BNT162b2 post-exposure-prophylaxis against COVID-19

  1. Zohar Shmuelian
  2. Yehuda Warszawer
  3. Omri Or
  4. Sagit Arbel-Alon
  5. Hilla Giladi
  6. Meytal Avgil Tsadok
  7. Roy Cohen
  8. Galit Shefer
  9. Antonello Maruotti
  10. Giovanna Jona Lasinio
  11. Eithan Galun

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Background

During the COVID-19 pandemic, post-exposure-prophylaxis is not a practice. Following exposure, only patient isolation is imposed. Moreover, no therapeutic prevention approach is applied. We asked whether evidence exists for reduced mortality rate following post-exposure-prophylaxis.

Methods

To estimate the effectiveness of post-exposure-prophylaxis, we obtained data from the Israeli Ministry of Health (MoH) registry. The study population consisted of Israeli residents aged 12 years and older, identified for the first time as PCR-positive for SARS-CoV-2, between December 20 th , 2020 (the beginning of the vaccination campaign) and October 7 th , 2021. We compared “recently injected” patients - that proved PCR-positive on the same day or on one of the five consecutive days after first vaccination (representing an unintended post-exposure-prophylaxis), to unvaccinated control group.

Results

Among Israeli residents identified PCR-positive for SARS-CoV-2, 11,690 were found positive on the day they received their first vaccine injection (BNT162b2) or on one of the 5 days thereafter. In patients over 65 years, 143 deaths occurred among 1413 recently injected (10.12%) compared to 280 deaths among the 1413 unvaccinated (19.82%), odd ratio (OR) 0.46 (95% confidence interval (CI), 0.36 to 0.57; P<0.001). The most significant reduction in the death toll was observed among the 55 to 64 age group, with 8 deaths occurring among the 1322 recently injected (0.61%) compared to 43 deaths among the 1322 unvaccinated control (3.25%), OR 0.18 (95% CI, 0.07 to 0.39; P<0.001).

Conclusion

Post-exposure-prophylaxis is effective against death in COVID-19 infection.

Israeli MoH Registry Number

HMO-0372-20

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2022.01.07.22268869: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: This study was approved by the Hadassah Hebrew University Hospital institutional review board (IRB approval number HMO-0372-20).
    Consent: The study was exempt from the requirement for informed consent.
    Sex as a biological variablenot detected.
    RandomizationThe goal of matching is to produce covariate balance, that is, for the distributions of covariates in the two groups to be approximately equal to each other, as they would be in a successful randomized experiment.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.01.07.22268869v1 on medRxiv