Research and analysis

COVID-19 reinfection surveillance participant information

Published 15 March 2021

Public Health England (PHE) is contacting people to invite them to take part in national surveillance of Covid-19 reinfection. This research has been reviewed and approved by the PHE Research Ethics and Governance Public Health Practice Group (REGG, reference NR0259). This page provides some more information about this surveillance.

The purpose of this surveillance

This national surveillance aims to find out more about how often reinfection with SARS-CoV-2 virus (the virus that causes COVID-19 disease) occurs, how long protection lasts and whether this prevents you getting less serious illness or any illness at all. Reinfection can occur with other human coronaviruses where it has been reported to occur about 6 months after first infection.

We are just beginning to learn more about reinfection with COVID-19. Early data suggest that being infected once provides good protection against a second infection, for a few months at least, and even higher protection against being ill with COVID-19 if you are infected again. This research aims to help us understand more about reinfection.

People running the surveillance

This surveillance is being carried out by the Immunisation Department, National Infection Service, PHE. PHE is one of the agencies that has responsibility for disease surveillance in England.

The team brings together professionals with extensive experience and training in immunisation, virology, infectious diseases, data analysis and surveillance of immunisation programmes.

PHE is organising this surveillance as part of its core responsibilities under Section 60 of the Health and Social Care Act 2001 (now subsumed into the National Information Governance Board for Health and Social Care, with Section 60 now Section 251 of the NHS ACT 2006).

People being asked to take part

PHE is following up everyone with a second positive COVID-19 test result reported through community testing (pillar 2), that is at least 90 days after an earlier positive test result. Anyone contacted directly by PHE will be invited to fill out a short online survey with questions on their symptoms and reasons for testing.

Some people may be invited to take part in further testing to look at their antibody immunity (levels of protection) and see whether this is what we would expect after a second infection. This will help us decide whether the 90-day cut-off we are using looks like a reliable way of identifying second infections.

Anyone who is invited to take part is completely free to decide whether they would like to do so. Participants can drop out at any time without needing to give any reason.

The surveillance

For most people the surveillance will be an invitation to complete a short online survey that will take less than 10 minutes. This asks questions about each infection – why people were tested, whether they were ill, whether they needed medical advice or help and whether one episode was worse than the other.

Some people who fill in the survey will then be invited to provide further samples so that we can look at whether they still have the virus and their protection against the virus (looking at their antibodies).

If someone chooses to do this they will be asked to:

1. Take 3 samples close to the time of their second infection

• the first sample involves using a simple device to collect a small amount of blood (less than a quarter teaspoon) from the top of the arm. It is painless and can be done quickly and easily by the person themselves.
• the second is a sample from the mouth using a foam tipped swab – this is easy and painless as you just rub the foam sponge along the gum line for a couple of minutes
• finally, we ask for a throat and nose swab

2.  A second kit pack will be sent about a month after the first to everyone who returned their first kit

• this will contain 2 devices to take a blood sample from the top of each arm

Everyone who would like to take part will be sent a sample kit that will contain full instructions and everything needed to take the samples, to package and post them back to PHE.

If the repeat nose and throat swab requested by PHE is positive, taken within 90-days of the last positive test and the individual has not developed any new symptoms of COVID-19, then the need for a second period of self-isolation does not apply, as covered by the Health Protection (coronavirus, restrictions) (self-isolation) (England) Regulations 2020 England.

The benefits and risks of taking part

Anyone who chooses to take part will help us better understand COVID-19 reinfections which will enable PHE to provide advice based on scientific information. Since this is surveillance, it will not interfere with a patient’s usual care.

There are no anticipated harms associated with completing a survey.

Results of the testing of the blood and oral fluid samples will take some time but will be interpreted and explained by a consultant virologist when the information is provided to the participants. Self-taken swabs can cause mild temporary discomfort but we will only be requesting nose and throat swabs. There is small risk of discomfort from blood sampling using the home testing kit provided.

Withdrawing from the surveillance

Anyone who is invited to take part is completely free to decide whether they would like to do so. Participants can drop out at any time without needing to give any reason.

Where information or samples have already been provided these will still be used unless a request is made for these to be removed altogether. In such cases a request should be made by email to covidreinfection@phe.gov.uk and the 8-digit reference number should be included with the request.

Confidentiality

Any information obtained as part of the surveillance will be confidential. COVID-19 testing data and other linked outcome datasets are stored on PHE systems. Email addresses are stored within P2 testing requests. This information will be retained in linked datasets while individuals for surveillance follow up are identified, and then will be later removed.

Details of enhanced surveillance survey response and laboratory test results will be stored in a bespoke database on a secure PHE server, accessible only to members of the PHE Immunisation Department. All data will be processed in line with PHE policies on data processing and legal requirements such as the General Data Protection Regulation (GDPR), the Data Protection Act 2018 and the NHS Caldicott principles. Our staff have the same duty as other healthcare professionals to maintain confidentiality. Further information is available in the PHE personal information charter.

All data will be anonymised prior to statistical analysis and it will not be possible to identify an individual from any reports.

Results of the study

Participants will be informed of their own testing results. We will ensure that any peer reviewed publications or reports are made available on the reinfection web pages.

Review of the surveillance

PHE is organising this surveillance as part of its core responsibilities under Section 60 of the Health and Social Care Act 2001 (now subsumed into the National Information Governance Board for Health and Social Care, with Section 60 now Section 251 of the NHS ACT 2006).

The PHE research and public Health Practice Ethics and Governance group has reviewed and approved this surveillance.

Who do I contact in the event of a complaint?

Complaints Manager
Strategy Directorate
Wellington House
133-155 Waterloo Road
London SE1 8UG

Alternatively, you can email complaints@phe.gov.uk

Further information is available on the PHE’s complaint procedure.

Further information

If you agree to take part, would like more information or have any questions or concerns about the study, email covidreinfection@phe.gov.uk

For more general information, visit:

• NHS.UK - coronavirus

• GOV.UK/coronavirus

• NHS.UK - coronavirus vaccine