COVID-19 vaccine effectiveness
(Randomized evidence)

Methods

Protocol

Results of booster studies are available in the tables below and are updated on a daily basis.

As of December 14, 2022, the COVID-NMA revised its protocol and discontinued the inclusion of prime vaccination trials in its analysis. The analysis presented on this page for prime vaccines compared to placebo or other vaccines includes trials that were identified and included up to December 14, 2022. A list of studies that were eligible up to this date but not extracted is provided in detail here .

On December 7, 2022, we published results of the systematic review "Efficacy and safety of COVID‐19 vaccines" which included 41 preprints and published trials of 12 different COVID-19 used as prime vaccination and that were published before 5 November 2021.

meta-COVID

Perform your own analysis using COVID-NMA data, create and download your forest plots by clicking below:

go to metacovid

Vaccine types

Vaccine efficacy and safety for vaccine vs placebo / no vaccine (forest plots)

Vaccine efficacy and safety for vaccine vs vaccine (forest plots)

Vaccine efficacy and safety against variants of concern (forest plots)

Vaccine efficacy, immunogenicity and safety of heterologous vs homologous vaccination (tables)

Vaccine efficacy, immunogenicity and safety of booster vs no booster (tables)

Vaccine efficacy, immunogenicity and safety of booster VS booster (tables)

Trials reports under extraction

In addition to the below included trials, we have included and presently extracting 15 new vaccine randomized trials

Description of primary studies

In this table, we report the main characteristics of the COVID-19 vaccine candidates from RCTs identified, in addition to the overall risk of bias assessment.

For prime vaccination, early phase trials were extracted only when the dose has been selected. Results from phase 1-2 studies are included in forest plots for the chosen vaccine dose and schedule only. List of early phases included but not extracted are detailed on here .

Search studies

Search by Vaccine name Author Registration number
Trial Type Comparisons Design Participants Sample size Overall risk
of bias
Highest assessment
Full description
Intervention 1 Intervention 2
NCT04999111
Janssen Pharmaceutical Companies
Amplify, Unpublished, 2023 b
New

Full text
Heterologous booster

BNT162b2/ Boost Ad26.COV2.S 1*10^10 vp

BNT162b2/ Boost Ad26.COV2.S 2.5*10^10 vp

BNT162b2/ Boost Ad26.COV2.S

RCT
Phase 2
Adults including elderly and stable co-morbidities with no history of COVID-19 in 21 centres in USA. N= 764
Some concerns
Details

Full description

NCT04999111
Janssen Pharmaceutical Companies
Amplify, Unpublished, 2023 a
New

Full text
Homologous booster

Ad26.COV2.S/Boost Ad26.COV2.S 1*10^10 vp

Ad26.COV2.S/Boost Ad26.COV2.S 2.5*10^10 vp

Ad26.COV2.S//Boost Ad26.COV2.S

RCT
Phase 2
Adults including elderly and stable co-morbidities with no history of COVID-19 in 21 centres in USA. N= 777
Some concerns
Details

Full description

NCT05069129
Sinopharm-Beijing/ National Vaccine and Serum Institute, China
Al Kaabi N, Nat Commun, 2022 b
New

Full text
Commentary
Commentary
Heterologous booster

BBIBP-CorV/boostNVSI-06-08 4-6m

BBIBP-CorV/boostNVSI-06-08 7-9m

BBIBP-CorV/boostNVSI-06-08 >9m

BBIBP-CorV/boostBBIBP-CorV 4-6 months

BBIBP-CorV/boostBBIBP-CorV 7-9m

BBIBP-CorV/boostBBIBP-CorV >9m

RCT
Phase 2
Healthy adults that were HIV-negative and with no previous history of COVID-19 in a single centre in the United Arab Emirates. N= 1833
Some concerns
Details

Full description

NCT05216601
Medigen Vaccine Biologics+Dynavax+NIAID
Lien C, SSRN, 2022 b
New

Full text
Full text
Commentary
Commentary
Commentary
Commentary
Heterologous booster

Prime series MVC-COV1901+boost MVC-COV1901+boost MVC-COV1901 Beta 15mcg

Prime series MVC-COV1901+boost MVC-COV1901+boost MVC-COV1901 Beta 25mcg

Prime series MVC-COV1901+boost MVC-COV1901+boost MVC-COV1901

RCT
Phase 1
Healthy adults or with stable co-morbidities that were HIV-negative and with no history of COVID-19 in 2 centres in Taiwan (China). N= 62
Some concerns
Details

Full description

NCT05216601
Medigen Vaccine Biologics+Dynavax+NIAID
Lien C, SSRN, 2022 a
New

Full text
Full text
Commentary
Commentary
Commentary
Commentary
Heterologous booster

MVC-COV1901/boost MVC-COV1901-Beta 15 mcg

MVC-COV1901/boost MVC-COV1901-Beta 25 mcg

MVC-COV1901/boost MVC-COV1901

RCT
Phase 1
Healthy adults or with stable co-morbidities that were HIV-negative and with no history of COVID-19 in 2 centres in Taiwan (China). N= 45
Some concerns
Details

Full description

NCT05303584
CanSino Biological Inc
Tang R, Lancet Resp Med, 2023
New

Full text
Full text
Commentary
Commentary
Heterologous booster

Coronavac/boost Coronovac/boost Ad5-nCoV IN

Coronavac/boost Coronovac/boost Ad5-nCoV IM

Coronavac/boost Coronovac/boost Coronavac

RCT
Phase 4
Healthy adults previously in receipt of 3 doses of CoronaVac and with no history of SARS-CoV-2/COVID-19 in multiple centres in China. N= 356
Some concerns
Details

Full description

TCTR20210907003, TCTR20211102006
AstraZeneca + University of Oxford ; Pfizer/BioNTech + Fosun Pharma
Niyomnaitham S, Vaccines, 2022

Full text
Commentary
Commentary
Non replicating viral vector

Prime Coronavac/Boost ID 1/5 ChAdOx1

Prime Coronavac/Boost ID 1/6 BNT162b2

RCT
Phase 1-2
Healthy adults with no known history of previous SARS-CoV-2 infection at a single center in Thailand. N= 90
Some concerns
Details

Full description

EudraCT 2021-002693-10
Moderna+NIAID; Pfizer/BioNTech+Fosun Pharma; AstraZeneca + University of Oxford
Mrak D, Nat Commun, 2022

Full text
Commentary
Commentary
Homologous booster

BNT162b2 or mRNA-1273/Boost ChAdOx1

mRNA-1273 or BNT162b2/Homologous boost

RCT
Phase 2
Immunosuppressed adults including elderly with no history of COVID-19 in a single centre in Austria. N= 51
Low
Details

Full description

NCT05049226
AstraZeneca + University of Oxford ; Pfizer/BioNTech + Fosun Pharma
Niyomnaitham S, medRxiv, 2022

Full text
Commentary
Commentary
Heterologous booster

Coronavac/Boost ChAdOx1

CoronaVac/Boost BNT162b2

RCT
Phase 2
Healthy adults without recent (3 months) COVID-19 at 7 centers in Thailand. N= 1243
Some concerns
Details

Full description

ChiCTR2200057758
Walvax Biotech Co., Ltd ; Walvax Biotechnology + Shanghai RNACure Biopharma ; Shanghai Zerun Biotechnology + Walvax Biotechnology + CEPI ; Sinovac Research an
Zhang Y, EClinicalMedicine, 2022

Full text
Commentary
Non replicating viral vector

CoronaVac/Boost ChAdTS-S

CoronaVac/Boost RQ3013

CoronaVac/Boost ZR202-CoV

CoronaVac/Boost CoronaVac

CoronaVac/Boost placebo

RCT
Phase 2
Adults aged 18-59, healthy or with stable pre-existing disease and with no history of SARS-CoV-2 infection, at a single center in China. N= 250
Some concerns
Details

Full description