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Infections, Hospitalizations, and Deaths Averted Via Direct Effects of the Pfizer-BioNTech BNT162b2 mRNA COVID-19 Vaccine in a Nationwide Vaccination Campaign, Israel

25 Pages Posted: 13 May 2021

See all articles by Eric J. Haas

Eric J. Haas

Ministry of Health (Israel) - Public Health Services

John M. McLaughlin

Pfizer, Inc.

Farid Khan

Pfizer, Inc.

Frederick J. Angulo

Pfizer, Inc.

Emilia Anis

Yale University; Ministry of Health (Israel) - Public Health Services

Marc Lipsitch

Harvard T.H. Chan School of Public Health - Center for Communicable Disease Dynamics

Shepherd R. Singer

Ministry of Health (Israel) - Public Health Services

Gabriel Mircus

Pfizer Pharmaceuticals Israel Ltd

Nati Brooks

Ministry of Health (Israel) - Information Technology Department

Meir Smaja

Ministry of Health (Israel) - Information Technology Department

Kaijie Pan

Pfizer, Inc.

Jo Southern

Pfizer, Inc.

David L. Swerdlow

Pfizer, Inc.

Luis Jodar

Pfizer, Inc. - Vaccines Medical Development & Scientific Affairs

Yeheskel Levy

Ministry of Health (Israel)

Sharon Alroy-Preis

Ministry of Health (Israel) - Department of Maternal and Child Health; Ministry of Health (Israel) - Public Health Services

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Abstract

Background: Israel recently initiated a rapid nationwide COVID-19 vaccination campaign to immunize persons ≥16 years of age and used exclusively Pfizer–BioNTech BNT162b2 mRNA COVID-19 vaccine according to schedule (two doses, 21 days apart). We provide the first estimates of the number of COVID-19 cases, hospitalizations, and deaths averted by a nationwide vaccination campaign. 

Methods: We used national surveillance data from the first 112 days (Dec 20, 2020 ‒ Apr 10, 2021) of Israel’s vaccination campaign to estimate averted burden of four outcomes: SARS-CoV-2 infections and COVID-19-related hospitalizations, severe or critical hospitalizations, and deaths. The direct effects of the immunization program were estimated for all susceptible individuals (i.e., no previous evidence of laboratory-confirmed SARS-CoV-2 infection) who were at least partially vaccinated (defined as receipt of at least one dose with ≥14 days after the first dose). Cases averted were estimated based on cumulative daily, age-specific rate differences comparing rates among unvaccinated to those who were at least partially vaccinated for each of the four outcomes and the (age-specific) size of the susceptible population and proportion that was at least partially vaccinated. 

Findings: Through Apr 10, 2021, we estimated that Israel’s vaccination campaign averted 158,665 (95% uncertainty range: 115,899‒201,431) SARS-CoV-2 infections, 24,597 (6,622‒42,571) hospitalizations, 17,432 (3,065‒31,799) severe and critical hospitalizations, and 5,533 (-1,146‒12,213) deaths. Of these, 66% of hospitalizations and 91% of deaths averted were among those ≥65 years of age. Seventy-three percent of SARS-CoV-2 infections and 79% of COVID-19-related hospitalizations and deaths averted stemmed from the protective effects in fully vaccinated persons. 

Interpretations: Without vaccination, Israel would have likely experienced triple the number of hospitalizations and deaths compared to what actually occurred during their largest wave of SARS-CoV-2 to date, which would have likely overwhelmed the healthcare system. Indirect effects and long-term benefits of the program, which could be substantial, were not included in these estimates and warrant future research. 

Funding: None.

Declaration of Interest: John McLaughlin, Frederick Angulo, Farid Khan, Gabriel Mircus, Kaijie Pan, Jo Southern, David Swerdlow, and Luis Jodar hold stock and stock options in Pfizer Inc. Marc Lipsitch has provided advice on COVID-19 free of charge to Janssen, Astra-Zeneca, Pfizer, and COVAXX (United Biomedical), as well as to the nonprofit One Day Sooner and has received consulting income or honoraria from Merck, Bristol Meyers Squibb, and Sanofi, and institutional research support from Pfizer. All other authors report no conflicts.

Keywords: COVID-19, SARS-CoV-2, cases averted, impact, hospitalizations, deaths, Israel, model, public health, pandemic

Suggested Citation

Haas, Eric J. and McLaughlin, John M. and Khan, Farid and Angulo, Frederick J. and Anis, Emilia and Lipsitch, Marc and Singer, Shepherd R. and Mircus, Gabriel and Brooks, Nati and Smaja, Meir and Pan, Kaijie and Southern, Jo and Swerdlow, David L. and Jodar, Luis and Levy, Yeheskel and Alroy-Preis, Sharon, Infections, Hospitalizations, and Deaths Averted Via Direct Effects of the Pfizer-BioNTech BNT162b2 mRNA COVID-19 Vaccine in a Nationwide Vaccination Campaign, Israel. Available at SSRN: https://ssrn.com/abstract=3845367 or http://dx.doi.org/10.2139/ssrn.3845367

Eric J. Haas (Contact Author)

Ministry of Health (Israel) - Public Health Services ( email )

Jerusalem
Israel

John M. McLaughlin

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

Farid Khan

Pfizer, Inc.

235 East 42 Street
New York, NY 10017
United States

Frederick J. Angulo

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

Emilia Anis

Yale University ( email )

New Haven, CT 06520
United States

Ministry of Health (Israel) - Public Health Services ( email )

Jerusalem
Israel

Marc Lipsitch

Harvard T.H. Chan School of Public Health - Center for Communicable Disease Dynamics ( email )

677 Huntington Avenue
Boston, MA MA 02115
United States

Shepherd R. Singer

Ministry of Health (Israel) - Public Health Services ( email )

Jerusalem
Israel

Gabriel Mircus

Pfizer Pharmaceuticals Israel Ltd ( email )

235 East 42 Street
New York, NY 10017
United States

Nati Brooks

Ministry of Health (Israel) - Information Technology Department ( email )

Israel

Meir Smaja

Ministry of Health (Israel) - Information Technology Department ( email )

Israel

Kaijie Pan

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

Jo Southern

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

David L. Swerdlow

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

Luis Jodar

Pfizer, Inc. - Vaccines Medical Development & Scientific Affairs

New York City, NY
United States

Yeheskel Levy

Ministry of Health (Israel) ( email )

Israel

Sharon Alroy-Preis

Ministry of Health (Israel) - Department of Maternal and Child Health

Jerusalem
Israel

Ministry of Health (Israel) - Public Health Services ( email )

Jerusalem
Israel

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