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Effectiveness of BNT162b2 mRNA COVID-19 Vaccine Against SARS-CoV-2 Variant Beta (B.1.351) Among Persons Identified Through Contact Tracing in Israel

29 Pages Posted: 13 Aug 2021

See all articles by Shepherd R. Singer

Shepherd R. Singer

Ministry of Health (Israel) - Public Health Services

Frederick J. Angulo

Pfizer, Inc.

David L. Swerdlow

Harvard University - Center for Communicable Disease Dynamics

John M. McLaughlin

Pfizer, Inc.

Itay Hazan

Ministry of Health (Israel)

Netanel Ginish

Israel Ministry of Health

Emilia Anis

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

Ella Mendelson

Sheba Medical Center - Central Virology Laboratory

Orna Mor

Sheba Medical Center - Central Virology Laboratory

Neta S. Zuckerman

Sheba Medical Center - Central Virology Laboratory

Oran Erster

Chaim Sheba Medical Center - Central Virology Laboratory

Jo Southern

Pfizer, Inc. - Vaccines Medical Development & Scientific Affairs

Kaijie Pan

Pfizer, Inc.

Gabriel Mircus

Pfizer Pharmaceuticals Israel Ltd

Marc Lipsitch

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

Eric J. Haas

Ministry of Health (Israel) - Public Health Services

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

More...

Abstract

Background: SARS-CoV-2 variant Beta (B.1.351) was designated as a Variant of Concern (VoC) after becoming the dominant strain in South Africa and spreading internationally. BNT162b2 showed lower levels of neutralizing antibodies against Beta than against other strains raising concerns about effectiveness of vaccines against infections caused by Beta. We estimated BNT162b2 effectiveness against Beta infections in Israel, a country with high vaccine uptake. 

Methods: The Ministry of Health (MoH) identified Beta cases through mandatory reporting of SARS-CoV-2 cases and whole genome sequencing (WGS) of specimens from vaccination-breakthrough infections, reinfections, arriving international travelers, and a selection of other infected persons. A cohort analysis was conducted of exposure events of contacts of primary Beta cases. WGS was conducted on available PCR-positive specimens collected from contacts. VE estimates with 95% confidence intervals (CIs) against confirmed and probable Beta infections were determined by comparing infection risk between unvaccinated and fully-vaccinated ( > 7 days after the second dose) contacts, and between unvaccinated and partially-vaccinated (<7 days after the second dose) contacts. 

Findings: MoH identified 310 Beta cases through Jun 27, 2021. During the study period (Jan 1, 2021 – Mar 25, 2021), 164 non-institutionalized primary Beta cases, with 552 contacts aged > 16 years, were identified. 343/552 (62%) contacts were interviewed and tested. 71/343 (21%) contacts were PCR-positive. WGS was performed on 7/71 (10%) PCR-positive specimens; all were Beta. Among SARS-CoV-2-infected contacts, 48/71 (68%) were symptomatic, 10/71 (14%) hospitalized, and 2/71 (3%) died. Fully-vaccinated VE against confirmed or probable Beta infections was 72% (95% CI -5 - 97%; p =0.04) and against  symptomatic confirmed or probable Beta infections was 100% (95% CI 19 - 100%; p =0.01). There was no evidence of protection in partially-vaccinated contacts. 

Interpretation: Two doses of BNT162b2 conferred protection against Beta infections and disease. Introductions of Beta did not interrupt control of the pandemic in Israel. 

Funding: None to declare.

Declaration of Interest: Frederick Angulo, David Swerdlow, John McLaughlin, Farid Khan, Gabriel Mircus, Kaijie Pan, Jo Southern, 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, Pfizer, Bristol Meyers Squibb, Janssen, and Sanofi, and institutional research support from Pfizer. He is on the Scientific Advisory Committee of the Coalition for Epidemic Preparedness and Innovations (CEPI). All other authors report no conflicts.

Ethical Approval: This study was approved by MoH’s Institutional Review Board (CoR-MoH-080-2021).

Suggested Citation

Singer, Shepherd R. and Angulo, Frederick J. and Swerdlow, David L. and McLaughlin, John M. and Hazan, Itay and Ginish, Netanel and Anis, Emilia and Anis, Emilia and Mendelson, Ella and Mor, Orna and Zuckerman, Neta S. and Erster, Oran and Southern, Jo and Pan, Kaijie and Mircus, Gabriel and Lipsitch, Marc and Haas, Eric J. and Jodar, Luis and Levy, Yeheskel and Alroy-Preis, Sharon, Effectiveness of BNT162b2 mRNA COVID-19 Vaccine Against SARS-CoV-2 Variant Beta (B.1.351) Among Persons Identified Through Contact Tracing in Israel. Available at SSRN: https://ssrn.com/abstract=3904701 or http://dx.doi.org/10.2139/ssrn.3904701

Shepherd R. Singer

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

Jerusalem
Israel

Frederick J. Angulo (Contact Author)

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

David L. Swerdlow

Harvard University - Center for Communicable Disease Dynamics ( email )

Boston, MA
United States

John M. McLaughlin

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

Itay Hazan

Ministry of Health (Israel) ( email )

Israel

Netanel Ginish

Israel Ministry of Health ( email )

Israel

Emilia Anis

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

Jerusalem
Israel

Yale University ( email )

493 College St
New Haven, CT CT 06520
United States

Ella Mendelson

Sheba Medical Center - Central Virology Laboratory ( email )

Ramat-Gan
Israel

Orna Mor

Sheba Medical Center - Central Virology Laboratory ( email )

Ramat-Gan
Israel

Neta S. Zuckerman

Sheba Medical Center - Central Virology Laboratory ( email )

Ramat-Gan
Israel

Oran Erster

Chaim Sheba Medical Center - Central Virology Laboratory ( email )

Jo Southern

Pfizer, Inc. - Vaccines Medical Development & Scientific Affairs ( email )

Kaijie Pan

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

Gabriel Mircus

Pfizer Pharmaceuticals Israel Ltd ( email )

235 East 42 Street
New York, NY 10017
United States

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

Eric J. Haas

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

Jerusalem
Israel

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