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Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data
Open accessAbstract
Background Following the emergency use authorisation of the Pfizer-BioNTech mRNA COVID-19 vaccine BNT162b2 (international non-proprietary name tozinameran) in Israel, the Ministry of Health (MoH) launched a campaign to immunise the 6·5 million residents of Israel aged 16 years and older. We estimated the real-world effectiveness of two doses of BNT162b2 against a range of SARS-CoV-2 outcomes and to evaluate the nationwide public-health impact following the widespread introduction of the vaccine.Methods We used national surveillance data from the first 4 months of the nationwide vaccination campaign to ascertain incident cases of laboratory-confirmed SARS-CoV-2 infections and outcomes, as well as vaccine uptake in residents of Israel aged 16 years and older. Vaccine effectiveness against SARS-CoV-2 outcomes (asymptomatic infection, symptomatic infection, and COVID-19-related hospitalisation, severe or critical hospitalisation, and death) was calculated on the basis of incidence rates in fully vaccinated individuals (defined as those for whom 7 days had passed since receiving the second dose of vaccine) compared with rates in unvaccinated individuals (who had not received any doses of the vaccine), with use of a negative binomial regression model adjusted for age group (16-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and ≥85 years), sex, and calendar week. The proportion of spike gene target failures on PCR test among a nationwide convenience-sample of SARS-CoV-2-positive specimens was used to estimate the prevelance of the B.1.1.7 variant.Findings During the analysis period (Jan 24 to April 3, 2021), there were 232 268 SARS-CoV-2 infections, 7694 COVID-19 hospitalisations, 4481 severe or critical COVID-19 hospitalisations, and 1113 COVID-19 deaths in people aged 16 years or older. By April 3, 2021, 4 714 932 (72·1%) of 6 538 911 people aged 16 years and older were fully vaccinated with two doses of BNT162b2. Adjusted estimates of vaccine effectiveness at 7 days or longer after the second dose were 95·3% (95% CI 94·9-95·7; incidence rate 91·5 per 100 000 person-days in unvaccinated vs 3·1 per 100 000 person-days in fully vaccinated individuals) against SARS-CoV-2 infection, 91·5% (90·7-92·2; 40·9 vs 1·8 per 100 000 person-days) against asymptomatic SARS-CoV-2 infection, 97·0% (96·7-97·2; 32·5 vs 0·8 per 100 000 person-days) against symptomatic COVID-19, 97·2% (96·8-97·5; 4·6 vs 0·3 per 100 000 person-days) against COVID-19-related hospitalisation, 97·5% (97·1-97·8; 2·7 vs 0·2 per 100 000 person-days) against severe or critical COVID-19-related hospitalisation, and 96·7% (96·0-97·3; 0·6 vs 0·1 per 100 000 person-days) against COVID-19-related death. In all age groups, as vaccine coverage increased, the incidence of SARS-CoV-2 outcomes declined. 8006 of 8472 samples tested showed a spike gene target failure, giving an estimated prevalence of the B.1.1.7 variant of 94·5% among SARS-CoV-2 infections.Interpretation Two doses of BNT162b2 are highly effective across all age groups (≥16 years, including older adults aged ≥85 years) in preventing symptomatic and asymptomatic SARS-CoV-2 infections and COVID-19-related hospitalisations, severe disease, and death, including those caused by the B.1.1.7 SARS-CoV-2 variant. There were marked and sustained declines in SARS-CoV-2 incidence corresponding to increasing vaccine coverage. These findings suggest that COVID-19 vaccination can help to control the pandemic.Funding None.
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“For context, for a state that is near the herd immunity threshold (70-80% based on recent estimates 22 ), a discrepancy of 10 percentage points in vaccination rates could be the difference between containment and uncontrolled exponential growth in new SARS-CoV-2 infections.”
From Unrepresentative big surveys significantly overestimated US vaccine uptake (2021) · cites this paper as [22]
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“Real-world setting studies performed, few months into vaccination campaigns, showed high effectiveness of these vaccines [1-8].”
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“As previously reported for other vaccines29–33, the neutralizing antibody titres against certain SARS-CoV-2 variants, such as the B.1.351 (Beta) and B.1.617.2 (Delta) variants, were lower than those against the parental strain WA1/2020.”
From Optimization of non-coding regions for a non-modified mRNA COVID-19 vaccine (2022) · cites this paper as [30]
Experimental — accuracy not yet measuredIn the citing paper
“Observational postmarketing studies, including this analysis, have consistently demonstrated a strong association between vaccination and risk reductions in COVID-19 hospitalization in immunocompetent individuals, suggesting that the high efficacy observed in mRNA clinical trials translates into beneficial effects in the community setting.2,3,10”
From Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity (2021) · cites this paper as [3]
In the citing paper
“A randomized, controlled trial and real-world studies have shown vaccine efficacy of 94 to 95% with the BNT162b2 vaccine (Pfizer–BioNTech) and vaccine effectiveness in preventing symptomatic coronavirus disease 2019 (Covid-19) 7 days or more after receipt of the second dose of vaccine.1,3-5”
From Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months (2021) · cites this paper as [4]
In the citing paper
“At the time of this study, the B.1.1.7 variant was the most widespread variant in Israel and accounted for up to 94.5% of SARS-CoV-2 isolates.1,16”
From Covid-19 Breakthrough Infections in Vaccinated Health Care Workers (2021) · cites this paper as [1]
In the citing paper
“Since its rollout in late 2020 in Israel, the BNT162b2 messenger RNA vaccine (Pfizer–BioNTech) has been highly effective in preventing clinically significant coronavirus disease 2019 (Covid-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1-3”
From Covid-19 Breakthrough Infections in Vaccinated Health Care Workers (2021) · cites this paper as [1]
In the citing paper
“We identified the B.1.1.7 variant in 85% of cases, similar to its prevalence in the community.1,16”
From Covid-19 Breakthrough Infections in Vaccinated Health Care Workers (2021) · cites this paper as [1]
In the citing paper
“In cohort studies from Israel and Qatar, the BNT162b vaccine also retained greater than 90% efficacy against this variant 210,211 (TABLe 2).”
From The biological and clinical significance of emerging SARS-CoV-2 variants (2021) · cites this paper as [210]
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Citations
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BackgroundBreakthrough SARS-COV-2 infection induces broad anti-viral T cell immunity
Lineburg, K. E., Crooks, P., Raju, J., Texier, L. L., Khaledi, P., Berry, K., Swaminathan, S., Panikkar, A., Rehan, S., Guppy-Coles, K., et al. (2023) · iScience · doi:10.1016/j.isci.2023.108474 · Cited by 9
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“An observational study from Israel [20] reported a higher estimate: in the period of ≥7 days after the second dose of BNT162b2 the vaccine effectiveness in the elderly was 88.”
BackgroundResultInfluentialPetráš, M., Lesná, I. K., Večeřová, L., Nyčová, E., Malinová, J., Klézl, P., Nezvedová, M., White, R. E., Máčalík, R., Dáňová, J., et al. (2021) · Vaccines · doi:10.3390/vaccines10010009 · Cited by 9
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mRNA vaccine-a desirable therapeutic strategy for surmounting COVID-19 pandemic
Chen, P., Shi, X., He, W., Zhong, G., Tang, Y., Wang, H., & Zhang, P. (2022) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2022.2040330 · Cited by 10
“However, the elders, a high-risk group of virus infection, it is necessary to inoculate vaccine as vaccine protection is still acceptable.(44)”
BackgroundBarmpounakis, P., Demiris, N., Kontoyiannis, I., Pavlakis, G. N., & Sypsa, V. (2022) · PLoS ONE · doi:10.1371/journal.pone.0263977 · Cited by 9
“We consider reduced infection probability for children by 48% [39].”
BackgroundModeling the Influence of Vaccine Administration on COVID-19 Testing Strategies
Forde, J. E., & Ciupe, S. M. (2021) · Viruses · doi:10.3390/v13122546 · Cited by 9
Bajpai, J., Kant, S., Verma, A. K., Patwa, A. K., Atam, V., Chaudhary, S. C., & Pandey, A. K. (2022) · Cureus · doi:10.7759/cureus.25378 · Cited by 9
“Most clinical trials on post-vaccination COVID-19 looked at disease severity in terms of symptomatic or asymptomatic presentation, the number of hospitalizations, ICU admissions, MV, or death events [22,23], concluding that vaccinated patients had a lower severity (depending on the study design).”
BackgroundSARS-CoV-2 vaccines in children and adolescents: Can immunization prevent hospitalization?
Liang, K., Hung, K.-F., Wang, M., Chang, T.-J., Cheng, Y., Chiang, S., Chen, M., Liao, Y.-T., Chiou, S., & Yang, D. (2022) · Journal of the Chinese Medical Association · doi:10.1097/jcma.0000000000000774 · Cited by 9
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Horváth, J. K., Ferenci, T., Ferenczi, A., Túri, G., Röst, G., & Oroszi, B. (2022) · Vaccines · doi:10.3390/vaccines10111824 · Cited by 11
González-Block, M. Á., Gutiérrez-Calderón, E., & Sarti, E. (2022) · Vaccines · doi:10.3390/vaccines10111944 · Cited by 9
“These perceptions are contrary to actual risks and the expected effectiveness of COVID-19 vaccines in reducing severity and death rather than transmission [23,24].”
ResultGrassi, T., Lobreglio, G., Panìco, A., Rosato, C., Zizza, A., Lazzari, R., Chicone, M., Indino, F., & Bagordo, F. (2022) · Vaccines · doi:10.3390/vaccines10111948 · Cited by 10
“It is now universally recognized that vaccination is the safest and optimal tool to protect people against COVID-19 infection, hospitalization, and death [1].”
Valencia, J. S., Soto-Becerra, P., Escobar-Agreda, S., Fernández-Navarro, M., Moscoso‐Porras, M., Solari, L., & Mayta‐Tristán, P. (2023) · Travel Medicine and Infectious Disease · doi:10.1016/j.tmaid.2023.102565 · Cited by 9
“[25] This could be the case, particularly for infection, as our estimates of effectiveness were lower than those reported with the mRNA vaccines in Israel [25], and the USA.”
Beccia, F., Lontano, A., Rossi, M. F., Marziali, E., Pascucci, D., Raponi, M., Santoro, P. E., Moscato, U., & Laurenti, P. (2023) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2023.2252708 · Cited by 9
Impact of SARS-CoV-2 vaccines on Covid-19 incidence and mortality in the United States
Fang, F., Clemens, J. D., Zhang, Z., & Brewer, T. F. (2024) · PLoS ONE · doi:10.1371/journal.pone.0301830 · Cited by 9
“This observation was consistent with the Israeli study 223 showing declined COVID-19 incidence as vaccination rates increased.(25) Similar results were 224 found in the stratified analyses of 10% incremental increases in vaccination rates.”
ResultRosero‐Bixby, L. (2022) · JMIR Public Health and Surveillance · doi:10.2196/35054 · Cited by 11
“The 2-dose Pfizer-BioNTech VEH was 97% in Israel [3], 98% in Ontario, Canada, in a vaccination program that had primarily allocated Pfizer-BioNTech vaccine (77%) [4], 91% in the United States in the first 4 months after full vaccination [5], 90% in California when 93% of COVID-19 cases were caused by the Delta variant…”
BackgroundInfluentialEvolution of Anti-SARS-CoV-2 IgG Antibody and IgG Avidity Post Pfizer and Moderna mRNA VaccinationsPreprint
Bliden, K. P., Liu, T., Sreedhar, D., Kost, J., Hsiung, J., Zhao, S., Shan, D., Usman, A., Walia, N., Cho, A., et al. (2021) · medRxiv · doi:10.1101/2021.06.28.21259338 · Cited by 10
Rodrigues, E. F., Moreno, J., Leite, P. P., Casaca, P., Nunes, B., Gomes, J. P., Ferreira, R., Isidro, J., Borges, V., Vieira, L., et al. (2022) · medRxiv · doi:10.1101/2022.01.21.22268602 · Cited by 9
“Vaccine effectiveness studies have shown that current vaccines effectively prevent symptomatic infection and disease that leads to hospitalization and reduce case-fatality rate (11).”
BackgroundEffectiveness of a nation-wide COVID-19 vaccination program in MexicoPreprint
Bello‐Chavolla, O. Y., Antonio‐Villa, N. E., Valdés‐Ferrer, S. I., Fermín‐Martínez, C. A., Fernández‐Chirino, L., Ramírez‐García, D., Mancilla-Galindo, J., Kammar‐García, A., Ávila‐Funes, J. A., Zuniga, C., et al. (2022) · medRxiv · doi:10.1101/2022.04.04.22273330 · Cited by 9
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“8 As previously reported for other vaccines [28-32], NAb titers were lower to certain SARS153 CoV-2 variants, including B.”
BackgroundChen, S.-C., Xu, C.-T., Chang, C.-F., Chao, T.-Y., Lin, C., Fu, P.-W., & Yu, C. (2023) · Applied Microbiology and Biotechnology · doi:10.1007/s00253-023-12442-2 · Cited by 8
Sun, J., Zheng, Q., Anzalone, A. J., Abraham, A. G., Olex, A. L., Zhang, Y., Mathew, J., Safdar, N., Haendel, M. A., Segev, D. L., et al. (2024) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofae019 · Cited by 9
Muhsen, K., Cohen, D., Glatman‐Freedman, A., Husseini, S., Perlman, S., & McNeil, C. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1308267 · Cited by 12
Rehms, R., Ellenbach, N., Rehfuess, E. A., Burns, J., Mansmann, U., & Hoffmann, S. (2024) · Biometrical Journal · doi:10.1002/bimj.202200341 · Cited by 8
“For example, Haas et al. (2021) found a higher effectiveness against COVID-19-related deaths of the BNT162b2 vaccine.”
BackgroundRobinson, A. G., Mazurek, A., Xu, M., & Gong, Y. (2021) · Current Oncology · doi:10.3390/curroncol29010006 · Cited by 8
Passive immune therapies: another tool against COVID-19
Estcourt, L. J. (2021) · Hematology · doi:10.1182/hematology.2021000299 · Cited by 8
Marrone, G., Nicolay, N., Bundle, N., Karki, T., Spiteri, G., Suija, H., Kärblane, K.-G., Mossong, J., Vergison, A., Avdicova, M., et al. (2022) · Eurosurveillance · doi:10.2807/1560-7917.es.2022.27.7.2200060 · Cited by 8
COVID-19 em Portugal: a estratégia
Duarte, R., Lopes, F., Alves, F. C., Aguiar, A., Monteiro, H. J., Pinto, M., & Felgueiras, Ó. (2022) · doi:10.21814/uminho.ed.71 · Cited by 9
Safety and immune response kinetics of GRAd-COV2 vaccine: phase 1 clinical trial results
Agrati, C., Castilletti, C., Battella, S., Cimini, E., Matusali, G., Sommella, A., Sacchi, A., Colavita, F., Contino, A. M., Bordoni, V., et al. (2022) · npj Vaccines · doi:10.1038/s41541-022-00531-8 · Cited by 9
Papazachariou, A., Tsioutis, C., Lytras, T., Malikides, O., Stamatelatou, M., Vasilaki, N., Milioni, A., Dasenaki, M., & Spernovasilis, N. A. (2022) · Vaccine · doi:10.1016/j.vaccine.2022.12.024 · Cited by 8
“Promoting primary prevention through vaccination, especially for high-risk groups such as the elderly and persons with comorbidities, is crucial for reducing the incidence of severe disease and death [2].”
Rojas-Botero, M. L., Fernández-Niño, J. A., Arregocés-Castillo, L., Palacios-Clavijo, A. F., Pinto-Álvarez, M., & Gómez, F. R. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0001845 · Cited by 8
Liu, Z., Alexander, J. L., Le, K., Zhou, X., Ibraheim, H., Anandabaskaran, S., Saifuddin, A., Lin, K. W., McFarlane, L. R., Constable, L. E., et al. (2023) · EClinicalMedicine · doi:10.1016/j.eclinm.2023.102249 · Cited by 8
Vaccinating against a Novel Pathogen: A Critical Review of COVID-19 Vaccine Effectiveness Evidence
Black, B. S., & Thaw, D. B. (2023) · Microorganisms · doi:10.3390/microorganisms12010089 · Cited by 9
“S vaccine against hospitalization and death was below the levels seen for the other vaccines. in [37,38] overlap. a The value for [36] is an average of estimates for shorter time periods after second dose. b Results reported as “100%” indicate no qualifying events in the treatment group and do not…”
BackgroundPaul, É., Brown, G. W., Ridde, V., & Sturmberg, J. P. (2024) · Public Health in Practice · doi:10.1016/j.puhip.2024.100493 · Cited by 14
“An analysis of the first four months of vaccination campaign in Israel, published on May 5, 2021, estimated the Pfizer vaccine effectiveness after 7 days of second dose to be between 91.5% for asymptomatic infection and 97.5% against severe or critical Covid-19-related hospitalisation [29].”
MethodInfluentialBurian, K., Heidler, F., Frahm, N., Hecker, M., Langhorst, S. E., Mashhadiakbar, P., Streckenbach, B., Baldt, J., Meißner, J., Richter, J., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-62541-x · Cited by 9
Lin, Y., Chang, Y., Chou, W., & Yen, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147260 · Cited by 8
“The experience of Israel indicated that vaccination against COVID-19 is effective in preventing symptomatic and asymptomatic COVID-19 infections and COVID-19-related hospitalizations, severe disease, and death [28].”
BackgroundJumping a Moving Train: SARS-CoV-2 Evolution in Real Time
Moustafa, A. M., & Planet, P. J. (2021) · Journal of the Pediatric Infectious Diseases Society · doi:10.1093/jpids/piab051 · Cited by 8
Briz‐Redón, Á., & Serrano‐Aroca, Á. (2022) · Stochastic Environmental Research and Risk Assessment · doi:10.1007/s00477-021-02166-y · Cited by 9
“However, the COVID-19 VE in reducing the COVID-19 transmission is still unclear, even though the study performed in Israel showed an association between COVID-19 incidence and vaccination (Haas et al., 2021).”
BackgroundResultInfluentialCOVID-19 Vaccination in Children: An Open Question
Bardanzellu, F., Campagnani, G., Pintus, M. C., Fanos, V., & Marcialis, M. A. (2021) · Current Pediatric Reviews · doi:10.2174/1573396318666211220093111 · Cited by 8
Ntziora, F., Kostaki, E. G., Grigoropoulos, I., Karapanou, Α., Kliani, I., Mylona, M., Thomollari, A., Tsiodras, S., Zaoutis, T., Paraskevis, D. N., et al. (2021) · Viruses · doi:10.3390/v14010026 · Cited by 8
Recurrence of Varicella-Zoster Virus Keratitis After SARS-CoV-2 Vaccination
Ryu, K. J., & Kim, D. H. (2022) · Cornea · doi:10.1097/ico.0000000000002999 · Cited by 8
The early impact of vaccination against SARS-CoV-2 in Region Stockholm, Sweden
Isitt, C. E., Sjöholm, D., Hergens, M., Granath, F. N., & Nauclér, P. (2022) · Vaccine · doi:10.1016/j.vaccine.2022.03.061 · Cited by 8
Reliably Assessing Duration of Protection for Coronavirus Disease 2019 Vaccines
Lin, D.-Y., Zeng, D., Gu, Y., Krause, P. R., & Fleming, T. R. (2022) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiac139 · Cited by 8
Ohara, Y., Kanie, J., & Hori, K. (2022) · HardwareX · doi:10.1016/j.ohx.2022.e00314 · Cited by 8
Zürcher, K., Abela, I. A., Stange, M., Dupont, C., Mugglin, C., Egli, A., Trkola, A., Egger, M., & Fenner, L. (2022) · Clinical Infectious Diseases · doi:10.1093/cid/ciab1005 · Cited by 8
“3) against COVID-19-related death (26).”
Siqueira, P. G., Duarte, H. O., & Moura, M. D. C. (2022) · Vaccine · doi:10.1016/j.vaccine.2022.05.038 · Cited by 10
“CoronaVac (CV): developed by Sinovac Life Sciences (Beijing, China) that uses the inactivated virus SARS-CoV-2 [14], AstraZeneca (AZ): the adenoviral vector vaccine that encodes full-length spike protection, developed by the University of Oxford and AstraZeneca [36], Pfizer (PF): a nucleoside modified mRNA encoding fu…”
Fox-Fisher, I., Piyanzin, S., Briller, M., Oiknine‐Djian, E., Alfi, O., Ben‐Ami, R., Peretz, A., Neiman, D., Ochana, B.-L., Fridlich, O., et al. (2022) · Med · doi:10.1016/j.medj.2022.05.005 · Cited by 8
Panìco, A., Lobreglio, G., Bagordo, F., Zizza, A., Donno, A. D., Rosato, C., Lazzari, R., Chicone, M., Indino, F., Recchia, V., et al. (2022) · Vaccines · doi:10.3390/vaccines10060862 · Cited by 8
Yupari-Azabache, I. L., Díaz-Ortega, J. L., Bardales-Aguirre, L. B., Sevillano, S. B., & Paredes-Díaz, S. E. (2022) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s374385 · Cited by 9
“However, the mainstay is vaccines, which decrease both the transmission of beta-coronavirus and the severity of the disease by stimulating antibody formation.(2,3) For decades, vaccines have been used as the main public health weapon to eliminate or reduce the risk of complications leading to death, as well as to redu…”
BackgroundVeys-Takeuchi, C., Gonseth, S., Estoppey, S., Zuppinger, C., Dupraz, J., Pasquier, J., Faivre, V., Scuderi, R., Vassaux, S., Bochud, M., et al. (2022) · International Journal of Public Health · doi:10.3389/ijph.2022.1604987 · Cited by 7
Fantin, R., Herrero, R., Hildesheim, A., Barboza‐Solís, C., Aparicio, A., Prevots, D. R., Pfeiffer, R. M., Gail, M. H., & the RESPIRA Study Group (2022) · BMC Infectious Diseases · doi:10.1186/s12879-022-07740-5 · Cited by 8
“The study of tozinameran in Israel [3] followed vaccinated and unvaccinated people through record linkage and reported effectiveness estimates of 97.”
BackgroundResultInfluentialMunamm, S. A. U., Nadeem, I., Mahdi, N., Saqlain, M., Rana, Z. K., Khatana, U. F., Bhatty, U., Navayogaarajah, V., Khan, F., & Rasool, M. U. (2022) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.1177/14782715221131409 · Cited by 9
Self-citationHussein, K., Dabaja‐Younis, H., Szwarcwort‐Cohen, M., Almog, R., Leiba, R., Weissman, A., Mekel, M., Hyams, G., Horowitz, N. A., Gepstein, V., et al. (2022) · Vaccines · doi:10.3390/vaccines10101741 · Cited by 8
“Published studies from Israel related to a two-dose regimen of the BNT162b2 vaccine between December 2020 and April 2021 have reported on its efficacy, effectiveness, and immunogenicity [2,3].”
BackgroundLaydon, D. J., Cauchemez, S., Hinsley, W. R., Bhatt, S., & Ferguson, N. M. (2023) · The Lancet Global Health · doi:10.1016/s2214-109x(23)00117-1 · Cited by 7
Cheung, K. S., Yan, V. K. C., Lam, L. K., Ye, X., Hung, I. F., Chan, E. W., & Leung, W. K. (2023) · Vaccines · doi:10.3390/vaccines11081341 · Cited by 8
“Vaccination is one of the most important measures in preventing severe symptoms and death [1].”
BackgroundPostvaccination SARS-COV-2 among Health Care Workers in New Jersey: A Genomic Epidemiological Study
Mathema, B., Chen, L., Chow, K. F., Zhao, Y., Zody, M. C., Mediavilla, J. R., Cunningham, M. H., Composto, K., Lee, A., Oschwald, D. M., et al. (2021) · Microbiology Spectrum · doi:10.1128/spectrum.01882-21 · Cited by 7
Kageyama, T., Tanaka, S., Etori, K., Hattori, K., Miyachi, K., Kasuya, T., Iwamoto, T., Ikeda, K., Igari, H., Yokote, K., et al. (2021) · Vaccine · doi:10.1016/j.vaccine.2022.02.045 · Cited by 8
Mor, O., Zuckerman, N. S., Hazan, I., Fluss, R., Ash, N., Ginish, N., Mendelson, E., Alroy‐Preis, S., Freedman, L. S., & Huppert, A. (2021) · medRxiv · doi:10.1101/2021.07.20.21260833 · Cited by 8
Self-citationStreamlined and on-demand preparation of mRNA products on a universal integrated platform
Wei, H., Rong, Z., Liu, L., Sang, Y., Yang, J., & Wang, S. (2023) · Microsystems & Nanoengineering · doi:10.1038/s41378-023-00538-8 · Cited by 7
Evolving SARS-CoV-2 Vaccines: From Current Solutions to Broad-Spectrum Protection
Qiao, R., Li, J., Gong, J., Shao, Y., Yu, J., Chen, Y., Lu, Y., Yang, L., Lin, L., Hu, Z., et al. (2025) · Vaccines · doi:10.3390/vaccines13060635 · Cited by 8
“While the BNT162b2 vaccine maintained broad-spectrum efficacy against dominant SARS-CoV-2 variants during the early phases of the pandemic [134], the emergence of antigenically divergent Omicron sublineages exhibiting enhanced immune evasion mechanisms has progressively eroded its protective…”
How many hospitalizations has the COVID-19 vaccination already prevented in São Paulo?
Izbicki, R., Bastos, L. S., Izbicki, M., Lopes, H. F., & dos Santos, T. M. (2021) · Clinics · doi:10.6061/clinics/2021/e3250 · Cited by 7
Klavs, I., Serdt, M., Učakar, V., Grgič-Vitek, M., Fafangel, M., Mrzel, M., Berlot, L., Glavan, U., Vrh, M., Kustec, T., et al. (2021) · Eurosurveillance · doi:10.2807/1560-7917.es.2021.26.42.2100937 · Cited by 7
He, Z., Xiang, H., Manyande, A., Xu, W., Li, F., & Xiang, B. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.736060 · Cited by 7
Deb, P., Molla, M. M. A., Saif‐Ur‐Rahman, K., Das, M. C., & Das, D. (2021) · Egyptian Journal of Bronchology · doi:10.1186/s43168-021-00090-x · Cited by 7
Sathyapalan, D. T., Moni, M., Prasanna, P., Marwaha, V., Madathil, S. B., Edathadathil, F., Jose, S. A., Pavithran, S., Muralikrishanan, R., Ramachandran, N., et al. (2022) · Vaccine X · doi:10.1016/j.jvacx.2022.100210 · Cited by 7
“AEFI related symptoms were reported to be lower among mRNA platform-based vaccine recipients receiving second dose vaccination with prior COVID history in comparison to those without a past history of COVID [12,19,22].”
ResultMusa, H. H., & Musa, T. H. (2022) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2022.2135927 · Cited by 11
Grupel, D., Pasternak, Y., & Schonmann, Y. (2022) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2022.11.009 · Cited by 7
The COVID-19 experience in Africa and the Middle East
Bizri, A. R., Akoury, N. A., Mhlanga, T., Morales, G. D. C., Haridy, H., Hussey, G. D., & Srivastava, A. K. (2023) · Annals of Medicine · doi:10.1080/07853890.2023.2222641 · Cited by 10
Dou, X., Peng, M., Jiang, R., Li, W., & Zhang, X. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1174406 · Cited by 7
Metadata
- Authors
- Haas, E. J., Angulo, F. J., McLaughlin, J. M., Anis, E., Singer, S. R., Khan, F., Brooks, N., Smaja, M., Mircus, G., Pan, K., Southern, J., Swerdlow, D. L., Jodar, L., Levy, Y., & Alroy-Preis, S.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- Pfizer (United States) (US)
- Hebrew University of Jerusalem (IL)
- Israel Ministry of Health (IL)
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 397
- Issue
- 10287
- Pages
- 1819-1829
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC8099315
- OpenAlex
- W3158276912
- Semantic Scholar
- 096d4aae680648191460c8297e1a9d74c3a73c03
- Cited by
- 1,564
- References
- 19
- Citations by year
- 2026: 36 · 2025: 68 · 2024: 161 · 2023: 277 · 2022: 604 · 2021: 417
- FWCI
- 115.42
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-07-17)
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Harvard University
- Weizmann Institute of Science
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- BNT162b2, COVID-19 mRNA vaccine, SARS-CoV-2, COVID-19 vaccine effectiveness, real-world effectiveness, COVID-19 hospitalization, COVID-19 mortality, asymptomatic infection, symptomatic infection, vaccine uptake, B.1.1.7 variant, public health impact
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Vaccines, BNT162 Vaccine, Adolescent, Adult, Aged, Aged, 80 and over, Female, Hospitalization, Humans, Israel, Male, Middle Aged, Population Surveillance, RNA, Messenger, Incidence, Mass Vaccination, Young Adult, Asymptomatic Infections, Pandemics
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