Background Intramuscular AZD7442 (Tixagevimab–Cilgavimab, (Evusheld)) has been found effective among immunocompromised individuals (ICI) in reducing Sars-Cov-2 infection and severe disease in ICIs. We evaluated the association between AZD7442 administration and SARS-CoV-2 infection and severe disease (COVID-19 hospitalization and all-cause mortality) among selected ICIs, during a fifth Omicron-dominated wave of COVID-19 (Dec 2021-April 2022) in Israel. Methods ICIs aged 12 and over identified in the Maccabi HealthCare Services database were invited by SMS/email to receive AZD7442. Demographic information, comorbidities, coronavirus vaccination and prior SARS-CoV-2 infection and COVID-19 outcome data (infection, severe disease), were extracted from the database. Rates of infection and severe disease were compared between those administered AZD7442 and those who did not respond to the invitation, over a three-month period. Results Of all 825 ICIs administered AZD7442, 29 (3.5%) became infected with SARS-CoV-2 compared to 308 (7.2%) of 4299 ICIs not administered AZD7442 (p < 0.001). After adjustment, the AZD7442 group were half as less likely to become infected with Sars-Cov-2 than the non-administered group (OR: 0.51, 95% CI: 0.30-0.84). One person in the AZD7442 group (0.1%) was hospitalized for COVID-19 compared to 27 (0.6%) in the non-administered group (p = 0.07). No mortality was recorded among the AZD7442 group, compared to 40 deaths (0.9%) in the non-administered group (p = 0.005). After adjustment, ICIs administered AZD7442 were 92% less likely to be hospitalized/die than those not administered AZD7442 (OR: 0.08, 95% CI: 0.01-0.54). Conclusions AZD7442 among ICI may protect against Omicron variant infection and severe disease, and should be considered for pre-exposure prophylactic AZD7442.

A retrospective cohort study was carried out in a large Israeli health maintenance organization to determine vaccine effectiveness (VE) of a third dose of BNT162b2 vaccine against covid-19 infection. Of nearly one million members receiving two doses of BNT162b2 in Jan-Feb 2021, infection rates (based on PCR results) were compared between those who received a third dose with those who did not during August-October 2021 (max: 70 days). Crude VE was 92.9% (95% CI:92.6-93.2%) and adjusted VE was 89.1% (95% CI:87.5-90.5%). We conclude that the third dose provides added protection against COVID-19 infection for those vaccinated six months ago.

Psychological readjustment apparently takes longer than other processes of adaptation. Several years after immigration, social and psychological factors have a more important role for the well-being of immigrants than their material conditions.

Israel experienced a new wave of coronavirus disease during June 2021, six months after implementing a national vaccination campaign. We conducted 3 discrete analyses using data from a large health maintenance organization in Israel to determine whether IgG levels of fully vaccinated persons decrease over time, describe the relationship between IgG titer and subsequent PCR-confirmed infection, and compare PCR-confirmed infection rates by period of vaccination. Mean IgG levels steadily decreased over the 6-month period in the total tested population and in all age groups. An inverse relationship was found between IgG titer and subsequent PCR-positive infection. Persons vaccinated during the first 2 months of the campaign were more likely to become infected than those subsequently vaccinated. The vaccinated group > 60 years of age had lower initial IgG levels and were at greater risk for infection. The findings support the decision to add a booster vaccine for persons > 60 years of age.

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