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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]
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“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]
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“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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The value of vaccine programme impact monitoring during the COVID-19 pandemic
Ortiz, J. R., & Neuzil, K. M. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02322-9 · Cited by 6
Kajanová, I., Lukáčiková, Ľ., Jelenska, L., Grossmannova, K., Rádiková, Ž., Vlček, M., Klempa, B., Kollár, R., Boďová, K., Kopáček, J., et al. (2021) · Acta Virologica · doi:10.4149/av_2021_407 · Cited by 6
Milazzo, L., Pezzati, L., Oreni, L. M., Kullmann, C., Lai, A., Gabrieli, A., Bestetti, G., Beschi, C., Conti, F., Ottomano, C., et al. (2021) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2021.2002639 · Cited by 6
Kanakan, A., Mehta, P., Devi, P., Saifi, S., Swaminathan, A., Maurya, R., Chattopadhyay, P., Tarai, B., Das, P., Jha, V., et al. (2022) · Frontiers in Microbiology · doi:10.3389/fmicb.2022.763169 · Cited by 6
“Several studies highlighting these aspects have been published (Butt et al., 2021; Daniel et al., 2021; Haas et al., 2021).”
BackgroundProgression to Critical Illness and Death in Patients With Breakthrough Hospitalizations
Suleyman, G., Fadel, R. A., Alsaadi, A., Ng-Sueng, L. F., Ghandour, A., Alkhatib, A., Singh, T., Parsons, A. J., Miller, J. B., Ramesh, M. S., et al. (2022) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofac213 · Cited by 6
“Haas EJ, Angulo FJ, McLaughlin JM, et al. 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.”
BackgroundInfluentialFano, V., Coviello, E., Consonni, D., Agresta, A., Orsini, N., Crielesi, A., Miglietta, A. S., Pasqua, C., Vairo, F., Vivaldi, F., et al. (2022) · Expert Review of Vaccines · doi:10.1080/14760584.2022.2080057 · Cited by 7
Third booster vaccination and stopping the Omicron, a new variant of concern
Ghazvini, K., Karbalaei, M., & Keikha, M. (2022) · Vacunas · doi:10.1016/j.vacun.2022.05.005 · Cited by 6
Effectiveness of the Inactivated SARS-CoV-2 (Vero Cell) Vaccine in Peruvian Health Workers
Solís-Castro, M. E., Jaramillo-Corrales, A., Seminario, R. V. G., Grados, N. J., Pilco, I. E. M., Quispe, K. E. V., Torre, L. L., Dominguez, M. N. V., Cusi, D. E., Minaya, P., et al. (2022) · Life · doi:10.3390/life12091318 · Cited by 6
Ochnik, D., Rogowska, A. M., Benatov, J., & Arzenšek, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811587 · Cited by 5
Macrae, K., Gong, C. Y., Sheth, P. M., Martínez-Cajas, J., & Gong, Y. (2022) · Vaccines · doi:10.3390/vaccines10101590 · Cited by 6
Ikeda, K., Nakada, T., Kageyama, T., Tanaka, S., Yoshida, N., Ishikawa, T., Goshima, Y., Otaki, N., Iwami, S., Shimamura, T., et al. (2022) · iScience · doi:10.1016/j.isci.2022.105237 · Cited by 6
“…the phase 3 trials that provided the basis for emergency use authorization, have shown that the SARS-CoV-2 vaccines reduce the infection, severe disease, and death of COVID-19 (Baden et al., 2021; Dagan et al., 2021; Frenck et al., 2021; Haas et al., 2021; Polack et al., 2020; Voysey et al., 2021).”
Kumar, S., Singh, R., Munta, K., Prakash, J., Khan, M. S., Kumar, R., Havaldar, A. A., Sheshala, K., Thomas, T. S., Raj, J. M., et al. (2022) · Indian Journal of Critical Care Medicine · doi:10.5005/jp-journals-10071-24349 · Cited by 6
The role of Israeli researchers in the scientific literature regarding COVID-19 vaccines
Rosen, B., Davidovitch, N., Chodick, G., & Israeli, A. (2022) · Israel Journal of Health Policy Research · doi:10.1186/s13584-022-00548-3 · Cited by 7
Łodyga, M., Maciejewska, K., & Rydzewska, G. M. (2022) · Medical Science Monitor · doi:10.12659/msm.938665 · Cited by 6
Lai, Y.-H., Chen, H.-Y., Chiu, H., Kang, Y., & Wong, S. (2022) · Vaccines · doi:10.3390/vaccines10122174 · Cited by 7
Impact of COVID-19 Pandemic on Human Papillomavirus Vaccine Uptake in Israel
Lavie, M., Lavie, I., Laskov, I., Cohen, A., Grisaru, D., Grisaru‐Soen, G., & Michaan, N. (2023) · Journal of Lower Genital Tract Disease · doi:10.1097/lgt.0000000000000729 · Cited by 6
Kampo Medicine Treatment for Coronavirus Disease 2019 (COVID-19)
Takayama, S., Namiki, T., Odaguchi, H., Mitani, K., Yakubo, S., Hisanaga, A., Kainuma, M., & Takashi, I. T. O. (2022) · 日本東洋醫學雜誌 · doi:10.3937/kampomed.73.117 · Cited by 6
Sayeed, M. A., Shalim, E., Farooqui, F., Farman, S., Khan, M., Iqbal, A., Ahmed, I., Rajput, A. W., Razzaque, A., & Quraishy, S. (2023) · Vaccines · doi:10.3390/vaccines11071178 · Cited by 6
Alebrahim, E., Khatibnezhad, H., Bajgiran, M. M., Solomon, M., Liang, C., Sagan, S. M., Lima, R. S., Berghaus, J. O., Aghasibeig, M., & Moreau, C. (2023) · Catalysts · doi:10.3390/catal13071141 · Cited by 6
Costa, G. J., da Silva, J. R., da Silva, C. C. A., Lima, T. P., Costa, M. M., Sousa, M. H. O., Costa, G. C. D. S., Júnior, J. I. C., & Sales, M. J. T. (2023) · Jornal Brasileiro de Pneumologia · doi:10.36416/1806-3756/e20230145 · Cited by 8
“(2-4,11,12) Vaccines against SARS-CoV-2 have been effective in reducing the number of new COVID-19 cases, hospitalizations, ICU admissions, and deaths.(5,6,13) Our study showed that, after multivariate regression analysis, the risk factors for death, even in vaccinated patients after the multivariate regression analys…”
BackgroundA Qualitative Study on Barriers to COVID-19 Vaccine Uptake among Community Members in Tanzania
Mgongo, M., Manongi, R. N., Mboya, I. B., Ngocho, J. S., Amour, C., Mtei, M., Bilakwate, J. S., Nyaki, A. Y., George, J. M., Leyaro, B. J., et al. (2023) · Vaccines · doi:10.3390/vaccines11081366 · Cited by 6
Lenart, C., Prager, M., Sachs, M., Steininger, C., Fernandes, C., & Thannesberger, J. (2023) · International Journal of Public Health · doi:10.3389/ijph.2023.1606042 · Cited by 6
Cernera, G., Gelzo, M., Placido, P. D., Pietroluongo, E., Raia, M., Scalia, G., Tortora, M., Formisano, P., Palmieri, G., Giuliano, M., et al. (2024) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2023-1283 · Cited by 6
Montagud, A. C., Llenas‐García, J., Moragues, R., Pérez-Bernabeu, A., Pertegal, M. J. A., Gómez, F. J. G., Serna, A. M. G., Morante, H. G., Caballero, P., & Tuells, J. (2024) · Revista Clínica Española · doi:10.1016/j.rce.2024.01.009 · Cited by 7
Immune Assessment of BNT162b2 m-RNA-Spike Based Vaccine Response in Adults
Segundo, D. S., Comins‐Boo, A., Irure‐Ventura, J., Renuncio‐García, M., Roa‐Bautista, A., González-López, E., Merino-Fernández, D., Lamadrid-Perojo, P., Alonso‐Peña, M., Ocejo-Vinyals, J. G., et al. (2021) · Biomedicines · doi:10.3390/biomedicines9080868 · Cited by 6
“The efficacy of vaccines in clinical trials has been described based on the frequency of infected cases and hospitalization after vaccination [17].”
BackgroundOhtake, F. (2021) · Japanese Economic Review · doi:10.1007/s42973-021-00095-7 · Cited by 7
Tekol, S. D. (2021) · Southern Clinics of Istanbul Eurasia · doi:10.14744/scie.2021.94899 · Cited by 5
Guzmán, C. A. F., Montero‐Zamora, P., Bolaños-Palmieri, C., Araya-Amador, J., Benavides-Rawson, J., & Avila-Aguero, M. L. (2021) · Cureus · doi:10.7759/cureus.18798 · Cited by 6
“Immunizations are one of the most successful and cost-effective health interventions for preventing infectious diseases, and vaccines against SARS-CoV-2 are, at the moment, the most effective strategies for controlling the current pandemic [4].”
BackgroundAvivi-Mintz, S., Lustig, Y., Indenbaum, V., Schwartz, E., & Danielli, A. (2021) · Biosensors · doi:10.3390/bios12010007 · Cited by 6
“The gold standard for the diagnosis of coronavirus disease 2019 (COVID-19) uses the reverse-transcription quantitative polymerase chain reaction (RT-qPCR) to directly detect the virus’ ribonucleic acid (RNA) in nasopharyngeal swab samples [1,2].”
ResultInfluentialAbd-Elsayed, A. A., & D'Souza, R. S. (2022) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000005858 · Cited by 6
Vocal fold paralysis following first dose of Oxford-AstraZeneca coronavirus disease 2019 vaccine
Jama, G. M., Amin, M., Hassaan, A. M., & Kaddour, H. S. (2022) · The Journal of Laryngology & Otology · doi:10.1017/s0022215122000597 · Cited by 6
Lombardi, A., Renisi, G., Consonni, D., Oggioni, M., Bono, P., Renteria, S. U., Piatti, A., Pesatori, A. C., Castaldi, S., Muscatello, A., et al. (2022) · BMC Infectious Diseases · doi:10.1186/s12879-022-07083-1 · Cited by 7
Tamura, M., Fujita, R., Sato, T., Sato, R., Kato, Y., Nagasawa, M., & Matsumoto, T. (2022) · Journal of Infection and Chemotherapy · doi:10.1016/j.jiac.2022.07.006 · Cited by 6
Immune Response to COVID-19 in India through Vaccination and Natural Infection
Sarraf, T. R., Maity, S., Ghosh, A. K., Bhattacharjee, S., Pani, A., Saha, K., Chattopadhyay, D., Ghosh, G., & Sen, M. (2022) · Fortune Journal of Health Sciences · doi:10.26502/fjhs.070 · Cited by 6
Li, J., Li, Z., Zhu, Y., Zhou, L., & Zhu, F. (2022) · Zoonoses · doi:10.15212/zoonoses-2022-0025 · Cited by 6
Monod, M., Blenkinsop, A., Brizzi, A., Chen, Y., Perello, C. C. C., Jogarah, V., Wang, Y., Flaxman, S. R., Bhatt, S., & Ratmann, O. (2022) · Bayesian Analysis · doi:10.1214/22-ba1334 · Cited by 7
Hertz‐Palmor, N., Ruppin, S., Matalon, N., Mosheva, M., Dorman-Ilan, S., Serur, Y., Avinir, A., Mekori‐Domachevsky, E., Hasson‐Ohayon, I., Gross, R., et al. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115119 · Cited by 6
“older) had received two doses of Pfizer’s BNT162b2 vaccine (Haas et al., 2021), making Israel the country with the highest per capita vaccinated population globally (Shilo et al.”
Iacobucci, G. (2021) · BMJ · doi:10.1136/bmj.n1164 · Cited by 6
Effectiveness of mRNA COVID-19 Vaccines among Employees in an American Healthcare SystemPreprint
Shrestha, N. K. M., Nowacki, A. S., Burke, P. C., Terpeluk, P., & Gordon, S. M. (2021) · medRxiv · doi:10.1101/2021.06.02.21258231 · Cited by 6
“This study found that the mRNA SARS-CoV-2 vaccines were 97.1% effective in protecting against SARS-CoV-2 infection, an effectiveness that was similar to vaccine efficacy noted in previously published clinical trials [1,2], and in large vaccine effectiveness studies in Israel [3,4].”
ResultInfluentialHosani, F. I. A., Stanciole, A. E., Aden, B., Timoshkin, A., Najim, O., Zaher, W. A., AlDhaheri, F. A., Mazrouei, S. A., Rizvi, T. A., & Mustafa, F. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3951143 · Cited by 6
Paul, E., & Fancourt, D. E. (2022) · medRxiv · doi:10.1101/2022.04.06.22273444 · Cited by 5
Allzain, H. (2021) · International Journal of Research -GRANTHAALAYAH · doi:10.29121/granthaalayah.v9.i7.2021.4062 · Cited by 5
“Iacobucci (2021), Ej et al. (2021) , Leshem andWilder-Smith (2021) A consistently high ef icacy of over .”
BackgroundMorfeld, P., Timmermann, B., Lewis, P., & Erren, T. C. (2022) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2022.0208 · Cited by 5
Özsoy, M., Cesur, S., Hatipoğlu, Ç. A., Erdinç, F. Ş., Ertem, G. T., & KINIKLI, S. (2023) · Anatolian Current Medical Journal · doi:10.38053/acmj.1218224 · Cited by 5
Syrimi, N., Sourri, F., Giannakopoulou, M.-C., Karamanis, D., Pantousas, A., Georgota, P., Rokka, E., Vladeni, Z., Tsiantoula, E., Soukara, E., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12093172 · Cited by 5
Vanetti, C., Stracuzzi, M., Crivellaro, E., Ciciliano, F., Garziano, M., Fenizia, C., Biasin, M., Rubinacci, V., Amendola, A., Tanzi, E., et al. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1301766 · Cited by 5
COVID-19 Vaccination Strategies in the Endemic Period: Lessons from Influenza
Nham, E., Noh, J. Y., Park, O. H., Choi, W. S., Song, J. Y., Cheong, H. J., & Kim, W. J. (2024) · Vaccines · doi:10.3390/vaccines12050514 · Cited by 6
“In the early phase of COVID-19 vaccinations, VE appeared to be similar between younger and older adults early after vaccination, but it declined faster thereafter in older adults [51,80,81].”
BackgroundSmits, R. A. L., van Raaij, B. F. M., Trompet, S., van der Linden, C. M. J., van der Bol, J. M., Jansen, S. W. M., Polinder‐Bos, H. A., Willems, H. C., van de Glind, E. M. M., Minnema, J., et al. (2024) · European Geriatric Medicine · doi:10.1007/s41999-024-01002-0 · Cited by 5
“Since the introduction of COVID-19 vaccines at the end of 2020, the beneficial effect of vaccination on risk of hospital admission, in-hospital outcomes and mortality has been proven [1, 2].”
BackgroundFormica, V., Piccinni, A., Saraff, G., Zafar, A., Mayer, G., Hummel, S., Schultz, J., Losada, R., Muñoz, E. S., Domínguez, L. M., et al. (2024) · Journal of Public Health · doi:10.1007/s10389-024-02298-9 · Cited by 5
“With the advent of COVID-19 vaccines by December 2020, mass vaccination plans were launched in several countries (Haas et al. 2021).”
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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