z., K.B., S.H., M.C., S.N.L., M.R., J.L.B.), the National Institute of Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine (N.A., C.N.J.C., G.A., K.B., M.R., J.L.B.), the NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London (M.Z., J.L.B.), Guy's and St. Thomas' Hospital NHS Trust (M.C.), and the Paediatric Infectious Diseases Research Group, St. George's University of London (S.N.L.), London, and Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford (S.H.) - all in the United Kingdom.

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Classifications MeSH

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