Protection of previous SARS-CoV-2 infection is similar to that of BNT162b2 vaccine protection: A three-month nationwide experience from Israel

Abstract

Worldwide shortage of vaccination against SARS-CoV-2 infection while the pandemic is still uncontrolled leads many states to the dilemma whether or not to vaccinate previously infected persons. Understanding the level of protection of previous infection compared to that of vaccination is important for policy making. We analyze an updated individual-level database of the entire population of Israel to assess the protection of both prior infection and vaccination in preventing subsequent SARS-CoV-2 infection, hospitalization with COVID-19, severe disease, and death due to COVID-19. Outcome data were collected from December 20, 2020 up to March 20, 2021. Vaccination was highly protective with overall estimated effectiveness for documented infection of 94.5% (CI: [94.3, 94.7]); hospitalization 95.8% (CI: [95.2, 96.2]); severe illness 96.3% (CI: [95.7, 96.9]); and death 96.0% (CI: [94.9, 96.9]). Similarly, the overall estimated level of protection from prior SARS-CoV-2 infection for documented infection is 94.8% (CI: [94.4, 95.1]); hospitalization 94.1% (CI: [91.9, 95.7]); and severe illness 96.4% (CI: [92.5, 98.3]). Our results should be considered by policymakers when deciding whether or not to prioritize vaccination of previously-infected adults.