Covid-19 living Data

COVID-19 vaccine effectiveness
(Randomized evidence)

Methods

Protocol

Analyses are updated every two weeks

meta-COVID

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

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)

Immunogenicity
Geometric mean titre specific antibodies

Reference	Intervention 1	Intervention 2	Follow up days	Participants	GMT1(N1)	GMT2(N2)	GMR [95% CI]	Evaluated by	Risk of bias
									A	B	C	D	E	Overall
Janssen C, 2022	1 dose BNT162b2/1 dose mRNA-1273	2 doses BNT162b2	28	Adults	3,706 (96)	2,698 (94)	1.37 [1.10, 1.72]	ELISA
Janssen C, 2022	1 dose mRNA-1273 /1 dose BNT162b2	2 doses mRNA-1273	28	Adults	2,690 (103)	3,995 (97)	0.67 [0.55, 0.82]	ELISA
Li J, 2022	1 dose CoronaVac / 1 dose Ad5-vectored	2 doses CoronaVac	14	Healthy adults	942 (51)	154 (50)	6.11 [3.90, 9.57]	ELISA
Puthanakit T, 2022 a	CoronaVac followed by BNT162b2 30 at 6week interva	CoronaVac followed by BNT162b2 30 at 3week interva	21	Adolescents	112 (20)	77 (20)	1.28 [1.09, 1.51]	ELISA
Puthanakit T, 2022 a	CoronaVac followed by BNT162b2 20 at 3week interva	CoronaVac followed by BNT162b2 30 at 3week interva	21	Adolescents	84 (17)	77 (20)	0.95 [0.80, 1.13]	ELISA
Puthanakit T, 2022 a	CoronaVac followed by BNT162b2 20 at 6week interva	CoronaVac followed by BNT162b2 30 at 3week interva	21	Adolescents	74 (19)	77 (20)	1.10 [0.94, 1.30]	ELISA

N1: Number of patients analyzed in intervention 1; N2: Number of patients analyzed in intervention 2; GMT1: Geometric mean titre for intervention 1; GMT2: Geometric mean titre for intervention 2

Geometric mean titre neutralizing antibodies

Reference	Intervention 1	Intervention 2	Follow up days	Participants	GMT1(N1)	GMT2(N2)	GMR [95% CI]	Evaluated by
	A	B	C	D	E	Overall
Janssen C, 2022	1 dose BNT162b2/1 dose mRNA-1273	2 doses BNT162b2	28	Adults	523 (96)	396 (94)	1.31 [1.02, 1.69]	CPE (cytopathic effect)-based virus neutralization test (VNT)
Li J, 2022	1 dose CoronaVac / 1 dose Ad5-vectored	2 doses CoronaVac	14	Healthy adults	54 (51)	13 (50)	4.3 [2.5, 7.3]	CPE-based microneutralization assay-wild-type
Jin P, 2022 b	CoronaVac/Ad5-nCoV	CoronaVac	14	Elderly	71 (47)	9 (46)	7.6 [4.1, 14.1]	Microneutralization assay

Safety
Serious adverse events

Reference	Intervention 1	Intervention 2	Follow up months	Participants	r1/N1	r2/N2	RR [95% CI]	Risk of bias
								A	B	C	D	E	Overall
Macchia A, 2022	Gam-COVID-Vac rAd26-S	Gam-COVID-Vac rAd26-S/BBIBP-CorV	1	Adults	0 / 87	0 / 65	NR
Stuart A, 2021 a	1 dose ChAdOx1 followed by 1 dose NVX-CoV2373	2 doses ChAdOx1	NR	Older adults	1 / 179	3 / 180	0.34 [0.04 - 3.19]
Stuart A, 2021 a	1 dose ChAdOx1 followed by 1 dose mRNA-1273	2 doses ChAdOx1	NR	Older adults	3 / 181	3 / 180	0.99 [0.2 - 4.86]
Stuart A, 2021 b	1 dose BNT162b2 followed by 1 dose NVX-CoV2373	2 doses BNT162b2	NR	Older adults	3 / 180	2 / 175	1.46 [0.25 - 8.62]
Stuart A, 2021 b	1 dose BNT162b2 followed by 1 dose mRNA-1273	2 doses BNT162b2	NR	Older adults	3 / 177	2 / 175	1.48 [0.25 - 8.77]
Janssen C, 2022	1 dose BNT162b2/1 dose mRNA-1273	2 doses BNT162b2	0.9	Adults	0 / 102	0 / 101	NR
Janssen C, 2022	1 dose mRNA-1273 /1 dose BNT162b2	2 doses mRNA-1273	0.9	Adults	0 / 106	0 / 105	NR
Li J, 2022	1 dose CoronaVac / 1 dose Ad5-vectored	2 doses CoronaVac	1	Healthy adults	0 / 51	0 / 50	NR
Liu X, 2022	1 dose ChAdOx1/ 1 dose BNT162b2	2 doses ChAdOx1	8.3	Adults	2 / 114	1 / 115	2.02 [0.19 - 21.94]
Liu X, 2022	1 dose BNT162b2 /1 dose ChAdOx1	2 doses BNT162b2	8.3	Adults	2 / 115	1 / 119	2.07 [0.19 - 22.51]
Jin P, 2022 b	CoronaVac/Ad5-nCoV	CoronaVac	6	Elderly	1 / 50	2 / 50	0.5 [0.05 - 5.33]

r1: Number of events in intervention 1, r2: Number of events in intervention 2, N1: Number of patients analyzed in intervention 1; N2: Number of patients analyzed in intervention 2.

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

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up months	Participants	r1/N1	r2/N2	Vaccine efficacy [95% CI]	Risk of bias
	A	B	C	D	E	Overall
Toledo-Romani ME, 2022 b	Protein subunit	FINLAY-FR-2-25 mcg	Boost FINLAY-FR-1-50 mcg	Placebo	*	Adults	0 / 13828	6 / 12486	100.0 [*, 100]

Efficacy
Severe or critical COVID-19 after complete vaccination
Confirmed symptomatic COVID-19 after complete vaccination

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up months	Participants	r1/N1	r2/N2	VE [95% CI]
	A	B	C	D	E	Overall
Moreira E D, 2022	RNA based vaccine	BNT162b2	Boost BNT162b2	Placebo	2.5	Adults and adolescents	6 / 4695	123 / 4671	95.3 [89.5, 98.3]
Wang X-Y, 2022	Inactivated virus	BBIBP-CorV or CoronaVac	Boost V-01	Placebo	2	Healthy adults	38 / 4935	72 / 4934	47.8 [22.6, 64.7]
Toledo-Romani ME, 2022 b	Protein subunit	FINLAY-FR-2-25 mcg	Boost FINLAY-FR-1-50 mcg	Placebo	*	Adults	6 / 13828	35 / 12486	92.0 [80.4, 96.7]

Immunogenicity
Geometric mean titre specific antibodies

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up days	Participants	GMT1(N1)	GMT2(N2)	GMR [95% CI]	Evaluated by	Risk of bias
											A	B	C	D	E	Overall
Hall VG, 2021	RNA based vaccine	mRNA-1273	Boost mRNA-1273	Placebo	28	Transplant recipients	3,145 (60)	86 (57)	36.5 [ 12.9, 94]	Roche Elecsys
Vadrevu KM, 2022	Inactivated virus	BBV152	Boost BBV152	Placebo	28	Adolescents and adults	7,013 (80)	4,294 (87)	1.56 [1.06, 2.28]	ELISA
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost m-RNA-1273	Placebo	28	Healthcare workers	4,379 (112)	107 (105)	40,92 [23,33, 71,78]	Liaison SARS CoV-2 TrimericS IgG
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Placebo	28	Healthcare workers	403 (106)	107 (105)	3,76 [2,11, 6,69]	Liaison SARS CoV-2 TrimericS IgG
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost BNT162b2	Placebo	28	Healthcare workers	2,671 (111)	107 (105)	24,96 [14,11, 44,14]	Liaison SARS CoV-2 TrimericS IgG

Number of patients analyzed in intervention 1; N2: Number of patients analyzed in intervention 2; GMT1: Geometric mean titre for intervention 1; GMT2: Geometric mean titre for intervention 2; N1GMR: Geometric mean ratio

Geometric mean titre neutralizing antibodies

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up days	Participants	GMT1(N1)	GMT2(N2)	GMR [95% CI]	Evaluated by	Risk of bias
											A	B	C	D	E	Overall
Munro A, 2021 f	RNA based vaccine	BNT162b2	Boost mRNA1273	Placebo	28	Adults, elderly, health care workers	2,019 (91)	175 (98)	12.04 [9.95, 14.58]	PNA
Munro A, 2021 f	RNA based vaccine	BNT162b2	Boost CVnCov	Placebo	28	Adults, elderly, health care workers	487 (91)	175 (98)	2.57 [2.13, 3.12]	PNA
Munro A, 2021 f	RNA based vaccine	BNT162b2	Boost BNT162b2 half dose	Placebo	28	Adults, elderly, health care workers	1,339 (92)	175 (98)	6.91 [5.70, 8.37]	PNA
Munro A, 2021 b	RNA based vaccine	BNT162b2	Boost ChadOx1	Placebo	28	Adults, elderly, health care workers	950 (98)	157 (111)	6.01 [4.87, 7.41]	PNA
Munro A, 2021 b	RNA based vaccine	BNT162b2	Boost Novavax	Placebo	28	Adults, elderly, health care workers	766 (94)	157 (111)	5.39 [4.35, 6.67]	PNA
Munro A, 2021 b	RNA based vaccine	BNT162b2	Boost Novavax half dose	Placebo	28	Adults, elderly, health care workers	606 (89)	157 (111)	3.50 [2.81, 4.36]	PNA
Munro A, 2021 d	RNA based vaccine	BNT162b2	Boost BNT162b2	Placebo	28	Adults, elderly, health care workers	1,789 (95)	205 (93)	8.35 [6.88, 10.14]	PNA
Munro A, 2021 d	RNA based vaccine	BNT162b2	Boost VLA2001	Placebo	28	Adults, elderly, health care workers	289 (91)	205 (93)	1.38 [1.14, 1.68]	PNA
Munro A, 2021 d	RNA based vaccine	BNT162b2	Boost VLA2001 half dose	Placebo	28	Adults, elderly, health care workers	234 (87)	205 (93)	1.22 [1.00, 1.49]	PNA
Munro A, 2021 d	RNA based vaccine	BNT162b2	Boost Ad26.COV2.S	Placebo	28	Adults, elderly, health care workers	1,441 (75)	205 (93)	7.84 [6.37, 9.64]	PNA
Munro A, 2021 e	Non replicating viral vector	ChadOx1	Boost mRNA1273	Placebo	28	Adults, elderly, health care workers	2,368 (97)	80 (101)	26.98 [21.88, 33.26]	PNA
Munro A, 2021 e	Non replicating viral vector	ChadOx1	Boost CVnCov	Placebo	28	Adults, elderly, health care workers	373 (99)	80 (101)	5.06 [4.11, 6.23]	PNA
Munro A, 2021 e	Non replicating viral vector	ChadOx1	Boost BNT162b2 half dose	Placebo	28	Adults, elderly, health care workers	1,344 (103)	80 (101)	15.14 [12.32, 18.60]	PNA
Munro A , 2021 a	Non replicating viral vector	ChadOx1	Boost ChadOx1	Placebo	28	Adults, elderly, health care workers	193 (98)	85 (90)	2.47 [1.96, 3.11]	PNA
Munro A , 2021 a	Non replicating viral vector	ChadOx1	Boost Novavax	Placebo	28	Adults, elderly, health care workers	727 (87)	85 (90)	8.86 [7.00, 11.22]	PNA
Munro A , 2021 a	Non replicating viral vector	ChadOx1	Boost Novavax half dose	Placebo	28	Adults, elderly, health care workers	470 (86)	85 (90)	5.89 [4.64, 7.46]	PNA
Munro A, 2021 c	Non replicating viral vector	ChadOx1	Boost BNT162b2	Placebo	28	Adults, elderly, health care workers	1,621 (93)	70 (91)	21.58 [16.93, 27.51]	PNA
Munro A, 2021 c	Non replicating viral vector	ChadOx1	Boost VLA2001	Placebo	28	Adults, elderly, health care workers	202 (89)	70 (91)	2.68 [2.10, 3.43]	PNA
Munro A, 2021 c	Non replicating viral vector	ChadOx1	Boost VLA2001 half dose	Placebo	28	Adults, elderly, health care workers	147 (95)	70 (91)	2.01 [1.57, 2.55]	PNA
Munro A, 2021 c	Non replicating viral vector	ChadOx1	Boost Ad26.COV2.S	Placebo	28	Adults, elderly, health care workers	563 (95)	70 (91)	6.85 [5.37, 8.73]	PNA
Wang X-Y, 2022	Inactivated virus	BBIBP-CorV or CoronaVac	Boost V-01	Placebo	14	Healthy adults	1,453 (199)	157 (221)	NR	Live SARS-CoV-2 neutralization assay.
Vadrevu KM, 2022	Inactivated virus	BBV152	Boost BBV152	Placebo	28	Adolescents and adults	746 (80)	101 (87)	7.41 [2.96, 18.51]	PRNT
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost m-RNA-1273	Placebo	28	Healthcare workers	2,007 (54)	73 (54)	27.49 [15.23, 49.60]	PRNT
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Placebo	28	Healthcare workers	235 (50)	73 (54)	3.21 [1.74, 5.93]	PRNT
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost BNT162b2	Placebo	28	Healthcare workers	1,446 (53)	73 (54)	19.80 [10.66, 36.79]	PRNT

Safety
Serious adverse events

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up months	Participants	r1/N1	r2/N2	RR [95% CI]	Risk of bias
										A	B	C	D	E	Overall
Moreira E D, 2022	RNA based vaccine	BNT162b2	Boost BNT162b2	Placebo	2.5	Adults and adolescents	16 / 5055	24 / 5020	0.66 [0.35 - 1.24]
Munro A, 2021 f	RNA based vaccine	BNT162b2	Boost mRNA1273	Placebo	2.7	Adults, elderly, health care workers	0 / 110	0 / 112	NR
Munro A, 2021 f	RNA based vaccine	BNT162b2	Boost CVnCov	Placebo	2.7	Adults, elderly, health care workers	1 / 106	0 / 112	3.17 [0.13 - 76.94]
Munro A, 2021 f	RNA based vaccine	BNT162b2	Boost BNT162b2 half dose	Placebo	2.7	Adults, elderly, health care workers	0 / 110	0 / 112	NR
Munro A, 2021 b	RNA based vaccine	BNT162b2	Boost ChadOx1	Placebo	2.7	Adults, elderly, health care workers	0 / 109	1 / 118	0.36 [0.01 - 8.76]
Munro A, 2021 b	RNA based vaccine	BNT162b2	Boost Novavax	Placebo	2.7	Adults, elderly, health care workers	1 / 114	1 / 118	1.04 [0.07 - 16.35]
Munro A, 2021 b	RNA based vaccine	BNT162b2	Boost Novavax half dose	Placebo	2.7	Adults, elderly, health care workers	2 / 112	1 / 118	2.11 [0.19 - 22.91]
Munro A, 2021 d	RNA based vaccine	BNT162b2	Boost BNT162b2	Placebo	2.7	Adults, elderly, health care workers	1 / 109	0 / 109	3 [0.12 - 72.84]
Munro A, 2021 d	RNA based vaccine	BNT162b2	Boost VLA2001	Placebo	2.7	Adults, elderly, health care workers	0 / 110	0 / 109	NR
Munro A, 2021 d	RNA based vaccine	BNT162b2	Boost VLA2001 half dose	Placebo	2.7	Adults, elderly, health care workers	1 / 110	0 / 109	2.97 [0.12 - 72.18]
Munro A, 2021 d	RNA based vaccine	BNT162b2	Boost Ad26.COV2.S	Placebo	2.7	Adults, elderly, health care workers	0 / 106	0 / 109	NR
Munro A, 2021 e	Non replicating viral vector	ChadOx1	Boost mRNA1273	Placebo	2.7	Adults, elderly, health care workers	1 / 112	0 / 114	3.05 [0.13 - 74.16]
Munro A, 2021 e	Non replicating viral vector	ChadOx1	Boost CVnCov	Placebo	2.7	Adults, elderly, health care workers	0 / 119	0 / 114	NR
Munro A, 2021 e	Non replicating viral vector	ChadOx1	Boost BNT162b2 half dose	Placebo	2.7	Adults, elderly, health care workers	0 / 116	0 / 114	NR
Munro A , 2021 a	Non replicating viral vector	ChadOx1	Boost ChadOx1	Placebo	2.7	Adults, elderly, health care workers	1 / 111	0 / 109	2.95 [0.12 - 71.54]
Munro A , 2021 a	Non replicating viral vector	ChadOx1	Boost Novavax	Placebo	2.7	Adults, elderly, health care workers	0 / 115	0 / 109	NR
Munro A , 2021 a	Non replicating viral vector	ChadOx1	Boost Novavax half dose	Placebo	2.7	Adults, elderly, health care workers	0 / 108	0 / 109	NR
Munro A, 2021 c	Non replicating viral vector	ChadOx1	Boost BNT162b2	Placebo	2.7	Adults, elderly, health care workers	0 / 106	1 / 105	0.33 [0.01 - 8.01]
Munro A, 2021 c	Non replicating viral vector	ChadOx1	Boost VLA2001	Placebo	2.7	Adults, elderly, health care workers	3 / 109	1 / 105	2.89 [0.31 - 27.34]
Munro A, 2021 c	Non replicating viral vector	ChadOx1	Boost VLA2001 half dose	Placebo	2.7	Adults, elderly, health care workers	0 / 111	1 / 105	0.32 [0.01 - 7.66]
Munro A, 2021 c	Non replicating viral vector	ChadOx1	Boost Ad26.COV2.S	Placebo	2.7	Adults, elderly, health care workers	1 / 108	1 / 105	0.97 [0.06 - 15.34]
Wang X-Y, 2022	Inactivated virus	BBIBP-CorV or CoronaVac	Boost V-01	Placebo	NR	Healthy adults	6 / 5108	8 / 5110	0.75 [0.26 - 2.16]
Vadrevu KM, 2022	Inactivated virus	BBV152	Boost BBV152	Placebo	1	Adolescents and adults	0 / 80	0 / 87	NR
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost m-RNA-1273	Placebo	1	Healthcare workers	0 / 112	0 / 105	NR
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Placebo	1	Healthcare workers	0 / 106	0 / 105	NR
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost BNT162b2	Placebo	1	Healthcare workers	0 / 111	0 / 105	NR
Sung J, 2022		2 doses BNT162b2 or BBIBP	Boost Recombinant inactiv Bacillus subtilis spores	Boost active adjuvant	1.2	Healthy adults	0 / 9	0 / 7	NR
Toledo-Romani ME, 2022 b	Protein subunit	FINLAY-FR-2-25 mcg	Boost FINLAY-FR-1-50 mcg	Placebo	2.7	Adults	1 / 14677	3 / 14675	0.33 [0.03 - 3.2]

r1: Number of events in intervention 1, r2: Number of events in intervention 2, N1: Number of patients analyzed in intervention 1; N2: Number of patients analyzed in intervention 2.

All-cause mortality

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up months	Participants	r1/N1	r2/N2	RR [95% CI]	Risk of bias
										A	B	C	D	E	Overall
Vadrevu KM, 2022	Inactivated virus	BBV152	Boost BBV152	Placebo	1	Adolescents and adults	0 / 80	0 / 87	NR
Toledo-Romani ME, 2022 b	Protein subunit	FINLAY-FR-2-25 mcg	Boost FINLAY-FR-1-50 mcg	Placebo	5.4	Adults	11 / 13883	24 / 14303	0.47 [0.23 - 0.96]
Moreira E D, 2022	RNA based vaccine	BNT162b2	Boost BNT162b2	Placebo	2.5	Adults and adolescents	0 / 5055	1 / 5020	0.33 [0.01 - 8.12]
Wang X-Y, 2022	Inactivated virus	BBIBP-CorV or CoronaVac	Boost V-01	Placebo	2	Healthy adults	0 / 5108	0 / 5110	NR
Sung J, 2022		2 doses BNT162b2 or BBIBP	Boost Recombinant inactiv Bacillus subtilis spores	Boost active adjuvant	1.2	Healthy adults	0 / 9	0 / 7	NR

r1: Number of events in intervention 1, r2: Number of events in intervention 2, N1: Number of patients analyzed in intervention 1; N2: Number of patients analyzed in intervention 2.

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

Immunogenicity
Geometric mean titre specific antibodies

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up days	Participants	GMT Boost1 (N1)	GMT Boost2 (N2)	GMR [95% CI]	Evaluated by	Risk of bias
											A	B	C	D	E	Overall
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost BNT162b2	Boost CoronaVac	28	Healthy adults	674,267 (333)	48,405 (281)	13.4 [11.6, 15.3]	multiplex immunoassay
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost ChAdOx1	Boost CoronaVac	28	Healthy adults	335,213 (296)	48,405 (281)	7.0 [6.1, 8.1]	multiplex immunoassay
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost AD26.COV2-S	Boost CoronaVac	28	Healthy adults	336,851 (294)	48,405 (281)	6.7 [5.8, 7.7]	multiplex immunoassay
Shinkai M, 2022	RNA based vaccine	BNT162b2	Boost S-268019-b	Boost BNT162b2	28	Adults	48,465 (101)	55,215 (101)	0.87 [0.72, 1.06]	ELISA
Nanthapisal S, 2022	Inactivated virus	2 doses of CoronaVac 21-28 days apart	Boost ChAdOx1-S standard dose	Boost ChAdOx1-S low-dose	14	Healthy adults	1,975 (209)	1,664 (209)	1.19 [1.07, 1.31]	ELISA
Li J, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored	Boost Coronavac	14	Healthy adults	3,090 (96)	369 (102)	8.37 [6.52, 10.75]	ELISA
Cao Y, 2021	Inactivated virus	CoronaVac	Boost ZF2001	Boost CoronaVac	14	Healthcare workers	10,417 (81)	7,496 (40)	*1.38 [, ]*	ELISA
Jin L, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored high dose	Boost CoronaVac	14	Healthy adults	6,175 (140)	670 (140)	9.21 [6.87, 12.35]	ELISA
Jin L, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored low dose	Boost CoronaVac	14	Healthy adults	4,625 (140)	670 (140)	6.9 [5.01, 9.50]	ELISA
Nantanee R, 2022	Non replicating viral vector	ChAdOx1	Boost BNT162b2 (half dose)	Boost BNT162b2	14	Healthy adults	2,330 (50)	2,575 (50)	0.90 [0.77, 1.06]	ELISA
Puthanakit T, 2022 b	*	CoronaVac 3 mcg (0.5mL)/BNT162b2 30 mcg or BNT162b2 20 mcg	Boost BNT162b2 15mcg	Boost BNT162b2 30mcg	14	Adolescents	0 (18)	2,828 (17)	0.91 [0.73, 1.13]	ELISA
Puthanakit T, 2022 b	*	CoronaVac 3 mcg (0.5mL)/BNT162b2 30 mcg or BNT162b2 20 mcg	Boost BNT162b2 10mcg	Boost BNT162b2 30mcg	14	Adolescents	0 (17)	2,828 (17)	0.73 [0.58, 0.91]	ELISA

Geometric mean titre neutralizing antibodies

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up days	Participants	GMT Boost1 (N1)	GMT Boost2 (N2)	GMR [95% CI]	Evaluated by	Risk of bias
											A	B	C	D	E	Overall
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost BNT162b2	Boost CoronaVac	28	Healthy adults	4,326 (49)	211 (46)	21.5 [14.5, 31.9]	Pseudovirus neutralisation titres
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost ChAdOx1	Boost CoronaVac	28	Healthy adults	2,137 (52)	211 (46)	10.6 [7.2, 15.6]	Pseudovirus neutralisation titres
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost AD26.COV2-S	Boost CoronaVac	28	Healthy adults	1,844 (47)	211 (46)	8.7 [5.9, 12.9]	Pseudovirus neutralisation titres
Shinkai M, 2022	RNA based vaccine	BNT162b2	Boost S-268019-b	Boost BNT162b2	14	Adults	128 (101)	139 (101)	0.94 [0.76, 1.09]	Cytopathic effect-based virus neutralization test
Nanthapisal S, 2022	Inactivated virus	2 doses of CoronaVac 21-28 days apart	Boost ChAdOx1-S standard dose	Boost ChAdOx1-S low-dose	14	Healthy adults	96 (207)	97 (203)	0.99 [0.97, 1.01]	Virus neutralization test (sVNT)
Mok C K P, 2022	Inactivated virus	CoronaVac	Boost CoronaVac	Boost BNT162b2	30	Adults	17 (40)	207 (40)	NR	PRNT90
Li J, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored	Boost Coronavac	14	Healthy adults	197 (96)	34 (102)	5.9 [4.5, 7.7]	Cytopathic effect-based microneutralization assay- wild-type SARS-CoV-2
Cao Y, 2021	Inactivated virus	CoronaVac	Boost ZF2001	Boost CoronaVac	14	Healthcare workers	1,306 (81)	794 (40)	1.64 [1.09, 2.46]	CPE
Al Kaabi N, 2022	Inactivated virus	BBIBP-CorV	Boost NVSI-06-07 (Interval 1-3 m)	Boost BBIBP-CorV (Interval 1-3 m)	14	Adults	1,335 (267)	296 (270)	4.36 [3.70, 5.13]	live-virus neutralization
Al Kaabi N, 2022	Inactivated virus	BBIBP-CorV	Boost NVSI-06-07 (Interval 4-6 m)	Boost BBIBP-CorV (Interval 4-6 m)	14	Adults	1,813 (279)	328 (290)	5.75 [4.99, 6.63]	live-virus neutralization
Al Kaabi N, 2022	Inactivated virus	BBIBP-CorV	Boost NVSI-06-07 (Interval >6m)	Boost BBIBP-CorV (Interval >6m)	14	Adults	1,907 (281)	449 (285)	4.38 [3.73, 5.15]	Live-virus neutralizationn
Toledo-Romani ME, 2021	Protein subunit	FINLAY-FR-2-25 mcg	Boost FR-1	Boost FINLAY-FR-2	28	Healthy adults	43 (55)	33 (51)	1.29 [0.81, 2.06]	Conventional virus neutralization test
Jin L, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored high dose	Boost CoronaVac	14	Healthy adults	714 (140)	79 (140)	9.09 [5.65, 14.63]	CPE-based microneutralisation
Jin L, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored low dose	Boost CoronaVac	14	Healthy adults	744 (140)	79 (140)	9.48 [6.09, 14.76]	CPE-based microneutralisation
Jin P, 2022 a	Inactivated virus	CoronaVac	Boost Ad5-vectored 5×10^10 vp	Boost CoronaVac	14	Elderly	286 (98)	48 (100)	6.2 [4.7, 8.1]	Microneutralization assay
Chuang C-H, 2022	Non replicating viral vector	ChAdOx1	Boost BNT162b2	Boost mRNA-1273 (half dose)	28	Healthcare workers	524 (83)	657 (85)	2.39 [1.99, 2.86]	ELISA
Chuang C-H, 2022	Non replicating viral vector	ChAdOx1	Boost BNT162b2	Boost mRNA-1273	28	Healthcare workers	524 (83)	709 (85)	2.39 [1.99, 2.86]	ELISA
Chuang C-H, 2022	Non replicating viral vector	ChAdOx1	Boost BNT162b2	Boost MVC-COV1901	28	Healthcare workers	524 (83)	219 (85)	2.39 [1.99, 2.86]	ELISA
Corominas J, 2022	RNA based vaccine	BNT162b2	Boost PHH-1V	Boost BNT162b2	14	Healthy adults	1,999 (500)	3,358 (241)	1.68 [1.44, 1.96]	Pseudovirion-based neutralisation assay
Branche A, 2022	*	Completed primary and booster COVID-19 vaccine series, either homologous or heterologous	Boost mRNA Omicron + Beta vaccine	Boost Original mRNA-1273 vaccine	15	Adults	19,760 (198)	20,969 (97)	0.91 [0.72, 1.14]	Pseudovirion-based neutralisation assay
Branche A, 2022	*	Completed primary and booster COVID-19 vaccine series, either homologous or heterologous	Boost mRNA Omicron + Delta vaccine	Boost Original mRNA-1273 vaccine	15	Adults	24,337 (99)	20,969 (97)	1.17 [0.9, 1.52]	Pseudovirion-based neutralisation assay
Branche A, 2022	*	Completed primary and booster COVID-19 vaccine series, either homologous or heterologous	Boost mRNA Omicron + Original mRNA-1273 vaccine	Boost Original mRNA-1273 vaccine	15	Adults	26,125 (96)	20,969 (97)	1.2 [0.92, 1.57]	Pseudovirion-based neutralisation assay
Branche A, 2022	*	Completed primary and booster COVID-19 vaccine series, either homologous or heterologous	Boost mRNA Omicron vaccine	Boost Original mRNA-1273 vaccine	15	Adults	19,167 (96)	20,969 (97)	0.85 [0.65, 1.1]	Pseudovirion-based neutralisation assay

Safety
Serious adverse events

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up months	Participants	r1/N1	r2/N2	RR [95% CI]	Risk of bias
										A	B	C	D	E	Overall
Bruminhent J, 2022	Inactivated virus	2 doses of CoronaVac (3–5 weeks apart) or followed by 1 dose of ChAdOx1 or 2 doses of ChAdOx1	Boost BNT162b2 or mRNA-1273	Boost ChAdOx1	0.2	Kidney transplant recipients	0 / 40	0 / 37	NR
Intapiboon P, 2021	Inactivated virus	CoronaVac	CoronaVac 3mcg D0/14	CoronaVac	1	Healthy adults	0 / 30	0 / 30	NR
Intapiboon P, 2021	Inactivated virus	CoronaVac	CoronaVac 3mcg D0/14	CoronaVac	1	Healthy adults	0 / 31	0 / 30	NR
Poh XY, 2022	RNA based vaccine	BNT162b2	Boost mRNA-1273	Boost BNT162b2	28	Adults	0 / 48	0 / 50	NR
Reindl-Schwaighofer R, 2021	RNA based vaccine	BNT162b2 or mRNA-1273	Boost BNT162b2 or mRNA-1273	Boost Ad26COVS1	1	Kidney transplant recipients	2 / 99	3 / 99	0.67 [0.11 - 3.9]
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost BNT162b2	Boost CoronaVac	1	Healthy adults	1 / 339	0 / 291	2.58 [0.11 - 62.99]
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost ChAdOx1	Boost CoronaVac	1	Healthy adults	1 / 304	0 / 291	2.87 [0.12 - 70.22]
Costa Clemens SA, 2022	Inactivated virus	CoronaVac	Boost AD26.COV2-S	Boost CoronaVac	1	Healthy adults	3 / 305	0 / 291	6.68 [0.35 - 128.75]
Shinkai M, 2022	RNA based vaccine	BNT162b2	Boost S-268019-b	Boost BNT162b2	NR	Adults	0 / 101	0 / 103	NR
Li J, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored	Boost Coronavac	1	Healthy adults	0 / 96	0 / 102	NR
Jin L, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored high dose	Boost CoronaVac	6	Healthy adults	0 / 137	1 / 137	0.33 [0.01 - 8.11]
Jin L, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored low dose	Boost CoronaVac	6	Healthy adults	2 / 139	1 / 137	1.97 [0.18 - 21.49]
Costa Clemens, 2022	Non replicating viral vector	ChadOx1	Boost 9 mcg SCB-2019 + alum	Boost ChadOx1	0.92	Adults	0 / 30	0 / 29	NR
Costa Clemens, 2022	Non replicating viral vector	ChadOx1	Boost 9 mcg SCB-2019 + CpG + alum	Boost ChadOx1	0.92	Adults	1 / 29	0 / 29	3 [0.13 - 70.59]
Costa Clemens, 2022	Non replicating viral vector	ChadOx1	Boost 30 mcg SCB-2019 + CpG + alum	Boost ChadOx1	0.92	Adults	0 / 32	0 / 29	NR
Jin P, 2022 a	Inactivated virus	CoronaVac	Boost Ad5-vectored 5×10^10 vp	Boost CoronaVac	6	Elderly	1 / 99	0 / 100	3.03 [0.12 - 73.49]
Munro APS, 2022	RNA based vaccine	BNT162b2 + boost BNT162b2	Boost BNT162b2	Boost half dose m-RNA 1273	1.7	Healthy adults	1 / 39	0 / 39	3 [0.13 - 71.37]
Munro APS, 2022	Non replicating viral vector	ChadOx1 + boost BNT162b2	Boost BNT162b2	Boost half dose m-RNA 1273	1.7	Healthy adults	2 / 44	0 / 44	5 [0.25 - 101.12]

r1: Number of events in intervention 1, r2: Number of events in intervention 2, N1: Number of patients analyzed in intervention 1; N2: Number of patients analyzed in intervention 2.

All-cause mortality

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up months	Participants	r1/N1	r2/N2	RR [95% CI]	Risk of bias
										A	B	C	D	E	Overall
Reindl-Schwaighofer R, 2021	RNA based vaccine	BNT162b2 or mRNA-1273	Boost BNT162b2 or mRNA-1273	Boost Ad26COVS1	3	Kidney transplant recipients	4 / 99	4 / 99	1 [0.26 - 3.88]
Shinkai M, 2022	RNA based vaccine	BNT162b2	Boost S-268019-b	Boost BNT162b2	*	Adults	0 / 101	0 / 103	NR
Al Kaabi N, 2022	Inactivated virus	BBIBP-CorV	Boost NVSI-06-07 (Interval 1-3 m)	Boost BBIBP-CorV (Interval 1-3 m)	*	Adults	NR	NR	NR
Al Kaabi N, 2022	Inactivated virus	BBIBP-CorV	Boost NVSI-06-07 (Interval 4-6 m)	Boost BBIBP-CorV (Interval 4-6 m)	*	Adults	NR	NR	NR
Al Kaabi N, 2022	Inactivated virus	BBIBP-CorV	Boost NVSI-06-07 (Interval >6m)	Boost BBIBP-CorV (Interval >6m)	*	Adults	NR	NR	NR
Toledo-Romani ME, 2021	Protein subunit	FINLAY-FR-2-25 mcg	Boost FR-1	Boost FINLAY-FR-2	1	Healthy adults	0 / 58	0 / 55	NR
Costa Clemens, 2022	Non replicating viral vector	ChadOx1	Boost 9 mcg SCB-2019 + alum	Boost ChadOx1	2.53	Adults	0 / 30	0 / 29	NR
Costa Clemens, 2022	Non replicating viral vector	ChadOx1	Boost 9 mcg SCB-2019 + CpG + alum	Boost ChadOx1	2.53	Adults	0 / 29	0 / 29	NR
Costa Clemens, 2022	Non replicating viral vector	ChadOx1	Boost 30 mcg SCB-2019 + CpG + alum	Boost ChadOx1	2.53	Adults	0 / 32	0 / 29	NR
Chuang C-H, 2022	Non replicating viral vector	ChAdOx1	Boost BNT162b2	Boost mRNA-1273 (half dose)	5.9	Healthcare workers	0 / 83	0 / 85	NR
Chuang C-H, 2022	Non replicating viral vector	ChAdOx1	Boost BNT162b2	Boost mRNA-1273	5.9	Healthcare workers	0 / 83	0 / 85	NR
Chuang C-H, 2022	Non replicating viral vector	ChAdOx1	Boost BNT162b2	Boost MVC-COV1901	5.9	Healthcare workers	0 / 83	0 / 85	NR
Corominas J, 2022	RNA based vaccine	BNT162b2	Boost PHH-1V	Boost BNT162b2	3.2	Healthy adults	0 / 513	0 / 252	NR

r1: Number of events in intervention 1, r2: Number of events in intervention 2, N1: Number of patients analyzed in intervention 1; N2: Number of patients analyzed in intervention 2.

Search studies

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Trial	Type	Comparisons	Design	Participants	Sample size	Overall risk of bias Highest assessment	Full description
CTRI/2021/01/030416 Zydus Cadila Khobragade A, Lancet , 2022 Full text Commentary	DNA based vaccine	ZyCoV-D 2mg D0/28/56	Placebo	RCT Phase 3	Healthy adults and adolescents aged (≥12 years) with no previous history of COVID-19 at 49 centers in India.	N=27703	Some concerns Details	Full description
NCT04642638 Inovio Pharmaceuticals Mammen Jr M, medRxiv, 2021 Full text Commentary Commentary	DNA based vaccine	INO-4800 1mg INO-4800 2mg	Placebo 1 Placebo 2	RCT Phase 2	Healthy adult volunteers SARS-CoV-2 seronegative at high risk of infection at 16 locations in the USA.	N=201	Some concerns Details	Full description

Trial

Type

Comparisons

Design

Participants

Sample size

Overall risk
of bias
Highest assessment

Full description

Intervention 1

Intervention 2

CTRI/2021/01/030416
Zydus Cadila
Khobragade A, Lancet , 2022

Full text
Commentary

DNA based vaccine

ZyCoV-D 2mg D0/28/56

Placebo

RCT
Phase 3

Healthy adults and adolescents aged (≥12 years) with no previous history of COVID-19 at 49 centers in India.

N=27703

Some concerns
Details

Full description

NCT04642638
Inovio Pharmaceuticals
Mammen Jr M, medRxiv, 2021

Full text
Commentary
Commentary

DNA based vaccine

INO-4800 1mg

INO-4800 2mg

Placebo 1

Placebo 2

RCT
Phase 2

Healthy adult volunteers SARS-CoV-2 seronegative at high risk of infection at 16 locations in the USA.

N=201

Some concerns
Details

Full description

COVID-19 vaccine effectiveness(Randomized evidence)

Methods

meta-COVID

Vaccine types

Search studies

COVID-19 vaccine effectiveness
(Randomized evidence)