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Article History

Received: 25 July 2025

Accepted: 21 November 2025

First Online: 16 January 2026

Declarations

:

: This study was conducted in accordance with the principles of the Declaration of Helsinki. The study was approved by the London School of Hygiene and Tropical Medicine Research Ethics Committee (Reference: 27896) and the Independent Scientific Advisory Committee of the UK Medicines and Healthcare Products Regulatory Agency (Approval Number: 22_001876).Under CPRD’s ethical approval from the UK Health Research Authority to support research using anonymised patient data, individual patient consent is not required. Individuals registered with participating GP practices are included in the CPRD dataset unless they opt out.

: Not applicable.

: MB is funded by a GSK PhD studentship to investigate the application of quantitative bias analysis in observational studies of COVID-19. ID has unrestricted grants from and shares in GSK. AS is employed by LSHTM on a fellowship funded by GSK. CTR and JQ report no conflicts of interest.