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Effectiveness of mRNA BNT162b2 Vaccine Against COVID-19 in Israel
Quick Takes
- This nationwide surveillance study reports the effectiveness of vaccination against SARS-CoV-2 with the mRNA BNT162b2 vaccine in Israel, where 72% of the population was fully vaccinated by April 3, 2021.
- Vaccination was over 90% effective at reducing the incidence of asymptomatic SARS-CoV-2 infections, moderate to severe COVID-19, as well as death due to COVID-19 across all age groups ≥16 years.
- The incidence of SARS-CoV-2 infection declined rapidly as vaccine uptake increased, even after lifting of the lockdown.
Study Questions:
What is the effectiveness of the mRNA BNT162b2 vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, coronavirus disease 2019 (COVID-19) hospitalizations, and deaths?
Methods:
The authors used national surveillance data from the first 4 months of the nationwide vaccination campaign in Israel (January 24–April 3, 2021) to assess BNT162b2 vaccine uptake and determine the incidence of laboratory-confirmed SARS-CoV-2 infections and outcomes. The outcomes examined were: asymptomatic infection; symptomatic infection; COVID-19–related hospitalization; severe or critical hospitalization (required oxygenation or ventilatory support); and death. The incidence of the aforementioned outcomes was compared between fully vaccinated individuals (in whom 7 days had passed since receiving the second dose of vaccine) and unvaccinated individuals (who had not received any doses of the vaccine). Analyses were stratified by age group.
Results:
In Israel, 72.1% (n = 4,714,932) of the population was fully vaccinated by April 2021: 90% of those aged ≥65 years, 79.8% of those aged 45-64 years, and 62.8% of adults aged 16-44 years. Median follow-up for people who received two doses was 48 days (interquartile range, 30–60). During the analysis period (January 24–April 3, 2021), there were 232,268 SARS-CoV-2 infections, 7,694 COVID-19 hospitalizations, 4,481 severe or critical COVID-19 hospitalizations, and 1,113 COVID-19 deaths. The prevalence of the B.1.1.7 variant was 94.5%. Estimates of vaccine effectiveness at ≥7 days after the second dose were 95.3% (95% confidence interval, 94.9–95.7) against SARS-CoV-2 infection, 91.5% (90.7–92.2) against asymptomatic SARS-CoV-2 infection, 97.0% (96.7–97.2) against symptomatic COVID-19, 97.2% (96.8–97.5) against COVID-19-related hospitalization, 97.5% (97.1–97.8) against severe or critical COVID-19–related hospitalization, and 96.7% (96.0–97.3) against COVID-19–related death. The effectiveness did not differ significantly between age groups. In all age groups, as vaccine coverage increased, the incidence of SARS-CoV-2 outcomes declined. The decline persisted after lifting of the lockdown.
Conclusions:
Two doses of BNT162b2 are >90% effective across all age groups ≥16 years in preventing the range of COVID-19–related outcomes, from asymptomatic infection to death.
Perspective:
What Israel has achieved in its approach towards the COVID-19 pandemic is remarkable. Heavy investment into securing vaccine doses early and leveraging a robust national health care system has propelled vaccination uptake, reaching 72% of the population in only 4 months. The incidence of SARS-CoV-2 has continued to decline, despite the predominance of the more infectious B.1.1.7 variant and the lifting of lockdown restrictions. The study confirms and highlights the effectiveness of the mRNA BNT162b2 in a real-world, nationwide setting, and follows a similar report on Scotland’s mass vaccination campaign. Overall, the data on vaccination continues to be reassuring. Maximizing vaccine uptake should be the top priority for policy makers across the world in order to end this pandemic.
Clinical Topics: COVID-19 Hub, Prevention
Keywords: Asymptomatic Infections, Coronavirus, COVID-19, ACC COVID-19 Podcast, Delivery of Health Care, Immunization Programs, Mass Vaccination, Primary Prevention, RNA, Messenger, SARS-CoV-2, Vaccination, Ventilation
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