BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting
Open accessAbstract
BACKGROUND: As mass vaccination campaigns against coronavirus disease 2019 (Covid-19) commence worldwide, vaccine effectiveness needs to be assessed for a range of outcomes across diverse populations in a noncontrolled setting. In this study, data from Israel's largest health care organization were used to evaluate the effectiveness of the BNT162b2 mRNA vaccine. METHODS: All persons who were newly vaccinated during the period from December 20, 2020, to February 1, 2021, were matched to unvaccinated controls in a 1:1 ratio according to demographic and clinical characteristics. Study outcomes included documented infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), symptomatic Covid-19, Covid-19-related hospitalization, severe illness, and death. We estimated vaccine effectiveness for each outcome as one minus the risk ratio, using the Kaplan-Meier estimator. RESULTS: Each study group included 596,618 persons. Estimated vaccine effectiveness for the study outcomes at days 14 through 20 after the first dose and at 7 or more days after the second dose was as follows: for documented infection, 46% (95% confidence interval [CI], 40 to 51) and 92% (95% CI, 88 to 95); for symptomatic Covid-19, 57% (95% CI, 50 to 63) and 94% (95% CI, 87 to 98); for hospitalization, 74% (95% CI, 56 to 86) and 87% (95% CI, 55 to 100); and for severe disease, 62% (95% CI, 39 to 80) and 92% (95% CI, 75 to 100), respectively. Estimated effectiveness in preventing death from Covid-19 was 72% (95% CI, 19 to 100) for days 14 through 20 after the first dose. Estimated effectiveness in specific subpopulations assessed for documented infection and symptomatic Covid-19 was consistent across age groups, with potentially slightly lower effectiveness in persons with multiple coexisting conditions. CONCLUSIONS: This study in a nationwide mass vaccination setting suggests that the BNT162b2 mRNA vaccine is effective for a wide range of Covid-19-related outcomes, a finding consistent with that of the randomized trial.
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The 7-day cutoff for defining breakthrough infection was chosen based on previous research on BNT162b2 vaccine effectiveness.
“The 7-day cutoff was chosen based on previous research the BNT162b2 vaccine effectivenesss1,11.”
From Waning effectiveness of the third dose of the BNT162b2 mRNA COVID-19 vaccine (2022) · cites this paper as [1]
Observational postmarketing studies, including this analysis, have consistently demonstrated a strong association between vaccination and risk reductions in COVID-19 hospitalization in immunocompetent individuals.
“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 [2]
High effectiveness (>80%) against severe disease and hospitalization has been reported for BNT162b2 and ChAdOx1 nCoV-19.
“It should be noted that high effectiveness (>80%) against severe disease and hospitalization has been reported for both BNT162b2 (refs93,94) and ChAdOx1 nCoV-19 (ref.95).”
From Immunological mechanisms of vaccine-induced protection against COVID-19 in humans (2021) · cites this paper as [93]
Early post-implementation analyses suggest mRNA vaccines reduce asymptomatic infection incidence and nasopharyngeal viral load in people infected despite vaccination.
“Some early post-implementation analyses have suggested that the mRNA vaccines also reduce the incidence of asymptomatic infection and the nasopharyngeal viral load in individuals who become infected despite the vaccination93,107, but it is yet unclear how this translates to risk of transmission.”
From Immunological mechanisms of vaccine-induced protection against COVID-19 in humans (2021) · cites this paper as [93]
The BNT162b2 Pfizer/BioNTech COVID-19 vaccine retains its efficacy against B.1.1.7 in the UK and in reports from Israel.
“Current epidemiological evidence is that the BNT162b2 Pfizer/BioNTech COVID-19 vaccine retains its efficacy against B.1.1.7 in the UK24 and in reports from Israel.28,29”
From Impact of SARS-CoV-2 variants on the total CD4+ and CD8+ T cell reactivity in infected or vaccinated individuals (2021) · cites this paper as [29]
The BNT162b2 vaccine has shown 94 to 95% efficacy and real-world effectiveness against symptomatic Covid-19 from 7 days after the second dose.
“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 [3]
Non-neutralizing antibody production after the first mRNA dose is substantial and occurs when neutralizing titers are low or absent.
“it is substantial and occurs during a time when neutralizing antibody titers are either very low or absent (Baden et al., 2020; Dagan et al., 2021; Polack et al., 2020).”
From SARS-CoV-2 mRNA vaccination induces functionally diverse antibodies to NTD, RBD, and S2 (2021) · cites this paper as Dagan et al., 2021
The BNT162b2 vaccine has been highly effective in preventing clinically significant Covid-19.
“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 [3]
Variability in vaccine effectiveness estimates between studies could result from differences in study design, testing protocols, and study populations.
“Variability in estimates of vaccine effectiveness between studies could result from differences in study design, testing protocols, and study populations”
BNT162b2 has shown high efficacy and an acceptable safety profile.
“BNT162b2, a messenger RNA (mRNA)-based vaccine, has demonstrated a high efficacy rate with an acceptable safety profile. 1 2”
Clinical studies have reported somewhat reduced efficacy and effectiveness against the B.1.1.7, B.1.351, and B.1.617.2 variants.
“Likewise, clinical studies have reported somewhat reduced efficacy and effectiveness against the B.1.1.7, B.1.351, and B.1.617.2 variants (10–12).”
From Durability of mRNA-1273 vaccine–induced antibodies against SARS-CoV-2 variants (2021) · cites this paper as [11]
In a mass vaccination study which included 3,159,136 participants from Israel, vaccine effectiveness of BNT162b2 as a two-dose scheme was 94%.
“In a mass vaccination study which included 3,159,136 participants from Israel, vaccine effectiveness of BNT162b2 as a two-dose scheme was 94%.397”
From Advances in COVID-19 mRNA vaccine development (2022) · cites this paper as [397]
BNT162b2 has >90% efficacy in real-world conditions in the USA and Israel.
“>90% efficacy in real-world conditions in USA132 and Israel126”
From mRNA vaccines for infectious diseases: principles, delivery and clinical translation (2021) · cites this paper as [126]
In a mass vaccination campaign involving 3,159,136 participants in Israel, two doses of BNT162b2 were 94% effective at preventing symptomatic COVID-19, 87% effective at preventing hospitalizations and 92% effective at preventing the onset of severe COVID-19.
“In a mass vaccination campaign involving 3,159,136 participants in Israel, two doses of BNT162b2 were 94% effective at preventing symptomatic COVID-19, 87% effective at preventing hospitalizations and 92% effective at preventing the onset of severe COVID-19 (ref.126).”
From mRNA vaccines for infectious diseases: principles, delivery and clinical translation (2021) · cites this paper as [126]
Early protection after a single dose of BNT162b2 has been reported in clinical trials and on the basis of real-world data.
“Although BNT162b2 is a two-dose regimen, early protection after a single dose has been reported in clinical trials and on the basis of real-world data.5,19,20”
From Safety, immunogenicity, and efficacy of the BNT162b2 covid-19 vaccine in adolescents (2021) · cites this paper as [19]
Recent real-world data suggest that BNT162b2 prevents asymptomatic infection.
“Recent real-world data suggest that BNT162b2 prevents asymptomatic infection.19,27”
From Safety, immunogenicity, and efficacy of the BNT162b2 covid-19 vaccine in adolescents (2021) · cites this paper as [19]
Covid-19 vaccines are highly effective against symptomatic disease and, more so, against severe disease and fatal outcomes caused by the original strain of SARS-CoV-2 as well as the alpha variant.
“Coronavirus disease 2019 (Covid-19) vaccines are highly effective against symptomatic disease and, more so, against severe disease and fatal outcomes caused by the original strain of SARS-CoV-2 as well as the alpha (B.1.1.7) variant that predominated in early 2021.”
From Effectiveness of COVID-19 vaccines against the Omicron (B.1.1.529) variant of concern (2021) · cites this paper as [14]
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ResultInfluentialAdvances in COVID-19 mRNA vaccine development
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“Johnson & Johnson and AstraZeneca), elicit robust humoral responses and have shown safety in the majority of populations vaccinated [12].”
BackgroundEffectiveness of Covid-19 Vaccines in Ambulatory and Inpatient Care Settings
Thompson, M. G., Stenehjem, E. A., Grannis, S. J., Ball, S. W., Naleway, A. L., Ong, T. C., DeSilva, M. B., Natarajan, K., Bozio, C. H., Lewis, N., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2110362 · Cited by 459 · see citing works
Effect of Covid-19 Vaccination on Transmission of Alpha and Delta Variants
Eyre, D. W., Taylor, D., Purver, M., Chapman, D., Fowler, T., Pouwels, K. B., Walker, A. S., & Peto, T. E. A. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2116597 · Cited by 464 · see citing works
Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection
Patone, M., Handunnetthi, L., Saatci, D., Pan, J., Katikireddi, S. V., Razvi, S., Hunt, D., Mei, X. W., Dixon, S., Zaccardi, F., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01556-7 · Cited by 394 · see citing works
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“for the Pfizer/BioNTech vaccine.(34) The highest effectiveness for the first dose of any vaccine against infection with B.”
BackgroundMethodInfluentialLustig, Y., Sapir, E., Regev-Yochay, G., Cohen, C., Fluss, R., Olmer, L., Indenbaum, V., Mandelboim, M., Doolman, R., Amit, S., et al. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(21)00220-4 · Cited by 342 · see citing works
Protection by a Fourth Dose of BNT162b2 against Omicron in Israel
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mRNA therapeutics in cancer immunotherapy
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Nirmatrelvir Use and Severe Covid-19 Outcomes during the Omicron Surge
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Ranzani, O., Hitchings, M. D. T., Dorión, M., D’Agostini, T. L., de Paula, R. C., de Paula, O. F. P., Villela, E. F. D. M., Torres, M. S. S., de Oliveira, S. B., Schulz, W. L., et al. (2021) · BMJ · doi:10.1136/bmj.n2015 · Cited by 348 · see citing works
Novel SARS-CoV-2 variants: the pandemics within the pandemic
Boehm, E., Kronig, I., Neher, R. A., Eckerle, I., Vetter, P., & Kaiser, L. (2021) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2021.05.022 · Cited by 341 · see citing works
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SARS-CoV-2 breakthrough infections in vaccinated individuals: measurement, causes and impact
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Self-citationBNT162b2 Vaccine Booster and Mortality Due to Covid-19
Arbel, R., Hammerman, A., Sergienko, R., Friger, M., Peretz, A., Netzer, D., & Yaron, S. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2115624 · Cited by 339 · see citing works
Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study
Mizrahi, B., Sudry, T., Flaks‐Manov, N., Yehezkelli, Y., Kalkstein, N., Akiva, P., Ekka-Zohar, A., David, S. S. B., Lerner, U., Bivas‐Benita, M., et al. (2023) · BMJ · doi:10.1136/bmj-2022-072529 · Cited by 335 · see citing works
“30 31 Recent studies have also shown that vaccination results in reduction in the risk of the post-acute sequelae of covid-19.”
BackgroundUnadjuvanted intranasal spike vaccine elicits protective mucosal immunity against sarbecoviruses
Mao, T., Israelow, B., Peña-Hernández, M. A., Suberi, A., Zhou, L., Luyten, S., Reschke, M., Dong, H., Homer, R. J., Saltzman, W., et al. (2022) · Science · doi:10.1126/science.abo2523 · Cited by 288 · see citing works
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“As effectiveness of BNT162b2was studied in patientsmore than 7 days after the second dose in most clinical studies [2,4,5], either symptom onset, the first positive PCR test or the date of admission, whichever happened first, had to be more than 7 days after the second dose.”
Impact of vaccination on new SARS-CoV-2 infections in the United Kingdom
Pritchard, E., Matthews, P. C., Stoesser, N. E., Eyre, D. W., Gethings, O., Vihta, K.-D., Jones, J. W., House, T., VanSteenhouse, H. C., Bell, I., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01410-w · Cited by 315 · see citing works
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Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy
Dagan, N., Barda, N., Biron-Shental, T., Makov-Assif, M., Key, C., Kohane, I. S., Hernán, M. A., Lipsitch, M., Hernandez-Diaz, S., Reis, B. Y., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01490-8 · Cited by 312 · see citing works
“VE for women with chronic conditions may be somewhat lower than the average VE reported in this study, as previously reported for the general population (13).”
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Tenforde, M. W., Olson, S. M., Self, W. H., Talbot, H. K., Lindsell, C. J., Steingrub, J. S., Shapiro, N. I., Ginde, A. A., Douin, D. J., Prekker, M. E., et al. (2021) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7018e1 · Cited by 284 · see citing works
Association Between BNT162b2 Vaccination and Incidence of SARS-CoV-2 Infection in Pregnant Women
Goldshtein, I., Nevo, D., Steinberg, D. M., Rotem, R. S., Gorfine, M., Chodick, G., & Segal, Y. (2021) · JAMA · doi:10.1001/jama.2021.11035 · Cited by 289 · see citing works
Evaluation of Waning of SARS-CoV-2 Vaccine–Induced Immunity: A Systematic Review and Meta-analysis
Menegale, F., Manica, M., Zardini, A., Guzzetta, G., Marziano, V., d'Andrea, V., Trentini, F., Ajelli, M., Poletti, P., & Merler, S. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.10650 · Cited by 280 · see citing works
“We scrutinized the full texts of the remaining manuscripts to identify relevant sources among articles cited therein, and we selected manuscripts fulfilling all of the following criteria: (1) studies that included data and estimates of VE expressed as a percentage from studies comparing vaccinated and unvaccinated ind…”
MethodFourth Dose of BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting
Magen, O., Waxman, J. G., Makov-Assif, M., Vered, R., Dicker, D., Hernán, M. A., Lipsitch, M., Reis, B. Y., Balicer, R. D., & Dagan, N. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2201688 · Cited by 279 · see citing works
Self-citationZeng, B., Gao, L., Zhou, Q., Yu, K., & Sun, F. (2022) · BMC Medicine · doi:10.1186/s12916-022-02397-y · Cited by 267 · see citing works
“Finally, 33 articles (23 publications [6, 7, 19-22, 30-46] and 10 preprints [47-56]) were included in the present systematic review.”
BackgroundSARS-CoV-2 mRNA vaccination induces functionally diverse antibodies to NTD, RBD, and S2
Amanat, F., Thapa, M., Lei, T., Ahmed, S. M. S., Adelsberg, D. C., Carreño, J. M., Strohmeier, S., Schmitz, A. J., Zafar, S., Zhou, J. Q., et al. (2021) · Cell · doi:10.1016/j.cell.2021.06.005 · Cited by 273 · see citing works
“Production of non-neutralizing antibodies may also play a role in protection by mRNA vaccines after the first dose, as it is substantial and occurs during a time when neutralizing antibody titers are either very low or absent (Baden et al., 2020; Dagan et al., 2021; Polack et al., 2020).”
Rincón-Arévalo, H., Choi, M., Stefanski, A., Halleck, F., Weber, U., Szelinski, F., Jahrsdörfer, B., Schrezenmeier, H., Ludwig, C., Sattler, A., et al. (2021) · Science Immunology · doi:10.1126/sciimmunol.abj1031 · Cited by 271 · see citing works
Effectiveness of mRNA Covid-19 Vaccine among U.S. Health Care Personnel
Pilishvili, T., Gierke, R., Fleming-Dutra, K. E., Farrar, J. L., Mohr, N. M., Talan, D. A., Krishnadasan, A., Harland, K. K., Smithline, H. A., Hou, P. C., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2106599 · Cited by 264 · see citing works
“Complete vaccination 49/529 (9) 321/1068 (30) 91.”
InfluentialMassarweh, A., Eliakim‐Raz, N., Stemmer, A., Levy‐Barda, A., Yust‐Katz, S., Zer, A., Benouaich‐Amiel, A., Ben‐Zvi, H., Moskovits, N. B.-C., Brenner, B., et al. (2021) · JAMA Oncology · doi:10.1001/jamaoncol.2021.2155 · Cited by 265 · see citing works
“Immunotherapy + biological therapy 5 521 (505-2962) [11-3988]”
Irrgang, P., Gerling, J., Kocher, K., Lapuente, D., Steininger, P. A., Habenicht, K. M., Wytopil, M., Beileke, S., Schäfer, S., Zhong, J., et al. (2022) · Science Immunology · doi:10.1126/sciimmunol.ade2798 · Cited by 259 · see citing works
Effect of Vaccination on Transmission of SARS-CoV-2
Shah, A. S. V., Gribben, C., Bishop, J., Hanlon, P., Caldwell, D., Wood, R., Reid, M., McMenamin, J., Goldberg, D. J., Stockton, D., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmc2106757 · Cited by 257 · see citing works
Correlation of SARS-CoV-2-breakthrough infections to time-from-vaccine
Mizrahi, B., Lotan, R., Kalkstein, N., Peretz, A., Perez, G., Ben-Tov, A., Chodick, G., Gazit, S., & Patalon, T. (2021) · Nature Communications · doi:10.1038/s41467-021-26672-3 · Cited by 261 · see citing works
Ssentongo, P., Ssentongo, A. E., Voleti, N., Groff, D., Sun, A., Ba, D. M., Nunez, J., Parent, L. J., Chinchilli, V. M., & Paules, C. I. (2022) · BMC Infectious Diseases · doi:10.1186/s12879-022-07418-y · Cited by 260 · see citing works
SARS-CoV-2 Infection after Vaccination in Health Care Workers in California
Keehner, J., Horton, L. E., Pfeffer, M. A., Longhurst, C., Schooley, R. T., Currier, J. S., Abeles, S. R., & Torriani, F. J. (2021) · New England Journal of Medicine · doi:10.1056/nejmc2101927 · Cited by 257 · see citing works
mRNA Vaccines in the COVID-19 Pandemic and Beyond
Hogan, M. J., & Pardi, N. (2021) · Annual Review of Medicine · doi:10.1146/annurev-med-042420-112725 · Cited by 252 · see citing works
“These include Alpha (B.1.1.7), first identified in the United Kingdom; Beta (B.1.351), first identified in South Africa; Gamma (P.1), first identified in Brazil; and Delta (B.1.617.2), first identified in India.”
BackgroundMethodInfluentialPuranik, A., Lenehan, P. J., Silvert, E., Niesen, M. J. M., Corchado-García, J., O’Horo, J. C., Virk, A., Swift, M. D., Halamka, J. D., Badley, A. D., et al. (2021) · medRxiv · doi:10.1101/2021.08.06.21261707 · Cited by 243 · see citing works
“(6-8) Incidence Rate Ratio: Incidence Rate of the given vaccinated cohort divided by the Incidence Rate of the unvaccinated cohort, along with the exact 95% confidence interval.”
BackgroundAccelerated COVID-19 vaccine development: milestones, lessons, and prospects
Bok, K., Sitar, S., Graham, B. S., & Mascola, J. R. (2021) · Immunity · doi:10.1016/j.immuni.2021.07.017 · Cited by 254 · see citing works
Overview of the Main Anti-SARS-CoV-2 Vaccines: Mechanism of Action, Efficacy and Safety
Mascellino, M., Timoteo, F. D., Angelis, M. D., & Oliva, A. (2021) · Infection and Drug Resistance · doi:10.2147/idr.s315727 · Cited by 222 · see citing works
“0018%) were reported among the people who received the vaccine.(43) Frail or old people, those with comorbidities, teachers, and health care personnel are at higher risk for adverse events after vaccination.”
BackgroundConnors, J. M., Brooks, M. M., Sciurba, F. C., Krishnan, J. A., Bledsoe, J. R., Kindzelski, A., Baucom, A., Kirwan, B., Eng, H. F., Martin, D., et al. (2021) · JAMA · doi:10.1001/jama.2021.17272 · Cited by 259 · see citing works
Effectiveness of COVID-19 vaccines against the B.1.617.2 variant
Bernal, J. L., Andrews, N., Gower, C., Gallagher, E., Simmons, R., Thelwall, S., Stowe, J., Tessier, E., Groves, N., Dabrera, G., et al. (2021) · doi:10.1101/2021.05.22.21257658 · Cited by 2,888 · see citing works
“This has been backed by real world evidence showing high levels of effectiveness against symptomatic disease, infection and severe disease (10-14).”
BackgroundResultComparative Effectiveness of BNT162b2 and mRNA-1273 Vaccines in U.S. Veterans
Dickerman, B. A., Gerlovin, H., Madenci, A. L., Kurgansky, K. E., Ferolito, B. R., Muñiz, M. J. F., GAGNON, D. R., Gaziano, J. M., Cho, K., Casas, J. P., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2115463 · Cited by 244 · see citing works
Self-citationEfficacy, Immunogenicity and Safety of COVID-19 Vaccines: A Systematic Review and Meta-Analysis
Sharif, N., Alzahrani, K. J., Ahmed, S. N., & Dey, S. K. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.714170 · Cited by 230 · see citing works
“org 8 efficacy of the mRNA and adenovirus vector vaccines in people aged over 18 years (26, 27, 30, 32, 40, 41).”
BackgroundInfluentialSattler, A., Schrezenmeier, E. V., Weber, U., Potekhin, A., Bachmann, F., Straub-Hohenbleicher, H., Budde, K., Storz, E., Proß, V., Bergmann, Y., et al. (2021) · Journal of Clinical Investigation · doi:10.1172/jci150175 · Cited by 242 · see citing works
Levine-Tiefenbrun, M., Yelin, I., Alapi, H., Katz, R., Herzel, E., Kuint, J., Chodick, G., Gazit, S., Patalon, T., & Kishony, R. (2021) · Nature Medicine · doi:10.1038/s41591-021-01575-4 · Cited by 222 · see citing works
Evaluation of the safety profile of COVID-19 vaccines: a rapid review
Wu, Q., Dudley, M. Z., Chen, X., Bai, X., Dong, K., Zhuang, T., Salmon, D. A., & Yu, H. (2021) · BMC Medicine · doi:10.1186/s12916-021-02059-5 · Cited by 241 · see citing works
“Authorized COVID-19 vaccines can prevent a large proportion of symptomatic cases, hospitalizations, severe diseases, and death [101, 102].”
BackgroundSARS-CoV-2 vaccine protection and deaths among US veterans during 2021
Cohn, B. A., Cirillo, P. M., Murphy, C. C., Krigbaum, N. Y., & Wallace, A. W. (2021) · Science · doi:10.1126/science.abm0620 · Cited by 242 · see citing works
BNT162b2 vaccination induces durable SARS-CoV-2–specific T cells with a stem cell memory phenotype
Guerrera, G., Picozza, M., D’Orso, S., Placido, R., Pirronello, M., Verdiani, A., Termine, A., Fabrizio, C., Giannessi, F., Sambucci, M., et al. (2021) · Science Immunology · doi:10.1126/sciimmunol.abl5344 · Cited by 222 · see citing works
COVID-19 dynamics after a national immunization program in Israel
Rossman, H., Shilo, S., Meir, T., Gorfine, M., Shalit, U., & Segal, E. (2021) · Nature Medicine · doi:10.1038/s41591-021-01337-2 · Cited by 232 · see citing works
“Even if the real-life effectiveness of the vaccine is similar to the efficacy reported in the clinical trial, as shown by Dagan et al. 12 , the effect of the vaccination program on the population as a whole depends on additional factors, including the national vaccine coverage, vaccine allocation among different subgr…”
BackgroundResultInfluentialImmune responses to two and three doses of the BNT162b2 mRNA vaccine in adults with solid tumors
Shroff, R. T., Chalasani, P., Wei, R., Pennington, D., Quirk, G., Schoenle, M. V., Peyton, K. L., Uhrlaub, J. L., Ripperger, T. J., Jergović, M., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01542-z · Cited by 233 · see citing works
Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis
Rotshild, V., Raccah, B. H., Miskin, I. N., Muszkat, M., & Matok, I. (2021) · Scientific Reports · doi:10.1038/s41598-021-02321-z · Cited by 224 · see citing works
Frater, J., Ewer, K., Ogbe, A., Pace, M., Adele, S., Adland, E., Alagaratnam, J., Aley, P. K., Ali, M., Ansari, M. A., et al. (2021) · The Lancet HIV · doi:10.1016/s2352-3018(21)00103-x · Cited by 223 · see citing works
“…the safety and immunogenicity of vaccination in participants with HIV on ART with CD4 counts of more than 350 cells per µL receiving two doses, 4–6 weeks apart, of a non-replicating chimpanzee adenovirus-vectored vaccine expressing the SARS-CoV-2 spike protein (ChAdOx1 nCoV-19), which has…”
MethodMucosal Immune Response in BNT162b2 COVID-19 Vaccine Recipients
Azzi, L., Gasperina, D. D., Veronesi, G., Shallak, M., Ietto, G., Iovino, D., Baj, A., Gianfagna, F., Maurino, V., Focosi, D., et al. (2021) · EBioMedicine · doi:10.1016/j.ebiom.2021.103788 · Cited by 220 · see citing works
Kuodi, P., Gorelik, Y., Zayyad, H., Wertheim, O., Wiegler, K. B., Jabal, K. A., Dror, A. A., Nazzal, S., Glikman, D., & Edelstein, M. L. (2022) · npj Vaccines · doi:10.1038/s41541-022-00526-5 · Cited by 219 · see citing works
Protection against Covid-19 by BNT162b2 Booster across Age Groups
Bar-On, Y. M., Goldberg, Y., Mandel, M., Bodenheimer, O., Freedman, L. S., Alroy-Preis, S., Ash, N., Huppert, A., & Milo, R. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2115926 · Cited by 218 · see citing works
COVID-19 vaccine efficacy and effectiveness—the elephant (not) in the room
Olliaro, P., Torreele, E., & Vaillant, M. (2021) · The Lancet Microbe · doi:10.1016/s2666-5247(21)00069-0 · Cited by 214 · see citing works
Galmiche, S., Nguyen, L. B. L., Tartour, É., de Lamballerie, X. N., Wittkop, L., Loubet, P., & Launay, O. (2021) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2021.09.036 · Cited by 206 · see citing works
“Estimates of effectiveness appear lower than in the general population [183,213,214], which is consistent with the findings of this review regarding a diminished immunogenicity and reports of more breakthrough infections observed in these populations [215e217].”
ResultRahmani, K., Shavaleh, R., Forouhi, M., Disfani, H. F., Kamandi, M., Oskooi, R. K., Foogerdi, M., Soltani, M., Rahchamani, M., Mohaddespour, M., et al. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.873596 · Cited by 207 · see citing works
“In the people vaccinated with the second dose (fully vaccinated) of BNT162b2 mRNA, mRNA-1273, ChAdOx1, and combined studies, the rate of SARS-CoV-2 infection using IRR were reduced by 90% (IRR= 0.10, 95% CI: 0.07–0.17) (Figure 9) (11, 18, 19, 34, 35, 38, 39, 42–50, 80, 82).”
BackgroundMethodResultInfluentialGreenhawt, M., Abrams, E. M., Shaker, M. S., Chu, D. K., Khan, D. A., Akin, C., Alqurashi, W., Arkwright, P. D., Baldwin, J. L., Ben‐Shoshan, M., et al. (2021) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2021.06.006 · Cited by 204 · see citing works
- Authors
- Dagan, N., Barda, N., Kepten, E., Miron, O., Perchik, S., Katz, M. A., Hernán, M. A., Lipsitch, M., Reis, B., & Balicer, R. D.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- From the Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv (N.D., N.B., E.K., O.M., S.P., M.A.K., R.D.B.), and the School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be’er Sheva (O.M., M.A.K., R.D.B.) — both in Israel; University of Michigan School of Public Health, Ann Arbor (M.A.K.); and the Department of Biomedical Informatics (N.D., N.B.), Harvard Medical School (B.R.), the Departments of Epidemiology and Biostatistics (M.A.H.), and the Center for Communicable Disease Dynamics, Departments of Epidemiology and of Immunology and Infectious Diseases (M.L.), Harvard T.H. Chan School of Public Health, Harvard–MIT Division of Health Sciences and Technology (M.A.H.), and the Predictive Medicine Group, Computational Health Informatics Program, Boston Children’s Hospital (B.R.) — all in Boston.
- Corresponding author
- Balicer, Ran D.
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2021-04-15
- Volume
- 384
- Issue
- 15
- Pages
- 1412-1423
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC7944975
- OpenAlex
- W3131688063
- Cited by
- 2,527
- References
- 18
- Citations by year
- 2026: 59 · 2025: 114 · 2024: 202 · 2023: 367 · 2022: 831 · 2021: 926 · 2020: 28
- FWCI
- 184.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Morris–Singer Fund
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 vaccine effectiveness, SARS-CoV-2 infection prevention, symptomatic COVID-19, COVID-19 hospitalization, severe COVID-19, COVID-19 mortality, mass vaccination campaigns, real-world effectiveness, comorbidities, Israel
- MeSH terms
- Immunogenicity, Vaccine, COVID-19, COVID-19 Vaccines, BNT162 Vaccine, Adolescent, Adult, Aged, Aged, 80 and over, Female, Hospitalization, Humans, Israel, Male, Middle Aged, Incidence, Treatment Outcome, Mass Vaccination, Kaplan-Meier Estimate, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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