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. 2021 Dec:42:101190.
doi: 10.1016/j.eclinm.2021.101190. Epub 2021 Nov 29.

Effectiveness of BNT162b2 mRNA COVID-19 vaccine against SARS-CoV-2 variant Beta (B.1.351) among persons identified through contact tracing in Israel: A prospective cohort study

Shepherd R Singer  1   2 , Frederick J Angulo  3 , David L Swerdlow  3 , John M McLaughlin  3 , Itay Hazan  4 , Netanel Ginish  4 , Emilia Anis  1   2 , Ella Mendelson  5   6 , Orna Mor  5   6 , Neta S Zuckerman  5   6 , Oran Erster  5   6 , Jo Southern  3 , Kaijie Pan  3 , Gabriel Mircus  7 , Marc Lipsitch  8 , Eric J Haas  1   9 , Luis Jodar  3 , Yeheskel Levy  10 , Sharon Alroy-Preis  1
Affiliations

Effectiveness of BNT162b2 mRNA COVID-19 vaccine against SARS-CoV-2 variant Beta (B.1.351) among persons identified through contact tracing in Israel: A prospective cohort study

Shepherd R Singer et al. EClinicalMedicine. 2021 Dec.

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 vaccine effectiveness (VE) 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 (Dec 11, 2020 - 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: In a prospective observational study, two doses of BNT162b2 were effective against confirmed and probable Beta infections. Through the end of June 2021, introductions of Beta did not interrupt control of the pandemic in Israel.

Funding: Israel Ministry of Health and Pfizer.

Keywords: COVID-19; SARS-CoV-2; epidemiology; mRNA vaccines; prevention; vaccine effectiveness; variant Beta (B.1.351).

PubMed Disclaimer

Conflict of interest statement

Frederick Angulo, David Swerdlow, John McLaughlin, Farid Khan, Gabriel Mircus, Kaijie Pan, Jo Southern, and Luis Jodar are employees of Pfizer Inc, and 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.

Figures

FIGURE 1:
Figure 1
Daily reported laboratory-confirmed SARS-CoV-2 infections, Nov 1, 2020 – Jun 27, 2021, Israel
FIGURE 2:
Figure 2
Percent of PCR-positive specimens that are SARS-CoV-2 variants of concern (VoC), by week, Jan 3, 2021 – Jun 27, 2021, Israel
FIGURE 3:
Figure 3
Number of primary whole genome sequencing (WGS)-confirmed Beta cases identified during study period, Dec 11, 2020 – Mar 25, 2021, with contacts in the study, by week of laboratory-confirmation of SARS-CoV-2 infection, Israel.
FIGURE 4:
Figure 4
Contacts of primary Beta cases, Israel, Dec 11, 2020 – Mar 25, 2021.
See this image and copyright information in PMC

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