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The SARS-CoV-2 immunity and reinfection evaluation (SIREN) study is a unique, large-scale partnership with NHS healthcare workers providing an agile response to an evolving pandemic. It is one of the national core studies established in response to COVID-19 and a National Institute for Health Research (NIHR) urgent priority study, and continues to provide vital research into immunity and vaccine effectiveness.

The SIREN study was established early in the pandemic with participants undergoing regular testing for up to 2 years. Analysis of these testing samples helps the UK to evaluate the immune response to COVID-19, build understanding of the protection offered by vaccines and provide insight into COVID-19 reinfections.

Healthcare workers are enrolled in the UK-wide SIREN study through the hospital site they work at. A total of 135 sites have participated in the study involving almost 45,000 participants, making SIREN the largest study of its kind globally.

In winter 2022 to 2023, multiplex polymerase chain reaction (PCR) testing was introduced through the SIREN Winter Pressures sub-study, adding testing for influenza (flu) and respiratory syncytial virus (RSV) alongside COVID-19.

SIREN 2.0, the new phase of the SIREN study, began in September 2023 with active testing on a smaller sub-cohort from the original cohort of 45,000 throughout winter 2023 to 2024.

SIREN 2.0 will continue to play a central role in surveillance of COVID-19 across the UK, including the detection of emerging new variants and other respiratory viruses using regular multiplex testing for COVID-19, influenza and RSV.

The SIREN study is registered with .

Main findings from SIREN

The SIREN study has provided valuable evidence on immunity following SARS-CoV-2 infection and COVID-19 vaccination and provided surveillance data on infection and emerging variants. This evidence has played a critical role in informing the national COVID-19 response.

We have assessed the durability of protection following SARS-CoV-2 infection, COVID-19 vaccination, and a combination of the 2 (鈥榟ybrid protection鈥�) throughout the pandemic and across variant waves.

Our vaccine effectiveness findings, released in February 2021, demonstrating high short-term protection following the first 2 doses of COVID-19 vaccine in UK healthcare workers, provided important evidence to inform the UK roadmap out of lockdown.

In 2021, we established the SIREN Consortium consisting of academic, clinical and public health partners. This has allowed us to gain a better understanding of serological correlates of protection, and the role of T-cell responses in SARS-CoV-2. We are expanding this work for winter 2023 to 2024 for influenza and RSV.

We have also established a motivated and dynamic participant involvement panel in collaboration with the British Society for Immunology. The group is made up of SIREN study participants, with a diverse mix of gender, ethnicity and professions. They have helped to make sure SIREN continues to deliver relevant, feasible and translatable research, and have contributed directly to SIREN study protocols and co-author peer-reviewed papers.

Finally, SIREN will continue to work with our partners at Birmingham City University and within the UK Health Security Agency (UKHSA) to try and identify lessons from the pandemic, including understanding the barriers and facilitators for vaccination among healthcare workers, as part of our future pandemic preparedness response.

Watch videos for more information.

Our story:

Learn from SIREN study research teams:

Learn from SIREN study participants:

Learn about recent study findings:

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Learn about SIREN 2.0:

SIREN: the story so far

This infographic lists key moments during the SIREN study and indicates that the project has moved on to SIREN 2.0.

Text version of timeline

2020
May 鈥� ethics approval
June 鈥� first participant recruited
September 鈥� first reinfections investigated
December 鈥� vaccines introduced, SIREN investigates vaccine effectiveness, PITCH sub-study established

2021
January 鈥� first vaccine effectiveness analysis
March 鈥� 45,000 participants recruited in first year
July 鈥� SIREN continues for a second year
August 鈥� Medical Research Council 拢1.5 million funding establishes the SIREN consortium
October 鈥� serological re-infection analysis
December 鈥� first SIREN participant involvement panel (PIP)

2022
February 鈥� VIBRANT sub-study recruitment begins
October 鈥� enhanced questionnaires for symptoms
November to December 鈥� multiplex testing introduced
March 鈥� qualitative sub-study

2023
March 鈥� qualitative sub-study
August to September 鈥� recruitment opens to SIREN 2.0
September 鈥� SIREN 2.0

Partners

UKHSA runs the SIREN study in partnership with NHS sites, the Public Health Agency Northern Ireland, Public Health Scotland and Public Health Wales.

The SIREN study works with a number of academic partners. The SIREN Consortium was established in August 2021 and was by UK Research and Innovation (UKRI).

SIREN Consortium members include:

• Wellcome Sanger Institute
• The Francis Crick Institute
• Protective Immunity from T cells to COVID-19 in Health workers (PITCH):
  • University of Oxford
  • University of Liverpool
  • University of Sheffield
  • Newcastle University
  • University of Birmingham
• Humoral Immune Correlates for COVID-19 (HICC)
• Imperial College London
• University of Glasgow
• British Society for Immunology
• GenOMICC

For SIREN 2.0, we have established new collaborations with scientific partners, World Influenza Centre and the Wellcome Sanger Institute.

The Wellcome Sanger Institute in Cambridge is a world leader in genomic sequencing and metagenomics. They will sequence samples from the SIREN study and use metagenomics to investigate other pathogens that cause respiratory infection such as parainfluenza.

With the increasing interest in Influenza, we have also set up a collaboration with the World Influenza Centre (WIC) in London. The WIC is one of 6 centres in the world responsible for analysing influenza viruses circulating in the human population, overseen by the World Health Organization (WHO). We plan to share influenza viruses detected as part of SIREN 2.0, which may be used to design influenza vaccines for future seasons

Contributors

Staff across the 135 sites have helped with the running of the study.

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Funding

The SIREN study is funded by UKHSA, the Department of Health and Social Care and NIHR, with contributions from the Scottish, Welsh and Northern Irish governments and funding awarded through research grants.

Related articles

The SIREN study: .

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SIREN: - UKHSA

- Health Data Research UK

SIREN 2.0 press release

Scientific papers

Please find below a list of scientific outputs.

Published papers

1. Hall V J, Foulkes S, Charlett A and others. 鈥樷�� Lancet 2021: volume 397, issue 10,283, pages 1,459 to 1,469
2. Hall V J, Foulkes S, Saei A and others. 鈥樷�� Lancet 2021: volume 397, issue 10,286, pages 1,725 to 1,735
3. Atti A, Ferrari M, Castillo-Olivares J and others. 鈥樷�� Journal of Infection 2022: volume 84, issue 2, pages 248 to 288
4. Hall V, Foulkes S, Insalata F and others. 鈥樷�� New England Journal of Medicine 2022: volume 386, issue 13, pages 1,207 to 1,220
5. Wallace S, Hall V, Charlett A and others. 鈥樷�� British Medical Journal Open 2022: volume 12, issue 6, page e054336
6. Pople D, Monk E, Evans S and others. 鈥樷�� British Medical Journal (Clinical research edition) 2022: volume 378, page e070379
7. Atti A, Insalata F, Carr E J and others. SIREN Study Group and the Crick COVID Immunity Pipeline Consortium. 鈥樷�� The Journal of Infection 2022: volume 85, issue 5, pages 545 to 556
8. Foulkes S, Monk EJM, Sparkes D and others. 鈥樷�� Emerging Infectious Diseases 2023: volume 29, issue 1, pages 184 to 188
9. Atti A, Insalata F, Carr E J and others. 鈥樷�� Journal of Infection 2023
10. Howells A, Aquino EN, Bose D and others. 鈥樷�� Research Involvement and Engagement 2023
11. Hall VJ, Insalata F, Foulkes S, and others. 鈥樷�� Journal of Infection November 2023: volume S0163-4453, issue 23, pages 00553 to 00554
12. Kirwan PD, Hall VJ, Foulkes S and others.听.听The Lancet Regional Health - Europe January 2024: volume 36, 100809
13. Broad J, Sparkes D, Platt N and others.听鈥欌�樚齕version 2; peer review: 1 approved with reservations].听NIHR Open Research 2024: volume 4, issue 1
14. Foulkes S, Evans J, and others. 鈥樷�� Journal of Infection August 2024

Pre-prints

1. Wallace S, Hall V, Charlett A and others. 鈥樷�� medRxiv 2020: 2020.12.15.20247981
2. Hall V, Foulkes S, Charlett A and others (2021). 鈥樷�� medRxiv, 2021.2001.2013.21249642
3. Hall V, Foulkes S, Insalata F and others (2021). 鈥樷�� medRxiv, 2021.2011.2029.21267006
4. Otter AD, D鈥橝rcangelo S, Whitaker H and others (2022). 鈥樷�� medRxiv, 2022.2004.2021.22274025
5. Atti A, Insalata F, Carr E and others. 鈥樷��
6. Victoria J Hall, Ferdinando Insalata,听Sarah Foulkes, Peter Kirwan, Dominic Sparkes,听听 Ana Atti, Michelle Cole, Elen de Lacy, Lesley Price, Diane Corrigan, Colin S Brown, Jasmin Islam, The SIREN Study Group, Andre Charlett, Susan Hopkins (2023). 鈥樷��
7. Kirwan P, Hall V, Foulkes S and others (2023). 鈥樷�� medRxiv 2023.09.29.23296330

Site list

In the first year of the SIREN study, 135 sites across the UK contributed, with 87 sites contributing to the second year extension.

The following table lists different SIREN study sites within England, Northern Ireland, Scotland and Wales. According to the year of the study, 鈥榓ctive鈥� indicates sites with active SIREN testing and 鈥榗losed鈥� indicates sites where SIREN testing has stopped.

Please note, SIREN participants at sites who are no longer actively testing remain important contributors to the study. They will continue to receive communications and key study updates from the SIREN team and may be offered opportunities for further involvement.

SIREN study site	Year 1	Year 2	SIREN 2.0
England	听	听	听
St George鈥檚 University Hospitals NHS Foundation Trust	Active	Active	Active
University Hospitals Of Leicester NHS Trust	Active	Active	Active
University Hospitals Plymouth NHS Trust	Active	Active	Closed
Leeds Teaching Hospitals NHS Trust	Active	Active	Active
Mid Essex Hospital Services NHS Trust	Active	Active	Closed
North Middlesex University Hospital NHS Trust	Active	Active	Closed
Liverpool University Hospitals NHS Foundation Trust	Active	Active	Active
West Suffolk NHS Foundation Trust	Active	Active	Closed
Sheffield Teaching Hospitals NHS Foundation Trust	Active	Active	Active
University Hospitals of Morecambe Bay NHS Foundation Trust	Active	Active	Active
Southend University Hospital NHS Foundation Trust	Active	Active	Closed
University Hospitals Bristol and Weston NHS Foundation Trust	Active	Active	Active
King鈥檚 College Hospital NHS Foundation Trust	Active	Active	Closed
The Dudley Group NHS Foundation Trust	Active	Active	Closed
Royal Devon and Exeter NHS Foundation Trust	Active	Active	Closed
North Cumbria Integrated Care NHS Foundation Trust	Active	Active	Closed
St Helens and Knowsley Teaching Hospitals NHS Trust	Active	Active	Closed
Lewisham and Greenwich NHS Trust	Active	Active	Closed
The Newcastle Upon Tyne Hospitals NHS Foundation Trust	Active	Active	Active
The Princess Alexandra Hospital NHS Trust	Active	Active	Active
Imperial College Healthcare NHS Trust	Active	Active	Closed
Blackpool Teaching Hospitals NHS Foundation Trust	Active	Active	Closed
East Suffolk and North Essex NHS Foundation Trust	Active	Active	Closed
Hampshire Hospitals NHS Foundation Trust	Active	Active	Closed
James Paget University Hospitals NHS Foundation Trust	Active	Active	Active
Buckinghamshire Healthcare NHS Trust	Active	Active	Active
Sheffield Children鈥檚 NHS Foundation Trust	Active	Active	Active
Basildon and Thurrock University Hospitals NHS Foundation Trust	Active	Active	Closed
Frimley Health NHS Foundation Trust	Active	Active	Closed
Calderdale and Huddersfield NHS Foundation Trust	Active	Active	Closed
United Lincolnshire Hospitals NHS Trust	Active	Active	Closed
Isle Of Wight NHS Trust	Active	Active	Active
Warrington and Halton Teaching Hospitals NHS Foundation Trust	Active	Active	Closed
Royal Free London NHS Foundation Trust	Active	Active	Closed
Whittington Health NHS Trust	Active	Active	Active
The Clatterbridge Cancer Centre NHS Foundation Trust	Active	Active	Closed
University Hospitals Of North Midlands NHS Trust	Active	Active	Closed
Royal Papworth Hospital NHS Foundation Trust	Active	Active	Active
Shrewsbury and Telford Hospital NHS Trust	Active	Active	Active
Devon Partnership NHS Trust	Active	Active	Closed
The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust	Active	Active	Active
London North West University Healthcare NHS Trust	Active	Active	Closed
Croydon Health Services NHS Trust	Active	Active	Closed
Nottingham University Hospitals NHS Trust	Active	Active	Active
Mid Cheshire Hospitals NHS Foundation Trust	Active	Active	Active
Dartford and Gravesham NHS Trust	Active	Active	Closed
Lancashire Teaching Hospitals NHS Foundation Trust	Active	Active	Active
Bedfordshire Hospitals NHS Foundation Trust	Active	Active	Closed
Shropshire Community Health NHS Trust	Active	Active	Closed
Royal National Orthopaedic Hospital NHS Trust	Active	Active	Closed
Stockport NHS Foundation Trust	Active	Active	Active
Hounslow and Richmond Community Healthcare NHS Trust	Active	Active	Active
Salisbury NHS Foundation Trust	Active	Active	Active
Derbyshire Healthcare NHS Foundation Trust	Active	Active	Active
Birmingham and Solihull Mental Health NHS Foundation Trust	Active	Active	Closed
Black Country Healthcare NHS Foundation Trust	Active	Active	Active
Solent NHS Trust	Active	Active	Closed
Southern Health NHS Foundation Trust	Active	Active	Active
George Eliot Hospital NHS Trust	Active	Active	Closed
Lincolnshire Partnership NHS Foundation Trust	Active	Active	Closed
The Hillingdon Hospitals NHS Foundation Trust	Active	Active	Closed
Central and North West London NHS Foundation Trust	Active	Active	Active
Lancashire and South Cumbria NHS Foundation Trust	Active	Active	Active
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust	Active	Active	Closed
Bolton NHS Foundation Trust	Active	Active	Closed
Southport and Ormskirk Hospital NHS Trust	Active	Active	Closed
Norfolk and Norwich University Hospitals NHS Foundation Trust	Active	Active	Active
Mid Yorkshire Hospitals NHS Trust	Active	Active	Active
Somerset NHS Foundation Trust	Active	Closed	Closed
University Hospitals Of Derby and Burton NHS Foundation Trust	Active	Closed	Active
Sherwood Forest Hospitals NHS Foundation Trust	Active	Closed	Closed
Gloucestershire Hospitals NHS Foundation Trust	Active	Closed	Closed
Hull University Teaching Hospitals NHS Trust	Active	Closed	Closed
Yeovil District Hospital NHS Foundation Trust	Active	Closed	Closed
Sandwell and West Birmingham Hospitals NHS Trust	Active	Closed	Closed
Royal Cornwall Hospitals NHS Trust	Active	Closed	Closed
Moorfields Eye Hospital NHS Foundation Trust	Active	Closed	Closed
Torbay and South Devon NHS Foundation Trust	Active	Closed	Active
Ashford and St Peter鈥檚 Hospitals NHS Foundation Trust	Active	Closed	Active
York Teaching Hospital NHS Foundation Trust	Active	Closed	Closed
Northern Devon Healthcare NHS Trust	Active	Closed	Closed
Countess Of Chester Hospital NHS Foundation Trust	Active	Closed	Closed
Portsmouth Hospitals NHS Trust	Active	Closed	Closed
Walsall Healthcare NHS Trust	Active	Closed	Closed
Royal Surrey County Hospital NHS Foundation Trust	Active	Closed	Active
University Hospital Southampton NHS Foundation Trust	Active	Closed	Closed
Manchester University NHS Foundation Trust	Active	Closed	Active
North West Anglia NHS Foundation Trust	Active	Closed	Closed
Royal United Hospitals Bath NHS Foundation Trust	Active	Closed	Closed
Surrey and Sussex Healthcare NHS Trust	Active	Closed	Closed
Great Western Hospitals NHS Foundation Trust	Active	Closed	Closed
Epsom and St Helier University Hospitals NHS Trust	Active	Closed	Closed
University Hospitals Coventry and Warwickshire NHS Trust	Active	Closed	Closed
Western Sussex Hospitals NHS Foundation Trust	Active	Closed	Closed
The Royal Wolverhampton NHS Trust	Active	Closed	Closed
Chesterfield Royal Hospital NHS Foundation Trust	Active	Closed	Closed
Brighton and Sussex University Hospitals NHS Trust	Active	Closed	Closed
Wye Valley NHS Trust	Active	Closed	Closed
Wirral University Teaching Hospital NHS Foundation Trust	Active	Closed	Closed
East Sussex Healthcare NHS Trust	Active	Closed	Closed
Maidstone and Tunbridge Wells NHS Trust	Active	Closed	Closed
Queen Victoria Hospital NHS Foundation Trust	Active	Closed	Closed
Cornwall Partnership NHS Foundation Trust	Active	Closed	Closed
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust	Active	Closed	Closed
Poole Hospital NHS Foundation Trust	Active	Closed	Closed
Northern Lincolnshire and Goole NHS Foundation Trust	Active	Closed	Closed
Leicestershire Partnership NHS Trust	Active	Closed	Closed
Birmingham Community Healthcare NHS Foundation Trust	Active	Closed	Closed
Dorset County Hospital NHS Foundation Trust	Active	Closed	Closed
Alder Hey Children鈥檚 NHS Foundation Trust	Active	Closed	Closed
Royal Berkshire NHS Foundation Trust	Active	Closed	Closed
Dorset Healthcare University NHS Foundation Trust	Active	Closed	Closed
Derbyshire Community Health Services NHS Foundation Trust	Active	Closed	Active
Northern Ireland	听	听	听
Southern Health and Social Care Trust	Active	Active	Active
South Eastern Health and Social Care	Active	Active	Active
Belfast Health and Social Care Trust	Active	Active	Active
Western Health and Social Care Trust	Active	Active	Closed
Northern Heath and Social Care Trust	Active	Active	Closed
Scotland	听	听	听
NHS Lothian	Active	Active	Active
NHS Greater Glasgow and Clyde	Active	Active	Active
NHS Lanarkshire	Active	Active	Active
NHS Grampian	Active	Active	Closed
NHS Highland	Active	Active	Active
NHS Fife	Active	Active	Active
NHS Forth Valley	Active	Active	Active
Golden Jubilee National Hospital	Active	Active	Active
NHS Western Isles	Active	Active	Active
NHS Borders	Active	Active	Closed
Wales	听	听	听
Aneurin Bevan University LHB	Active	Active	Active
Swansea Bay University LHB	Active	Active	Closed
Cwm Taf Morgannwg University LHB	Active	Active	Active
Hywel Dda University LHB	Active	Active	Closed
Velindre NHS Trust	Active	Closed	Closed
Betsi Cadwaladr University LHB	Active	Closed	Closed
Powys Teaching LHB	Active	Closed	Closed

SIREN 2.0 map

This map is a visual representation of the SIREN NHS sites listed above.