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

Elliott, Paul, Haw, David, Wang, Haowei, Eales, Oliver, Walters, Caroline E., Ainslie, Kylie E. C., Atchison, Christina, Fronterre, Claudio, Diggle, Peter J., Page, Andrew J., Trotter, Alexander J., Prosolek, Sophie J., Ashby, Deborah, Donnelly, Christl A., Barclay, Wendy, Taylor, Graham, Cooke, Graham, Ward, Helen, Darzi, Ara, Riley, Steven, Robson, Samuel C., Loman, Nicholas J., Connor, Thomas R., Golubchik, Tanya, Martinez Nunez, Rocio T., Ludden, Catherine, Corden, Sally, Johnston, Ian, Bonsall, David, Smith, Colin P., Awan, Ali R., Bucca, Giselda, Torok, M. Estee, Saeed, Kordo, Prieto, Jacqui A., Jackson, David K., Hamilton, William L., Snell, Luke B., Moore, Catherine, Harrison, Ewan M., Goncalves, Sonia, Jackson, Leigh M., Goodfellow, Ian G., Fairley, Derek J., Loose, Matthew W., Watkins, Joanne, Livett, Rich, Moses, Samuel, Amato, Roberto, Nicholls, Sam, Bull, Matthew, Smith, Darren, Barrett, Jeff, Aanensen, David M., Curran, Martin D., Parmar, Surendra, Aggarwal, Dinesh, Shepherd, James G., Parker, Matthew D., Glaysher, Sharon, Bashton, Matthew, Underwood, Anthony P., Pacchiarini, Nicole, Loveson, Katie F., Carabelli, Alessandro M., Templeton, Kate E., Langford, Cordelia F., Sillitoe, John, de Silva, Thushan I., Wang, Dennis, Kwiatkowski, Dominic, Rambaut, Andrew, O’Grady, Justin, Cottrell, Simon, Holden, Matthew T.G., Thomson, Emma C., Osman, Husam, Andersson, Monique, Chauhan, Anoop J., Hassan-Ibrahim, Mohammed O., Lawniczak, Mara, Gupta, Ravi Kumar, Alderton, Alex, Chand, Meera, Constantinidou, Chrystala, Unnikrishnan, Meera, Darby, Alistair C., Hiscox, Julian A., Paterson, Steve, Martincorena, Inigo, Robertson, David L., Volz, Erik M., Page, Andrew J., Pybus, Oliver G., Bassett, Andrew R., Ariani, Cristina V., Spencer Chapman, Michael H., Li, Kathy K., Shah, Rajiv N., Jesudason, Natasha G., Taha, Yusri, McHugh, Martin P., Dewar, Rebecca, Jahun, Aminu S., McMurray, Claire, Pandey, Sarojini, McKenna, James P., Nelson, Andrew, Young, Greg, McCann, Clare, Elliott, Scott, Lowe, Hannah, Temperton, Ben, Roy, Sunando, Price, Anna, Rey, Sara, Wyles, Matthew, Rooke, Stefan, Shaaban, Sharif, de Cesare, Mariateresa, Letchford, Laura, Silveira, Siona, Pelosi, Emanuela, Wilson-Davies, Eleri, Hosmillo, Myra, O'Toole, Áine, Hesketh, Andrew R., Stark, Richard, du Plessis, Louis, Ruis, Chris, Adams, Helen, Bourgeois, Yann, Michell, Stephen L., Grammatopoulos, Dimitris, Edgeworth, Jonathan, Breuer, Judith, Todd, John A., Fraser, Christophe, Buck, David, John, Michaela, Kay, Gemma L., Palmer, Steve, Peacock, Sharon J., Heyburn, David, Weldon, Danni, Robinson, Esther, McNally, Alan, Muir, Peter, Vipond, Ian B., Boyes, John, Sivaprakasam, Venkat, Saluja, Tranprit, Dervisevic, Samir, Meader, Emma J., Park, Naomi R., Oliver, Karen, Jeffries, Aaron R., Ott, Sascha, da Silva Filipe, Ana, Simpson, David A., Williams, Chris, Masoli, Jane A.H., Knight, Bridget A., Jones, Christopher R., Koshy, Cherian, Ash, Amy, Casey, Anna, Bosworth, Andrew, Ratcliffe, Liz, Xu-McCrae, Li, Pymont, Hannah M., Hutchings, Stephanie, Berry, Lisa, Jones, Katie, Halstead, Fenella, Davis, Thomas, Holmes, Christopher, Iturriza-Gomara, Miren, Lucaci, Anita O., Randell, Paul Anthony, Cox, Alison, Madona, Pinglawathee, Harris, Kathryn Ann, Brown, Julianne Rose, Mahungu, Tabitha W., Irish-Tavares, Dianne, Haque, Tanzina, Hart, Jennifer, Witele, Eric, Fenton, Melisa Louise, Liggett, Steven, Graham, Clive, Swindells, Emma, Collins, Jennifer, Eltringham, Gary, Campbell, Sharon, McClure, Patrick C., Clark, Gemma, Sloan, Tim J., Jones, Carl, Lynch, Jessica, Warne, Ben, Leonard, Steven, Durham, Jillian, Williams, Thomas, Haldenby, Sam T., Storey, Nathaniel, Alikhan, Nabil-Fareed, Holmes, Nadine, Moore, Christopher, Carlile, Matthew, Perry, Malorie, Craine, Noel, Lyons, Ronan A., Beckett, Angela H., Goudarzi, Salman, Fearn, Christopher, Cook, Kate, Dent, Hannah, Paul, Hannah, Davies, Robert, Blane, Beth, Girgis, Sophia T., Beale, Mathew A., Bellis, Katherine L., Dorman, Matthew J., Drury, Eleanor, Kane, Leanne, Kay, Sally, McGuigan, Samantha, Nelson, Rachel, Prestwood, Liam, Rajatileka, Shavanthi, Batra, Rahul, Williams, Rachel J., Kristiansen, Mark, Green, Angie, Justice, Anita, Mahanama, Adhyana I.K., Samaraweera, Buddhini, Hadjirin, Nazreen F., Quick, Joshua and Poplawski, Radoslaw (2021) Exponential growth, high prevalence of SARS-CoV-2, and vaccine effectiveness associated with the Delta variant. Science, 374 (6574). abl9551. ISSN 0036-8075

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Abstract

SARS-CoV-2 infections were rising during early summer 2021 in many countries associated with the Delta variant. We assessed RT-PCR swab-positivity in the REal-time Assessment of Community Transmission-1 (REACT-1) study in England. We observed sustained exponential growth with average doubling time (June-July 2021) of 25 days driven by complete replacement of Alpha variant by Delta, and by high prevalence at younger less-vaccinated ages. Unvaccinated people were three times more likely than double-vaccinated people to test positive. However, after adjusting for age and other variables, vaccine effectiveness for double-vaccinated people was estimated at between ~50% and ~60% during this period in England. Increased social mixing in the presence of Delta had the potential to generate sustained growth in infections, even at high levels of vaccination.

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