Utilising the Benefit Risk Assessment of Vaccines (BRAVE) toolkit to evaluate the benefits and risks of Vaxzevria in the EU: a population-based study

Summary: Background: Several COVID-19 vaccines have been licensed. To support the assessment of safety signals, we developed a toolkit to support COVID-19 vaccine monitoring and benefit–risk assessment. We aim to show the application of our toolkit in the EU using thrombosis with thrombocytopenia s...

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Main Authors: Hector Gonzalez Dorta, MSc, Johan Verbeeck, PhD, Jonas Crevecoeur, PhD, Daniel R Morales, PhD, Neilshan Loedy, MSc, Catherine Cohet, PhD, Lander Willem, PhD, Geert Molenberghs, ProfPhD, Niel Hens, ProfPhD, Xavier Kurz, PhD, Chantal Quinten, PhD, Steven Abrams, PhD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:The Lancet: Digital Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2589750025000251
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author Hector Gonzalez Dorta, MSc
Johan Verbeeck, PhD
Jonas Crevecoeur, PhD
Daniel R Morales, PhD
Neilshan Loedy, MSc
Catherine Cohet, PhD
Lander Willem, PhD
Geert Molenberghs, ProfPhD
Niel Hens, ProfPhD
Xavier Kurz, PhD
Chantal Quinten, PhD
Steven Abrams, PhD
author_facet Hector Gonzalez Dorta, MSc
Johan Verbeeck, PhD
Jonas Crevecoeur, PhD
Daniel R Morales, PhD
Neilshan Loedy, MSc
Catherine Cohet, PhD
Lander Willem, PhD
Geert Molenberghs, ProfPhD
Niel Hens, ProfPhD
Xavier Kurz, PhD
Chantal Quinten, PhD
Steven Abrams, PhD
author_sort Hector Gonzalez Dorta, MSc
collection DOAJ
description Summary: Background: Several COVID-19 vaccines have been licensed. To support the assessment of safety signals, we developed a toolkit to support COVID-19 vaccine monitoring and benefit–risk assessment. We aim to show the application of our toolkit in the EU using thrombosis with thrombocytopenia syndrome (TTS) associated with the Vaxzevria (AstraZeneca) vaccine as a use case. Methods: In this population-based study, we used a model incorporating data from multiple EU sources such as The European Surveillance System and EudraVigilance, and estimated the benefits of COVID-19 vaccines by comparing the observed COVID-19 confirmed cases, hospitalisations, intensive care unit (ICU) admissions, and deaths across Europe to the expected numbers in the absence of Vaxzevria vaccination. Risks of TTS associated with Vaxzevria were calculated by comparing the observed number of TTS events in individuals who received Vaxzevria to the expected number of events based on background incidence rates. To visualise the results, we developed a toolkit with an interactive web application. Findings: 62 598 505 Vaxzevria vaccines (32 763 183 to females and 29 835 322 to males) had been administered in Europe by Feb 10, 2021. Our results showed that a first dose of Vaxzevria provided benefits across all age groups. Based on vaccine effectiveness estimates and reported coverage in Europe, from Dec 13, 2020 to Dec 31, 2021, vaccination with Vaxzevria was estimated to prevent (per 100 000 doses) 12 113 COVID-19 cases, 1140 hospitalisations, 184 ICU admissions, and 261 deaths. Women aged 30–59 years and males aged 20–29 years had the highest frequency of TTS events. The benefits of vaccination outweighed the risks of TTS in all age groups, with the highest benefits and risks observed in individuals aged 60–69 years. Interpretation: Our toolkit and underlying model contextualised the risk of TTS associated with Vaxzevria relative to its benefits. The methodology employed could be applied to other serious adverse events related to COVID-19 or other vaccines. The adaptability and versatility of such toolkits might contribute to strengthening preparedness for future public health emergencies. Funding: European Medicines Agency.
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spelling doaj-art-e7491276a572473aa4975b78c73b19ba2025-08-20T02:17:19ZengElsevierThe Lancet: Digital Health2589-75002025-05-017510086110.1016/j.landig.2025.02.001Utilising the Benefit Risk Assessment of Vaccines (BRAVE) toolkit to evaluate the benefits and risks of Vaxzevria in the EU: a population-based studyHector Gonzalez Dorta, MSc0Johan Verbeeck, PhD1Jonas Crevecoeur, PhD2Daniel R Morales, PhD3Neilshan Loedy, MSc4Catherine Cohet, PhD5Lander Willem, PhD6Geert Molenberghs, ProfPhD7Niel Hens, ProfPhD8Xavier Kurz, PhD9Chantal Quinten, PhD10Steven Abrams, PhD11European Medicines Agency, Amsterdam, NetherlandsData Science Institute, I-BioStat, Universiteit Hasselt, Hasselt, BelgiumData Science Institute, I-BioStat, Universiteit Hasselt, Hasselt, Belgium; I-BioStat, KU Leuven, Leuven, BelgiumEuropean Medicines Agency, Amsterdam, Netherlands; Division of Population Health and Genomics, University of Dundee, Dundee, UKData Science Institute, I-BioStat, Universiteit Hasselt, Hasselt, BelgiumEuropean Medicines Agency, Amsterdam, NetherlandsCentre for Health Economics Research and Modelling of Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, BelgiumData Science Institute, I-BioStat, Universiteit Hasselt, Hasselt, Belgium; I-BioStat, KU Leuven, Leuven, BelgiumData Science Institute, I-BioStat, Universiteit Hasselt, Hasselt, Belgium; Centre for Health Economics Research and Modelling of Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, BelgiumEuropean Medicines Agency, Amsterdam, NetherlandsEuropean Medicines Agency, Amsterdam, Netherlands; Correspondence to: Dr Chantal Quinten, European Medicines Agency, 1083 HS Amsterdam, NetherlandsData Science Institute, I-BioStat, Universiteit Hasselt, Hasselt, Belgium; Global Health Institute, Family Medicine and Population Health, University of Antwerp, Antwerp, BelgiumSummary: Background: Several COVID-19 vaccines have been licensed. To support the assessment of safety signals, we developed a toolkit to support COVID-19 vaccine monitoring and benefit–risk assessment. We aim to show the application of our toolkit in the EU using thrombosis with thrombocytopenia syndrome (TTS) associated with the Vaxzevria (AstraZeneca) vaccine as a use case. Methods: In this population-based study, we used a model incorporating data from multiple EU sources such as The European Surveillance System and EudraVigilance, and estimated the benefits of COVID-19 vaccines by comparing the observed COVID-19 confirmed cases, hospitalisations, intensive care unit (ICU) admissions, and deaths across Europe to the expected numbers in the absence of Vaxzevria vaccination. Risks of TTS associated with Vaxzevria were calculated by comparing the observed number of TTS events in individuals who received Vaxzevria to the expected number of events based on background incidence rates. To visualise the results, we developed a toolkit with an interactive web application. Findings: 62 598 505 Vaxzevria vaccines (32 763 183 to females and 29 835 322 to males) had been administered in Europe by Feb 10, 2021. Our results showed that a first dose of Vaxzevria provided benefits across all age groups. Based on vaccine effectiveness estimates and reported coverage in Europe, from Dec 13, 2020 to Dec 31, 2021, vaccination with Vaxzevria was estimated to prevent (per 100 000 doses) 12 113 COVID-19 cases, 1140 hospitalisations, 184 ICU admissions, and 261 deaths. Women aged 30–59 years and males aged 20–29 years had the highest frequency of TTS events. The benefits of vaccination outweighed the risks of TTS in all age groups, with the highest benefits and risks observed in individuals aged 60–69 years. Interpretation: Our toolkit and underlying model contextualised the risk of TTS associated with Vaxzevria relative to its benefits. The methodology employed could be applied to other serious adverse events related to COVID-19 or other vaccines. The adaptability and versatility of such toolkits might contribute to strengthening preparedness for future public health emergencies. Funding: European Medicines Agency.http://www.sciencedirect.com/science/article/pii/S2589750025000251
spellingShingle Hector Gonzalez Dorta, MSc
Johan Verbeeck, PhD
Jonas Crevecoeur, PhD
Daniel R Morales, PhD
Neilshan Loedy, MSc
Catherine Cohet, PhD
Lander Willem, PhD
Geert Molenberghs, ProfPhD
Niel Hens, ProfPhD
Xavier Kurz, PhD
Chantal Quinten, PhD
Steven Abrams, PhD
Utilising the Benefit Risk Assessment of Vaccines (BRAVE) toolkit to evaluate the benefits and risks of Vaxzevria in the EU: a population-based study
The Lancet: Digital Health
title Utilising the Benefit Risk Assessment of Vaccines (BRAVE) toolkit to evaluate the benefits and risks of Vaxzevria in the EU: a population-based study
title_full Utilising the Benefit Risk Assessment of Vaccines (BRAVE) toolkit to evaluate the benefits and risks of Vaxzevria in the EU: a population-based study
title_fullStr Utilising the Benefit Risk Assessment of Vaccines (BRAVE) toolkit to evaluate the benefits and risks of Vaxzevria in the EU: a population-based study
title_full_unstemmed Utilising the Benefit Risk Assessment of Vaccines (BRAVE) toolkit to evaluate the benefits and risks of Vaxzevria in the EU: a population-based study
title_short Utilising the Benefit Risk Assessment of Vaccines (BRAVE) toolkit to evaluate the benefits and risks of Vaxzevria in the EU: a population-based study
title_sort utilising the benefit risk assessment of vaccines brave toolkit to evaluate the benefits and risks of vaxzevria in the eu a population based study
url http://www.sciencedirect.com/science/article/pii/S2589750025000251
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