Effectiveness of the COVID-19 vaccines against hospitalisation with Omicron sub-lineages BA.4 and BA.5 in England

The Omicron sub-lineages BA.4 and BA.5, identified in South Africa in early 2022, were first detected in England in April 2022. A case surge followed despite England having recently experienced waves with BA.1 and BA.2. BA.4 and BA.5 have identical spike proteins most similar to that of BA.2 but with additional mutations including the 69–70 deletion, L452R, F486V and wild-type amino acid at position Q493.1 Neutralisation assays have found BA.4 and BA.5 display increased evasion of antibodies from plasma of vaccinated or BA.1 infected individuals, as compared to BA.2.3, Recent data from Denmark and Portugal have found that the odds of being vaccinated did not differ amongst BA.5 and BA.2 cases.6,7 The Portuguese study did find lower VE against hospitalisation for BA.5 using a cohort study design.

Author list



  1. UK Health Security Agency, London, United Kingdom
  2. NIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, United Kingdom
  3. Guys and St Thomas’s Hospital NHS Trust, London, United Kingdom
  4. NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, United Kingdom


Freja Cordelia Møller Kirsebom,1 Nick Andrews,1,2 Julia Stowe,1 Natalie Groves,1 Meera Chand,1,3 Mary Ramsay,1,2 and Jamie Lopez Bernal1,2,4*

Novel Coronavirus SARS-CoV-2


The Lancet - Regional Health