A n effective and safe vaccination campaign is urgently needed to halt the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the resulting disease, COVID-19. The BNT162b2 vaccine, developed by BioNTech in cooperation with Pfizer, is a lipid nucleoside-modified RNA encoding the SARS-CoV-2 full-length spike protein 1 . Results from a phase 3 randomized placebo-controlled trial demonstrated that a two-dose regimen in a 21-d interval conferred 95% protection against laboratory-confirmed COVID-19 infection in individuals 16 years of age or older 2 . On 11 December 2020, the Food and Drug Administration issued an Emergency Use Authorization for emergency use of the vaccine for the prevention of COVID-19 (ref. 3 ), and, after that, an emergency use of the vaccine was also issued by the Israeli Ministry of Health (MOH).On 20 December 2020, Israel launched a national COVID-19 vaccination campaign 4 , in which BNT162b2 vaccines were administered. The Israeli health system comprises four health maintenance organizations (HMOs), and vaccinations were widely available, according to a prioritization schedule determined by the Israeli MOH. During the early phases of the distribution process, individuals considered as being at high risk for COVID-19 were prioritized for vaccination, including individuals older than 60 years, nursing home residents, healthcare workers and individuals with severe comorbidities. The vaccination campaign was further expanded for individuals aged 55 years and older 5 and 40 years 6 and older on 12 January 2021 and 19 January 2021, respectively. On 21 January, individuals aged 16-18 years were also prioritized for vaccination. On 28 January, the vaccination campaign expanded to those aged 35 and older 7 . On 4 February, all individuals aged 16 years and older were eligible to receive the vaccine. However, the HMOs were still instructed to focus their efforts on those aged 50 years and older 8 .
As the COVID-19 pandemic progresses, obtaining information on symptoms dynamics is of essence. Here, we extracted data from primary-care electronic health records and nationwide distributed surveys to assess the longitudinal dynamics of symptoms prior to and throughout SARS-CoV-2 infection. Information was available for 206,377 individuals, including 2471 positive cases. The two datasources were discordant, with survey data capturing most of the symptoms more sensitively. The most prevalent symptoms included fever, cough and fatigue. Loss of taste and smell 3 weeks prior to testing, either self-reported or recorded by physicians, were the most discriminative symptoms for COVID-19. Additional discriminative symptoms included self-reported headache and fatigue and a documentation of syncope, rhinorrhea and fever. Children had a significantly shorter disease duration. Several symptoms were reported weeks after recovery. By a unique integration of two datasources, our study shed light on the longitudinal course of symptoms experienced by cases in primary care.
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