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Several studies have characterized the effectiveness of vaccines against SARS-CoV-2 infections. However, estimates of their impact on transmissibility remain limited. Here, we evaluated the impact of isolation and vaccination (7 days after the 2nd dose) on SARS-CoV-2 transmission within Israeli households. From December 2020 to April 2021, confirmed cases were identified among healthcare workers of the Sheba Medical Centre and their family members. Recruited households were followed up with repeated PCR for at least ten days after case confirmation. Data were analyzed using a data augmentation Bayesian framework. 210 households with 215 index cases were enrolled. 269 out of 667 (40%) susceptible household contacts developed a SARS-CoV-2 infection. Of those, 170 (63%) developed symptoms. Compared with unvaccinated and unisolated adult/teenager contacts, vaccination reduced the risk of infection among unisolated adult/teenager contacts above 12 (RR=0.21, 95% CrI credible interval 0.08-0.44) and isolation reduced the risk of infection among unvaccinated adult/teenager (RR=0.12, 95% CrI 0.06-0.21) and child contacts (RR=0.17, 95% CrI 0.08-0.32). Infectivity was reduced in vaccinated cases (RR=0.25, 95% CrI 0.06-0.77). Within households, vaccination reduces both the risk of infection and of transmission if infected. When contacts were unvaccinated, isolation also led to important reductions in the risk of transmission.

Impact of BNT162b2 Vaccination and Isolation on SARS-CoV-2 Transmission in Israeli Households: An Observational Study