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The SARS-CoV-2 Immunity and Reinfection Evaluation (SIREN) study: investigating immunity and vaccine effectiveness throughout the evolving COVID-19 pandemic  

The SARS-CoV-2 immunity and reinfection evaluation (SIREN) study is a large-scale partnership with NHS healthcare workers. The SIREN study has provided valuable evidence on immunity following SARS-CoV-2 infection and COVID-19 vaccination and provided surveillance data on infection and emerging variants. This evidence has played a critical role in informing the national COVID-19 response. SIREN has also been a valuable source of authoritative evidence, given the study design and scale, for policymakers internationally. 

SIREN has an established PPI panel, facilitated by the British Society for Immunology. The panel has reviewed concerns in real-time and ensured responsive communications and engagement activities. SIREN has an active and evolving participant engagement and retention programme, with regular participant webinars, newsletters and celebration events, informed by participant feedback. 


Coronavirus (COVID-19) Infection Survey 

The Coronavirus (COVID-19) Infection Survey ran from April 2020 to March 2023 with Prof Sarah Walker as Chief Investigator of the Survey. Over 535,000 people from around 267,220 households across all four nations of the UK took part in the SurveyWe were able to use the survey to identify symptoms and COVID-19 positivity in the general population in the UK, monitor populations at risk of infection, track the emergency of the Alpha Variant in the UK, and assess impact of vaccine effectiveness. 



We developed a fast and high-throughput SARS-CoV-2 sequencing pipeline that was translated successfully to the routine laboratory at the Oxford University Hospitals Foundation NHS Trust. The sequencing results were integrated into the national system for SARS-CoV-2 surveillance, as well as being added to the Global Pathogen Analysis Service (GPAS), to aid the surveillance and tracking of SARS-CoV-2 globally. The lab team reported that using GPAS had cut processing times from days to minutes and allowed wet lab members to get directly involved in analysis. 


Surveillance of COVID in the OUH staff population  

We set up an observational cohort study of >1o,000 hospital healthcare workers and support staff from Oxfordshire. Findings led to an internal report and multiple changes to better protect staff at Oxford University Hospitals. 

 Our cohort also allowed us to present the first systematic evidence of protection against reinfection worldwide, with reduced rates of both symptomatic and asymptomatic infection seen in staff previously infected with positive antibodies. 


Modelling healthcare associated COVID-19  

Models of SARS-CoV-2 transmission and control within hospital settings were used to inform decision-making on infection prevention control (IPC) strategies in hospital settings. Model findings were used to create an infographic for NHS Trusts on effectiveness of different components of IPC bundles in collaboration with the Healthcare Onset COVID-19 Infection Working Group (SAGE subgroup).  


COVID-19 infectivity and implications for use of lateral flow devices 

Our major study of linked data on COVID-19 tests and contacts showed that the index patient’s viral load was a major factor in determining whether or not an infected individual was likely to transmit COVID-19 to their contacts. From this, and from the known ability of lateral flow devices (LFD) to detect virus, the study showed that LFDs were able to detect individuals responsible for 83-90% of transmission events. These results allowed the UK Government and PHE to make rational recommendations on how best to use LFDs in the wider population, in particular to detect asymptomatic infection in hospitals and workplaces, use of daily testing of COVID-19 contacts to avoid quarantine, and large-scale pre-event testing to enhance safer attendance.