Early rate reductions of SARS-CoV-2 infection and COVID-19 in BNT162b2 vaccine recipients

Amit, Sharon; Regev‐Yochay, Gili; Afek, Arnon; Kreiss, Yitshak; Leshem, Eyal

doi:10.1016/s0140-6736(21)00448-7

Cited by 317 publications

(359 citation statements)

References 3 publications

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“…These findings are consistent with those from the mRNA vaccines' Phase III trials (1,2) and recent observational studies of the mRNA vaccine effectiveness against severe COVID-19 (3). The findings complement and expand upon these preceding reports by demonstrating that the vaccines can also reduce the risk for infection regardless of COVID-19-associated illness symptom status (4,5). Reducing the risk for transmissible infection, which can occur among persons with asymptomatic infection or among persons several days before symptoms onset (6), is especially important among health care personnel, first responders, and other essential and frontline workers given their potential to transmit the virus through frequent close contact with patients and the public.…”

Section: Discussionsupporting

confidence: 81%

“…Partial immunization (≥14 days after first dose but before second dose) provided preventive benefits with vaccine effectiveness of 80%. This finding is similar to an analysis of Phase III trial results (1,2,7) and two other recent estimates of vaccine effectiveness for partial immunization with Pfizer-BioNTech vaccine among health care personnel, including a vaccine effectiveness (≥21 days after first dose) of 72% (95% CI = 58%-86%) against PCR-confirmed infection identified by routine testing in the United Kingdom (4) and a vaccine effectiveness (>14 days after first dose) of 60% (95% CI = 38%-74%) against PCR-confirmed infection identified by records review in Israel (5). This finding is also consistent with early descriptive findings of SARS-CoV-2 employee and clinical testing results by mRNA vaccination status in the United States (8,9).…”

Section: Discussionmentioning

confidence: 99%

“…As the study progresses, viruses will be genetically characterized to examine the viral features of breakthrough infections. Given that there is uncertainty related to the number of days required to develop immunity postvaccination (3)(4)(5)7), future research examining vaccine effectiveness at different intervals is warranted.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers — Eight U.S. Locations, December 2020–March 2021

Thompson¹,

Burgess²,

Naleway³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

731

587

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On March 29, 2021, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr)Messenger RNA (mRNA) BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines have been shown to be effective in preventing symptomatic COVID-19 in randomized placebo-controlled Phase III trials (1,2); however, the benefits of these vaccines for preventing asymptomatic and symptomatic SARS-CoV-2 (the virus that causes COVID-19) infection, particularly when administered in real-world conditions, is less well understood. Using prospective cohorts of health care personnel, first responders, and other essential and frontline workers* in eight U.S. locations during December 14, 2020-March 13, 2021, CDC routinely tested for SARS-CoV-2 infections every week regardless of symptom status and at the onset of symptoms consistent with COVID-19-associated illness. Among 3,950 participants with no previous laboratory documentation of SARS-CoV-2 infection, 2,479 (62.8%) received both recommended mRNA doses and 477 (12.1%) received only one dose of mRNA vaccine. † Among unvaccinated participants, 1.38 SARS-CoV-2 infections were confirmed by reverse transcription-polymerase chain reaction (RT-PCR) per 1,000 person-days. § In contrast, among fully immunized (≥14 days after second dose) persons, 0.04 infections per 1,000 person-days were reported, and among partially immunized (≥14 days after first dose and * Occupational categories: primary health care personnel (physicians, physician assistants, nurse practitioners, and dentists), other allied health care personnel (nurses, therapists, technicians, medical assistants, orderlies, and all other persons providing clinical support in inpatient or outpatient settings), first responders (firefighters, law enforcement, corrections, and emergency medical technicians), other essential and frontline workers (workers in hospitality, delivery, and retail; teachers; and all other occupations that require contact within 3 feet of the public, customers, or coworkers as a routine part of their job). † An additional five participants received the Janssen COVID-19 vaccine (Johnson & Johnson), resulting in 2,961 vaccinated participants. § Person-days is an estimate of the time-at-risk (to SARS-CoV-2 infection) that each participant contributed to the study.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers — Eight U.S. Locations, December 2020–March 2021

Thompson¹,

Burgess²,

Naleway³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

731

587

View full text Add to dashboard Cite

show abstract

“…Differences between a mass vaccine distribution strategy that prioritizes people based on both their age and neighbourhood of residence and a strategy based on age alone will become larger in the context of vaccine scarcity, with increasing duration of the vaccine rollout beyond May 31, 2021, if the daily incidence of SARS-CoV-2 cases increases, if vaccination also protects against asymptomatic infection and transmission, 14 and if an age-based strategy is inequitable, resulting in higher vaccination rates in wealthier neighbourhoods, as currently observed in the United States. 3,4…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccination Strategy for Ontario Using Age and Neighbourhood-Based Prioritization

Brown¹,

Stall²,

Joh³

et al. 2021

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on behalf of the Ontario COVID-19 Science Advisory Table Key Message SARS-CoV-2 infection has taken a disproportionate toll on Ontario older adults, and on residents of disadvantaged and racialized urban neighbourhoods throughout the province. Prioritizing and implementing vaccine distribution for Ontarians based on both age and neighbourhood of residence could ensure that those at the highest risk of SARS-CoV-2 infection, and hospitalization, ICU admission or death from COVID-19 will be among the first to receive vaccines. This vaccine strategy will maximize the prevention of deaths and long-term morbidity, and best maintain health care system capacity by reducing hospitalizations and ICU admissions due to COVID-19 as compared with a strategy that prioritizes vaccination based on age alone (Figure 1). The strategy would not interfere with the ongoing and future vaccination of any specific high-risk population, as it is intended to guide the mass distribution of vaccines to the general Ontario population. Figure 1. Projected Number of Prevented COVID-19 Hospitalizations, ICU Admissions and Deaths by Two Strategies for Mass Distribution of Vaccines in Ontario, March 1 to May 31, 2021 Bar graph presenting the projected number of prevented hospitalizations, ICU admissions and deaths due to COVID-19 in Ontario from March 1-May 31, 2021 under two strategies for mass distribution of vaccines: 1) prioritization based on age alone (blue bars) and 2) prioritization based on age and neighbourhood of residence (orange bars). The brackets above the bar graphs report the relative difference (%) in prevented outcomes between the two strategies for mass distribution of vaccines. See Table 1 below for the number of projected events associated with the different distribution strategies.

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“…This sensible approach worked better than most would have anticipated, with a two dose efficacy rate of stopping symptomatic COVID at 94-95% in trial data (1,2), with reports from Israeli health agencies Maccabi and Cialit reporting similar figures in Israel's population (3). Surprisingly, one dose efficacy against symptomatic disease was also very high 93-94% in trial data (2,4) with multiple sources of data around the world confirming a 80% to 90% one dose efficacy once sufficient time is given for the immune system to mount a response (5,6,7). Lower viral titres in those who had received one dose that do get infected would point to decreased transmission of virus even without the second dose (8) and asymptomatic infections also appear to be reduced by 4 fold (9).…”

Section: Introductionmentioning

confidence: 99%

Modelled Optimization of SARS-Cov-2 Vaccine Distribution: an Evaluation of Second Dose Deferral Spacing of 6, 12, and 24 weeks

G¹,

Lackner²

2021

Preprint

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Background: Multiple recent studies have shown strong first dose vaccine efficacy for both Moderna mRNA-1273 and Pfizer/BioNTech BNT 162b2, which has stimulated discussion of maximizing initial population immunity during a time of vaccine shortage by using a deferred second dose strategy for these vaccines. Methods: Our model examines the size of the effect of spacing of the second dose with 6, 12, and 24 week deferred spacing regimens relative to 3 week spacing. Results: Deferring the second dose from 3 weeks to 6 weeks, 12 weeks, and 24 weeks shows progressive benefit to population immunity for any given time period, even with significant one dose efficacy decay. The benefits are influenced by vaccine supply per capita. Conclusion: The longer the second dose is deferred the larger the benefit in initial population immunity, provided one dose efficacy does not significantly wane. Monitoring one dose efficacy duration from the UK or Quebec minimizes this risk, as the gathered data will help ensure the second dose is given at an optimal time. How this information is implemented should vary depending on the population and whether the goal is to optimally protect high risk groups or to increase total population immunity as quickly as possible. Benefits to deferring the second dose are influenced by the length of deferral, one dose efficacy, and vaccine supply per capita. The time to herd immunity could be shortened by 4 weeks with the implementation of a 12 week spacing regimen or 10 weeks with a 24 week spacing regimen.

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Early rate reductions of SARS-CoV-2 infection and COVID-19 in BNT162b2 vaccine recipients

Cited by 317 publications

References 3 publications

Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers — Eight U.S. Locations, December 2020–March 2021

Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers — Eight U.S. Locations, December 2020–March 2021

COVID-19 Vaccination Strategy for Ontario Using Age and Neighbourhood-Based Prioritization

Modelled Optimization of SARS-Cov-2 Vaccine Distribution: an Evaluation of Second Dose Deferral Spacing of 6, 12, and 24 weeks

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