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Successful Vaccination in Israel

 Pfizer Vaccine Succeeds in Real World Setting
      
    Multiple vaccines are now being distributed in many countries across the world including the Pfizer vaccine in Israel. Every country has its own unique approach to vaccination, with some approaches being more efficient than others. Israel is one such country that has succeeded with its rapid vaccine distribution. According to the Centers for Diseases Control and Prevention, Israel began it's vaccine distribution in December 2020 and by February 2021, already 84% of Israelis aged 70 years or older and 10% of Israelis aged under 50 years received a complete 2 doses of the Pfizer vaccine. In comparison, only 7.7% of Americans have been fully vaccinated as of March 1, 2021. Data from mass vaccine rollouts (like Israel) are a great indicator of a vaccine's efficacy in the real world, where the setting is not limited by factors such as sample size or restrictive inclusion as in clinical trials. An article published in the New England Journal of Medicine on February 24, 2021 details the effects of the Pfizer vaccine in Israel.

About the Study

    Data was taken from Clalit Health Services in Tel Aviv, Israel between December 20, 2020 and February 1, 2021, when the distribution of the 2-dose Pfizer vaccine was taking place. In order to receive the vaccine, individuals had to be at least 16 years or older, a member of the healthcare organization, and not have a previous positive COVID-19 test. Vaccine recipients were each matched with a non-vaccinated (control) individual based on a variety of factors including age, sex, sector, neighborhood of residence, history of influenza vaccination, pregnancy, and co-existing conditions. All in all, 596,618 vaccinated individuals were matched to 596,618 unvaccinated controls, amounting to a total of over 1 million participants.

Study Results

    What makes this real world study unique is not only the large sample size, but also the well-balanced baseline characteristics, or varying demographic groups, across the control and vaccinated participants. After an average follow up of 15 days, 10,560 participants were  infected with the coronavirus. Of these infected individuals, 6,100 people belonged to the unvaccinated cohort and 4,460 individuals belonged to the vaccinated cohort. Out of those infected, 5,996 were symptomatic with COVID-19 with 3,607 individuals in the unvaccinated cohort and 2,389 in the vaccinated cohort. Additionally, 259 unvaccinated participants and 110 vaccinated participants were hospitalized due to COVID-19 while 174 unvaccinated and 55 vaccinated participants suffered from severe COVID-19. There were a total of 41 deaths, of which 32 were unvaccinated individuals and 9 were vaccinated individuals. (See figure below)

    Below are the results from the trial detailing the efficacy of the Pfizer vaccine 14 to 20 days after the first dose and 7 days after the second dose:
  • COVID-19 infection- 46% and 92%
  • Symptomatic COVID-19- 57% and 94%
  • COVID-19 hospitalization- 74% and 87%
  • Severe disease- 62% and 92%
  • Death from COVID-19- 72%
    The vaccine efficacy against infection and symptomatic COVID-19 was consistent across all age groups with "potentially slightly lower effectiveness" in individuals with multiple co-existing conditions. Efficacy was also highest 7 days after the second dose, emphasizing the importance of receiving the complete 2 dosages of the Pfizer vaccine. The results from this study (92% vaccine effective against infection)  were also very similar to the results from Pfizer's phase 3 clinical trial, which resulted in a 95% efficacy against COVID-19 also 7 days after the second dose. Additionally, the study was conducted during a period where there were increasing cases of the COVID-19 B.1.1.7 variant in Israel. This suggests that the Pfizer vaccine is also effective against the B.1.1.7 variant. 

Conclusion

    Israel's rapid vaccine distribution and positive results serves as encouraging news for the rest of the world currently distributing vaccines. With the vaccines already developed, it is now up to government leaders to efficiently distribute the vaccines to its citizens. However, vaccination is not just dependent on the government but also on the willingness of individuals to receive the vaccine. The study results not only prove that efficient vaccine distribution is possible and important, but also confirms the efficacy of the Pfizer vaccine in a real world setting which may be important news for individuals on the fence about whether or not to get vaccinated. If you are eligible to get vaccinated in your country, go do it! Multiple trials and studies like this one, have confirmed the efficacy of the currently approved COVID-19 vaccines.  (If you're not sure which vaccine to get see Comparing Vaccines) Getting as many people vaccinated, as soon as possible, is imperative to slowing the spread of the coronavirus and returning back to pre-COVID life. 

Sources

1. Dagan, Noa, et al. “BNT162b2 MRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting.” New England Journal of Medicine, 24 Feb. 2021, doi:https://doi.org/fw7w.

2. Rinott, Ehud, et al. “Reduction in COVID-19 Patients Requiring Mechanical Ventilation Following Implementation of a National COVID-19 Vaccination Program - Israel, December 2020–February 2021.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 26 Feb. 2021, www.cdc.gov/mmwr/volumes/70/wr/mm7009e3.htm?s_cid=mm7009e3_x.

3. “CDC COVID Vaccinations in the United States.” COVID Data Tracker, Centers for Disease Control and Prevention, covid.cdc.gov/covid-data-tracker/#vaccinations.

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