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Article History

Received: 18 December 2023

Accepted: 26 February 2025

First Online: 10 March 2025

Declarations

:

: The study underwent a rigorous ethical and regulatory approval process, following an Integrated Research Application System application [IRAS project ID: 283439], a favourable written authorization was gained from NHS Research Ethics Service, Wales Research Ethics Committee 7, c/o Public Health Wales, Building 1, Jobswell Road, St David’s Park, SA31 3HB on 11/09/2020. Our research complies with the declaration of Helsinki with anonymized data and ethical review, as explained below informed consent for data sharing was waived due to overriding public interest. See: The requirement for informed consent was waived by NHS Research Ethics Service, Wales Research Ethics Committee 7 (see above), given overriding public interest in the research. Furthermore, during project development prior to ethics review, a public and patient involvement meeting conducted at North Bristol NHS Trust by author MH received similar support. North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust signed data sharing agreements confirming this waiver. See: All data were fully anonymized before they were transferred to the research team for analysis.

: NHS Research Ethics Service, Wales Research Ethics Committee 7 and North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust (see above) waived the requirement for informed patient consent for publication.

: Dr Catherine Hyams is the Principal Investigator of the AvonCAP study, which is a University of Bristol sponsored study funded by Pfizer. This does not alter our adherence to BMC policies on sharing data and materials.