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Katz MA, Harlev EB, Chazan B, Chowers M, Greenberg D, Peretz A, Tshori S, Levy J, Yacobi M, Hirsch A, Amichay D, Weinberger R, Dor AB, Taraday EK, Reznik D, Chayat CB, Sagas D, Zvi HB, Berdinstein R, Rashid G, Avni YS, Mandelboim M, Zuckerman N, Rainy N, Akriv A, Dagan N, Kepten E, Barda N, Balicer RD. Early effectiveness of BNT162b2 Covid-19 vaccine in preventing SARS-CoV-2 infection in healthcare personnel in six Israeli hospitals (CoVEHPI). Vaccine 2022; 40:512-520. [PMID: 34903372 PMCID: PMC8662353 DOI: 10.1016/j.vaccine.2021.11.092] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Methodologically rigorous studies on Covid-19 vaccine effectiveness (VE) in preventing SARS-CoV-2 infection are critically needed to inform national and global policy on Covid-19 vaccine use. In Israel, healthcare personnel (HCP) were initially prioritized for Covid-19 vaccination, creating an ideal setting to evaluate early real-world VE in a closely monitored population. METHODS We conducted a prospective study among HCP in 6 hospitals to estimate the effectiveness of the BNT162b2 mRNA Covid-19 vaccine in preventing SARS-CoV-2 infection. Participants filled out weekly symptom questionnaires, provided weekly nasal specimens, and three serology samples - at enrollment, 30 days and 90 days. We estimated VE against PCR-confirmed SARS-CoV-2 infection using the Cox Proportional Hazards model and against a combined PCR/serology endpoint using Fisher's exact test. RESULTS Of the 1567 HCP enrolled between December 27, 2020 and February 15, 2021, 1250 previously uninfected participants were included in the primary analysis; 998 (79.8%) were vaccinated with their first dose prior to or at enrollment, all with Pfizer BNT162b2 mRNA vaccine. There were four PCR-positive events among vaccinated participants, and nine among unvaccinated participants. Adjusted two-dose VE against any PCR-confirmed infection was 94.5% (95% CI: 82.6%-98.2%); adjusted two-dose VE against a combined endpoint of PCR and seroconversion for a 60-day follow-up period was 94.5% (95% CI: 63.0%-99.0%). Five PCR-positive samples from study participants were sequenced; all were alpha variant. CONCLUSIONS Our prospective VE study of HCP in Israel with rigorous weekly surveillance found very high VE for two doses of Pfizer BNT162b2 mRNA vaccine against SARS-CoV-2 infection in recently vaccinated HCP during a period of predominant alpha variant circulation. FUNDING Clalit Health Services.
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Affiliation(s)
- Mark A Katz
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel; School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Efrat Bron Harlev
- Schneider Children's Medical Center of Israel, Petach Tikvah, Israel
| | - Bibiana Chazan
- Infectious Diseases and Infection Control Unit, Ha'Emek Medical Center, Afula, Israel; Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Michal Chowers
- Infectious Diseases, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - David Greenberg
- Pediatric Infectious Disease Unit the Pediatric Division, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Alon Peretz
- Occupational Medicine Clinic, Rabin Medical Center, Petah Tikva, Israel
| | - Sagi Tshori
- Research Authority, Kaplan Medical Center, Rehovot, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joseph Levy
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel
| | - Mili Yacobi
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel
| | - Avital Hirsch
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel
| | - Doron Amichay
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; Clalit Central Laboratory, Clalit Health Services, Tel Aviv, Israel
| | - Ronit Weinberger
- Clalit Central Laboratory, Clalit Health Services, Tel Aviv, Israel
| | - Anat Ben Dor
- Clalit Central Laboratory, Clalit Health Services, Tel Aviv, Israel
| | | | - Dana Reznik
- Schneider Children's Medical Center of Israel, Petach Tikvah, Israel
| | - Chen Barazani Chayat
- Multidisciplinary Laboratory, Schneider Children's Medical Center of Israel, Petach Tikvah, Israel
| | - Dana Sagas
- Clinical Microbiology Laboratory, Ha'Emek Medical Center, Afula, Israel
| | - Haim Ben Zvi
- Microbiology Department, Rabin Medical Center, Petah Tikva, Israel
| | - Rita Berdinstein
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Microbiology Department, Kaplan Medical Center, Rehovot, Israel
| | - Gloria Rashid
- Department of Clinical Laboratories, Meir Medical Center, Kfar Saba, Israel
| | | | - Michal Mandelboim
- Central Virology Laboratory, Chaim Sheba Medical Center, Ministry of Health, Ramat Gan, Israel; Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Neta Zuckerman
- Central Virology Laboratory, Chaim Sheba Medical Center, Ministry of Health, Ramat Gan, Israel
| | - Nir Rainy
- Laboratory Division, Shamir Medical Center, Zerifin, Israel
| | - Amichay Akriv
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel
| | - Noa Dagan
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel; Software and Information Systems Engineering, Ben Gurion University, Beer Sheva, Israel; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA; Ivan and Francesca Berkowitz Family Living Laboratory at Harvard Medical School, Boston, MA, USA
| | - Eldad Kepten
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel
| | - Noam Barda
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel; Software and Information Systems Engineering, Ben Gurion University, Beer Sheva, Israel; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA; Ivan and Francesca Berkowitz Family Living Laboratory at Harvard Medical School, Boston, MA, USA
| | - Ran D Balicer
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat Gan, Israel; School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
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