BNT162b2 Vaccine Effectiveness in Preventing Asymptomatic Infection With SARS-CoV-2 Virus: A Nationwide Historical Cohort Study

Background There is strong evidence regarding the efficacy and effectiveness of the BNT162b2 vaccine in preventing symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is a relative paucity of data regarding its effectiveness in the prevention of asymptomatic infection. Methods In this real-world observational study, we identified a subpopulation of individuals in a large health maintenance organization who were repeatedly tested for SARS-CoV-2 infection by polymerase chain reaction (PCR). We included these individuals in the study cohort and compared those who were vaccinated with BNT162b2 mRNA vaccine to unvaccinated individuals. A positive SARS-CoV-2 PCR test result was used as the outcome. The follow-up period was from January 1, 2021, until February 11, 2021. Results A total of 6286 individuals were included in the cohort. Seven days after the second vaccine dose, a rate of 6 positive PCR tests per 10 000 person-days was recorded, compared with a rate of 53 positive tests per 10 000 person-days for the unvaccinated group. The estimated vaccine effectiveness against infection with SARS-CoV-2 virus after 2 vaccine doses was 89% (95% CI, 82%-94%). The estimated effectiveness 2 weeks after the first vaccine dose was 61% (95% CI, 49%-71%). Conclusions In this study, vaccination with BNT162b2 reduced infection rates among individuals who underwent screening by frequent SARS-CoV-2 PCR testing. Using a cohort of frequently tested individuals reduced the indication bias for the PCR testing, which enabled estimation of infection rates. The effectiveness of BNT162b2 vaccine in prevention of asymptomatic infection is unclear. Among individuals who were repeatedly tested for SARS-CoV-2 infection by PCR, we found that the estimated vaccine effectiveness against SARS-CoV-2 virus after two vaccine doses was 89%.

Automated summary

A real-world observational study found that vaccination with the BNT162b2 vaccine has an effectiveness of 89% in preventing SARS-CoV-2 infection. Among individuals who underwent frequent PCR testing, the vaccination significantly reduced the positive test rate after receiving two doses of the vaccine.