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A pre–emergency use authorization randomized, controlled trial published online in NEJM on Dec 10, 2020, found a vaccine efficacy against symptomatic COVID-19 of 95%. The Israeli study was designed to investigate real-world effectiveness in diverse populations with different underlying medical conditions amid the challenges of imperfect compliance with vaccination schedules, the need for cold storage, and complex deployment logistics. Analysis of proxy data showed vaccine effectiveness of 29% against asymptomatic infection 14 to 20 days after the first dose, climbing to 52% during days 21 to 27, and 90% 7 or more days after the second dose. The authors noted that the previous trial estimated vaccine effectiveness of 52% against asymptomatic infection. The difference, they said, may be explained by the rapid spread of coronavirus in Israel at the time of their study, which affected vaccinees and controls alike in the first 12 days after the first dose. To counter this potential

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