Infections, hospitalisations, and deaths averted via a nationwide vaccination campaign using the Pfizer–BioNTech BNT162b2 mRNA COVID-19 vaccine in Israel: a retrospective surveillance study

Abstract

Background On Dec 20, 2020, Israel initiated a nationwide COVID-19 vaccination campaign for people aged 16 years and older and exclusively used the Pfizer–BioNTech BNT162b2 mRNA COVID-19 vaccine (tozinameran). We provide estimates of the number of SARS-CoV-2 infections and COVID-19-related admissions to hospital (ie, hospitalisations) and deaths averted by the nationwide vaccination campaign. Methods In this retrospective surveillance study, we used national surveillance data routinely collected by the Israeli Ministry of Health from the first 112 days (Dec 20, 2020, up to our data cutoff of April 10, 2021) of Israel's vaccination campaign to estimate the averted burden of four outcomes: SARS-CoV-2 infections and COVID-19-related hospitalisations, severe or critical hospitalisations, and deaths. As part of the campaign, all individuals aged 16 years and older were eligible for inoculation with the BNT162b2 vaccine in a two-dose schedule 21 days apart. We estimated the direct effects of the immunisation programme for all susceptible individuals (ie, with no previous evidence of laboratory-confirmed SARS-CoV-2 infection) who were at least partly vaccinated (at least one dose and at least 14 days of follow-up after the first dose). We estimated the number of SARS-CoV-2 infection-related outcomes averted on the basis of cumulative daily, age-specific rate differences, comparing rates among unvaccinated individuals with those of at least partly vaccinated individuals for each of the four outcomes and the (age-specific) size of the susceptible population and proportion that was at least partly vaccinated. Findings We estimated that Israel's vaccination campaign averted 158 665 (95% CI 144 640–172 690) SARS-CoV-2 infections, 24 597 (18 942–30 252) hospitalisations, 17 432 (12 770–22 094) severe or critical hospitalisations, and 5532 (3085–7982) deaths. 16 213 (65·9%) of 24 597 hospitalisations and 5035 (91·0%) of 5532 of deaths averted were estimated to be among those aged 65 years and older. We estimated 116 000 (73·1%) SARS-CoV-2 infections, 19 467 (79·1%) COVID-19-related hospitalisations, and 4351 (79%) deaths averted were accounted for by the fully vaccinated population. Interpretation Without the national vaccination campaign, Israel probably would have had triple the number of hospitalisations and deaths compared with what actually occurred during its largest wave of the pandemic to date, and the health-care system might have become overwhelmed. Indirect effects and long-term benefits of the programme, which could be substantial, were not included in these estimates and warrant future research. Funding Israel Ministry of Health and Pfizer.

COVID-19 Vaccine Boosters: The Good, the Bad, and the Ugly

“…Although the risk of breakthrough infections may increase over time in vaccinated individuals due to the waning of serum antibody levels and can be further elevated due to circulation of some more transmissible SARS-CoV-2 variants (e.g., B.1.617.2), this does not equal an increased risk of breakthrough diseases, especially ones leading to hospitalization or risk of death. Data originating from different parts of the world consistently show that COVID-19 vaccines retain high levels of protection against severe infections and death; that is, the risk of hospitalization and death due to severe COVID-19 is significantly higher in unvaccinated individuals, although its exact values may vary across populations due to different settings and types of administered vaccines [44][45][46][47][48][49][50][51][52]. For example, data collected by the US Centers for Disease Control and Prevention indicate that, in August 2021, unvaccinated individuals had a 6-fold higher risk of SARS-CoV-2 infection and an 11-fold higher risk of dying from COVID-19 [53].…”

Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study

“…In a pivotal randomised controlled trial, the BNT162b2 mRNA vaccine (tozinameran, Pfizer-BioNTech) showed 95% or greater efficacy against symptomatic and severe COVID-19 disease due to SARS-CoV-2. 1 In the early months after its introduction, BNT162b2 has been shown to be highly effective in the real-world setting and to have had a large public health effect on reducing infections, hospital admissions, and deaths at a time when the alpha (B.1.1.7) variant was the predominant strain in Israel, [2][3][4] the USA, [5][6][7][8] Canada, 9 the UK, [10][11][12][13][14][15][16] and Qatar. 17,18 The continual emergence of SARS-CoV-2 variants has raised concern that COVID-19 vaccines could have reduced effectiveness against new viral strains; however, BNT162b2 has shown robust amounts of neutralising antibodies against all variants of concern evaluated to date.…”

Vaccines against COVID-19: Priority to mRNA-Based Formulations

“…As the vaccines induced immune response declines over time [54], a third dose more than six months after the second dose is recommended, particularly in elderly people or at-risk groups. In Israel, although a fourth wave of COVID came in summer 2021, it is estimated that, altogether, two thirds of hospitalizations and deaths have been prevented by the mRNA vaccine campaign [55]. This illustrates the great benefits brought by the anti-COVID mRNA vaccines.…”