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Article History

Accepted: 6 November 2024

First Online: 28 November 2024

Declarations

:

: None.

: This study was supported by a grant from the National Institute of Health Research (NIHR) School of Primary Care Research (SPCR) round 5-IV (Grant reference no: 620). Prof. Petrou receives support as a NIHR Senior Investigator (NF-SI-0616-10103) and from the NIHR Applied Research Collaboration Oxford and Thames Valley at the Oxford Health NHS Foundation Trust. Nicodemo receives support from the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the granting authority European Union’s Horizon Europe research and innovation programme. Neither the European Union nor the granting authority can be held responsible for them. The PCR-4-ALL project has received funding under the Horizon Europe research and innovation programme (Grant agreement no. 101095606) and from Thames Valley at the Oxford Health NHS Foundation Trust.

: S.W.K. carried out the bulk of the analyses, designed the economic study, drafted and revised the article, and approved the final article as submitted. S.P. designed the economic study, coordinated and supervised the analysis, critically reviewed the article, and approved the final version for publication. C.A. drafted and revised the article critically and approved the final version for publication. C.N. drafted and revised the article critically and approved the final version for publication. R.W. drafted and revised the article critically and approved the final version for publication. S.L. drafted and revised the article critically and approved the final version for publication. All authors read the final manuscript and approved the final version for publication.

: We obtained official confirmation from the University of Oxford Medical Sciences Interdivisional Research Ethics Committee (MS IDREC) (ref. R97572/RE001) that our study does not require ethics approval in the UK. EMIS Health’s COVID-19 Symptom Surveillance tool covered the underpinning research infrastructure and governance, including approval and consent procedures for voluntary participation as articulated in EMIS Health’s privacy policy. Processing of personal and sensitive data is conducted by EMIS Health under the legal basis of medical research or public interest. The data used for this study underwent previous full anonymization by EMIS Health. The research team had access to a dataset stripped of all personal identifiers.

: The Stata code used for this study is available upon request.

: EMIS Health obtained explicit consent from each survey participant (or their guardian, if aged 16–18 years) and provided de-identified data to the research team.

: Medical research to answer legitimate research questions in the public interest is justified under schedule 1, sections 2–4 of the Data Protection Act 2018 and in the presence of appropriate data subject safeguards. The legal basis for EMIS’s processing of data is consent or approval for exemption under Section 251 of the NHS Act 2006.

: These data were obtained from EMIS Health’s COVID-19 Symptom Surveillance tool. Accessing these data requires permission from EMIS Health as it is not publicly available.