COVID-19 vaccine effectiveness
(Randomized evidence)
Methods
Analyses are updated every two weeks
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 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:
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)
Search studies
| Trial | Type | Comparisons | Design | Participants | Sample size | Overall risk of bias Highest assessment |
Full description | |
|---|---|---|---|---|---|---|---|---|
| Intervention 1 | Intervention 2 | |||||||
|
NCT04649151 ModernaTX Ali K, N Engl J Med, 2021 Full text Commentary |
RNA based vaccine |
mRNA-1273 |
Placebo |
RCTPhase 2-3 | Healthy adolescents in 26 centers in the USA | N=3732 |
Some concerns Details |
|
|
NCT04907331; 2021-002171-19 AstraZeneca+University of Oxford; Pfizer/BioNTech+Fosun Pharma Bánki Z, EBioMedicine, 2022 HEVACC New Full text Commentary |
RNA based vaccine |
1 dose ChAdOx1/ 1 dose BNT162b2 |
ChAdOx1 |
RCTPhase 2 | Healthy adults with no history of COVID-19 in 3 centres in Austria. | N=234 |
Some concerns Details |
|
|
NCT04860739, EudraCT2021-001978-37 Pfizer/BioNTech+Fosun Pharma Borobia A M, Lancet, 2021 Full text Commentary |
RNA based vaccine |
BNT162b2 30 mcg 8-12 weeks after 1 dose ChAdOx1-S |
No second vaccine dose |
RCTPhase 2 | Healthy, or clinically stable, adults (aged ≥18 and ≤60) that were SARS-COV-2 infection free and who had received a prime ChAdOx1-S vaccination between 8 and 12 weeks before the screening visit in 5 centers in Spain. | N=676 |
Some concerns Details |
|
|
NCT05289037 Moderna + National Institute of Allergy and Infections Diseases (NIAID); ModernaTX Branche A, medRxiv, 2022 Full text Commentary Commentary Commentary |
RNA based vaccine |
2ndboost mRNA-1273Omicron + mRNA-1273Beta 2ndboost mRNA-1273Omicron + mRNA-1273 Delta 2ndboost mRNA-1273Omicron + mRNA-1273 2ndboost mRNA-1273 Omicron |
2ndboost mRNA-1273 |
RCTPhase 2 | Adults with completed primary and booster COVID-19 vaccine series, either homologous or heterologous, and in stable health at 22 centers in USA. | N=602 |
Some concerns Details |
|
|
TCTR20211102003 Sinovac Research and Development Co., Ltd; Pfizer/BioNTech + Fosun Pharma; Moderna + National Institute of Allergy and Infectious Diseases (NIAID); AstraZeneca + University of Oxford Bruminhent J, Am J Transplant, 2022 Updated Full text Full text Commentary |
RNA based vaccine |
Boost BNT162b2 or mRNA-1273 |
Boost ChAdOx1 |
RCTPhase 3 | Adult kidney transplant recipients without a history of COVID-19 in a single centre in Thailand. | N=85 |
Some concerns Details |
|
|
RBR–9nn3scw AstraZeneca+University of Oxford/Sinovac/Janssen Pharmaceutical Companies/Pfizer/BioNTech+Fosun Pharma Costa Clemens SA, Lancet, 2022 Full text Commentary Commentary |
Non replicating viral vector |
CoronaVac/Boost BNT162b2 CoronaVac/Boost ChAdOx1 CoronaVac/Boost AD26.COV2-S |
CoronaVac/Boost CoronaVac |
RCTPhase 4 | Healthy adults with no history of confirmed covid-19 who had previously received 2 doses of CoronaVac at two centers in Brazil | N=1240 |
Some concerns Details |
|
|
NCT04796896 ModernaTX Creech CB, N Engl J Med, 2022 KidCOVE Full text Commentary |
RNA based vaccine |
mRNA-1273 (50 mcg D0/28) |
Placebo |
RCTPhase 2-3 | Children aged 6-11 years, healthy or with stable chronic conditions and no known recent history of COVID-19 infection, at 87 centers in Canada and USA. | N=4016 |
Some concerns Details |
|
|
NCT04470427 ModernaTX El Sahly H, N Engl J Med, 2021 COVE Full text Full text Commentary Commentary |
RNA based vaccine |
mRNA-1273 100 mcg D1/28 |
Placebo D1/28 |
RCTPhase 3 | Healthy adults with no known history of SARS-CoV-2 infection in 99 centers in the US | N=30415 |
Some concerns Details |
|
|
INA-GO0HLGB AstraZeneca+University of Oxford;Pfizer/BioNTech + Fosun Pharma; Sinovac, Ltd Fadlyana E, Lancet Infect Dis, 2023 New Full text Commentary Commentary Commentary |
RNA based vaccine |
CoronaVac + boost BNT162b2 CoronaVac + boost BNT162b2 CoronaVac = booster BNT162b2 (half dose) Coronavac + boost ChAdOx1 (half dose) |
CoronaVac/Boost CoronaVac CoronaVac + boost BNT162b2 CoronaVac/Boost CoronaVac CoronaVac/Boost CoronaVac |
RCT* | Healthy adults without a history of laboratory confirmed COVID-19 within one month prior recruitment in 5 centres in Indonesia | N=960 |
Some concerns Details |
|
|
NCT04368728 Pfizer/BioNTech+Fosun Pharma Frenck R, N Engl J Med, 2021 Full text Commentary |
RNA based vaccine |
BNT162b2 3mcg D0/21 |
Placebo D0/21 |
RCTPhase 3 | Adolescents aged 12 to 15 years with no previous Covid-19 diagnosis or SARS-CoV-2 infection in 29 centers in the USA | N=2264 |
Some concerns Details |
|
|
NCT04885907 ModernaTX Hall VG, N Engl J Med, 2021 Full text Commentary Commentary |
RNA based vaccine |
mRNA-1273 |
Placebo |
RCTPhase 4 | Solid organ transplant recipients with no previous diagnosis of COVID-19 who has previously received two doses of mRNA-1273 at a single center in Canada | N=120 |
Some concerns Details |
|
|
NCT04588480 Pfizer/BioNTech+Fosun Pharma Haranaka M, Nat. Commun., 2021 Full text Commentary Commentary |
RNA based vaccine |
BNT162b2 |
Placebo |
RCTPhase 1-2 | Adults including elderly and co-morbidities with no history of COVID-19 at 2 centres in Japan | N=160 |
Low Details |
|
|
NCT04649021 Pfizer/BioNTech+Fosun Pharma Hui A-M, Lancet, 2022 Full text Full text Commentary Commentary |
RNA based vaccine |
BNT162b2 |
Placebo |
RCTPhase 2 | Healthy adults and those with a pre-existing stable condition, at 2 centers in China. | N=960 |
Low Details |
|
|
NCT04900467; EudraCT: 2021-002174-52 Moderna;Pfizer/BioNTech Janssen C, EClinicalMedicine, 2022 Full text Full text Commentary |
Heterologous vaccination scheme |
1 dose BNT162b2/1 dose mRNA-1273 1 dose mRNA-1273 /1 dose BNT162b2 |
2 doses BNT162b2 2 doses mRNA-1273 |
RCTPhase 2 | Adults with no known or suspected history of SARS-CoV-2 infection at 17 centers in France. | N=414 |
Some concerns Details |
|
|
NCT05030974 Moderna ; Pfizer/BioNTech + Fosun Pharma ; Janssen Pharmaceutical Kho M, Lancet Infect Dis, 2022 RECOVAC New Full text Commentary Commentary |
Heterologous booster |
mRNA vaccine/boost 2 doses mRNA-1273 mRNA vaccine/boost Ad26.COV2-S |
mRNAvaccine/boost mRNA-1273 |
RCTPhase 4 | Adult kidney transplant recipients without seroconversion after two doses of an mRNA vaccine and no history of COVID-19 at 4 centers in the Netherlands. | N=230 |
Some concerns Details |
|
|
NCT04652102; EudraCT 2020-003998-22 CureVac AG Kremsner P, Lancet Infect Dis, 2022 HERALD Full text Commentary |
RNA based vaccine |
CVnCoV |
Placebo |
RCTPhase 2-3 | Adults with no history of COVID-19 in 47 centers in Belgium, Germany, The Netherlands, Spain, Argentina, Colombia, Dominican Republic, Mexico, Panama and Peru | N=39680 |
Some concerns Details |
|
|
ChiCTR2000034825 ; NCT04523571 BioNTech RNA Pharmaceuticals Li J, Nature Medicine, 2021 Full text Commentary |
RNA based vaccine |
BNT162b1 10 mcg D0/21 BNT162b1 30 mcg D0/21 |
Placebo |
RCTPhase 1 | Healthy young adults between 18 and 55 years of age, and older adults between 65 and 85 that were SARS-COVID-2 infection-free at a single center in China. | N=144 |
Low Details |
|
|
ISRCTN69254139, EudraCT: 2020-005085-33 AstraZeneca+University of Oxford; Pfizer/BioNTech+Fosun Pharma Liu X, Lancet, 2022 Com-COV Full text Full text Commentary Commentary |
RNA based vaccine |
1 dose ChAdOx1/ 1 dose BNT162b2 1 dose BNT162b2 /1 dose ChAdOx1 |
2 doses ChAdOx1 2 doses BNT162b2 |
RCTPhase 2 | Adults 50 years or older with no previous SARS-CoV-2 infection, no or well-controlled mild-moderate comorbidities and HIV-negative in 8 centers in the UK | N=463 |
Some concerns Details |
|
|
NCT04480957 Arcturus Therapeutics Inc. Low J, medRxiv, 2021 a Full text Commentary Commentary |
RNA based vaccine |
ARCT-021 1mcg ARCT-021 5mcg ARCT-021 7.5mcg ARCT-021 10mcg |
Placebo |
RCTPhase 1 | Healthy HIV-negative adults at a single Center in Singapore. | N=42 |
Some concerns Details |
|
|
NCT04480957 Arcturus Therapeutics Inc. Low J, medRxiv, 2021 b Full text Commentary Commentary |
RNA based vaccine |
ARCT-021 3mcg ARCT-021 5mcg |
Placebo |
RCTPhase 2 | Healthy HIV-negative adults at a single Center in Singapore. | N=64 |
Some concerns Details |
|
|
NCT04962906; NCT05027672 Gamaleya Research Institute, AstraZeneca+University of Oxford;Moderna;Sinopharm Macchia A, Lancet Reg Health Am, 2022 Full text Commentary |
Non replicating viral vector |
Gam-COVID-Vac rAd26-S |
Gam-COVID-Vac rAd26-S/BBIBP-CorV |
RCTPhase 2 | Adults who had received the first dose (rAd26) of the Sputnik V vaccine at least 30 days earlier and no history of SARS-CoV-2 at a single centre in Argentina | N=540 |
Some concerns Details |
|
|
NCT04677660 ModernaTX Masuda T, Vaccine, 2022 a Full text Commentary |
RNA based vaccine |
mRNA-1273 |
Placebo |
RCTPhase 1-2 | Healthy adults aged ≥ 20 years with no known history/risk of SARS-CoV-2 infection at 2 centers in Japan. | N=200 |
Some concerns Details |
|
|
NCT04611243 Sinovac/Pfizer/BioNTech+Fosun Pharma Mok C K P, Am. J. Respir. Crit., 2022 Full text Commentary |
RNA based vaccine |
CoronaVac/Boost CoronaVac |
CoronaVac/Boost BNT162b2 |
RCT* | Adults that had received two doses of CoronaVac but had low immune response against SARS-CoV-2 at two centres in Hong Kong, China | N=80 |
Some concerns Details |
|
|
NCT04955626 Pfizer/BioNTech+Fosun Pharma Moreira E D, N Engl J Med, 2022 Full text Commentary |
RNA based vaccine |
Boost BNT162b2 after prime vaccination with BNT162b2 |
BNT162b2 |
RCTPhase 3 | Adults and adolescents (from age of 16 years) that had received two doses BNT162b2 in a previous trial at least 6 months previously and had no history of COVID-19 at 123 sites in Brazil, South Africa, and the USA | N=10136 |
Some concerns Details |
|
|
NCT04368728 Pfizer/BioNTech + Fosun Pharma Mulligan MJ, Nature, 2020 Full text Commentary |
RNA based vaccine |
* |
* |
RCTphase 1/2 | Healthy adult volunteers with HIV-negative and SARS-CoV-2 infection-free in multiple centres in the USA. | N=45 |
High Details |
|
|
ISRCTN73765130 AstraZeneca + University of Oxford; Janssen Pharmaceutical; Novovax; Moderna + NIAID; Pfizer BioNTech + Fosun Pharma; CureVac AG; Valneva, NIHR, UK Munro A, Lancet, 2021 d COV-BOOST Full text Commentary |
RNA based vaccine |
BNT162b2/boost BNT162b2 BNT162b2/boost VLA2001 BNT162b2/boost VLA2001 half dose BNT162b2/boost Ad26.COV2.S |
BNT162b2/Placebo |
RCTPhase 2 | Adults aged ≥30 years in good physical health at 18 centers in the UK. | N=545 |
Some concerns Details |
|
|
ISRCTN73765130 ; EudraCT 2021-002175-19 Pfizer/BioNTech;ModernaTX Munro APS, Lancet Infect Dis, 2022 COV-BOOST Full text Commentary |
RNA based vaccine |
BNT162b2 + 2 booster doses BNT162b2 ChadOx1 + boost 2 doses BNT162b2 |
BNT162b2 + booster dose BNT162b2+ 2nd booster half mRNA-1273 ChadOx1 + boost 1 dose BNT162b2+ half dose m-RNA 1273 |
RCTPhase 2 | Healthy adults aged 30 years or over, including elderly and those with well controlled or mild-moderate comorbidity, who had received a 2-dose primary schedule of either BNT162b2 or ChAdOx1 and a BNT162b2 booster at 18 centers in the UK | N=166 |
Some concerns Details |
|
|
NCT05142319 Pfizer/BioNTech+Fosun Pharma; ModernaTX Poh XY, Clin. Infect. Dis., 2022 PRIBIVAC Full text Commentary |
RNA based vaccine |
Boost mRNA-1273 after prime vaccination with BNT162b2 |
Boost BNT162b2 after prime vaccination with BNT162b2 |
RCT3 | Adults at a single center in Singapore with no previous history of COVID-19 who had received a primary series of BTN162b2 at least 6 months previously | N=100 |
Some concerns Details |
|
|
NCT04368728 Pfizer/BioNTech+Fosun Pharma Polack F, N Engl J Med, 2020 Full text Commentary ; Commentary ; Commentary ; Commentary ; Commentary |
RNA based vaccine |
BNT162b2 10mcg D1/D21 |
Normal saline (0.9% sodium chloride) D1/D21 |
RCTPhase 2/3 | Healthy SARS-CoV-2 DNA negative adults in multiple centres in Argentina, Brazil, Germany, South Africa, Turkey, and the USA | N=43448 |
Some concerns Details |
|
|
TCTR20210923012 Pfizer/BioNTech+Fosun Pharma Puthanakit T, Vaccine: X, 2022 b Full text Commentary |
RNA based vaccine |
Boost BNT162b2 15 mcg after prime vaccination Coronavac/BNT162b2 Boost BNT162b2 10 mcg after prime vaccination Coronavac/BNT162b2 |
Boost BNT162b2 30mcg after prime vaccination Coronavac/BNT162b2 |
RCTPhase 2 | Healthy adolescents with no prior COVID-19 infection or vaccination at a single center in Thailand. | N=52 |
Some concerns Details |
|
|
EudraCT021-002927-39 Pfizer/BioNTech+Fosun Pharma/Moderna/Janssen Pharmaceutical Companies Reindl-Schwaighofer R, JAMA, 2021 Full text Full text Commentary Commentary |
RNA based vaccine |
mRNA-1273 or BNT162b2/homologous booster |
mRNAorBNT/Ad26COVS1 booster |
RCTPhase 2 | Adult kidney transplant recipients with no history of COVID-19 infection and without an antibody response 4 weeks after a 2-dose mRNA vaccine schedule at a single center in Austria. | N=201 |
Some concerns Details |
|
|
NCT04927936 Janssen Pharmaceutical;Moderna ;Pfizer/BionTech+Fosun Pharma Sablerolles R, N Engl J Med, 2022 Full text Full text Commentary Commentary |
Non replicating viral vector |
Ad26.COV2.S/m-RNA-1273 Ad26.COV2.S/Ad26.COV2.S Ad26.COV2.S/BNT162b2 |
Ad26.COV2.S/No boost |
RCTPhase 3 | Healthcare workers aged 18-65 years, without severe comorbidities, and no known history of SARS-CoV-2 infection who received a single Ad26.COV2.S primary vaccination at 4 centers in the Netherlands. | N=461 |
Some concerns Details |
|
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jRCT2031210470 Shionogi;Pfizer/BioNTech+Fosun Pharma Shinkai M, Vaccine, 2022 Full text Full text Commentary Commentary |
Protein subunit |
BNT162b2/booster S-268019-b |
BNT162b2/boostBNT |
RCTPhase 2-3 | Adults who had received 2 doses of BNT162b2 vaccine at least 6 months earlier with no history of SARS-CoV-2 infection at a single centre in Japan | N=204 |
Some concerns Details |
|
|
NCT04805125 Pfizer/BioNTech+Fosun Pharma; ModernaTX Speich B, Clin Infect Dis, 2022 Full text Full text Commentary Commentary |
RNA based vaccine |
BNT162b2 |
mRNA-1273 |
RCTPhase 3 | Adult patients living with HIV (PLWH) or solid organ transplant recipients who were SARS-CoV-2 infection-free for the last 3 months in 3 centres in Switzerland. | N=430 |
Some concerns Details |
|
|
ISRCTN27841311; EudraCT 2021-001275-16 Pfizer BioNTech + Fosun Pharma / Novavax / Moderna + NIAID Stuart A, Lancet, 2021 b Com-COV2 Full text Commentary Commentary |
Protein subunit |
1 dose BNT162b2 followed by 1 dose NVX-CoV2373 1 dose BNT162b2 followed by 1 dose mRNA-1273 |
2 doses BNT162b2 |
RCTPhase 2 | Adults over 50 years previously vaccinated with one dose of BNT162b2 at 9 centres in the UK | N=532 |
Some concerns Details |
|
|
ISRCTN27841311; EudraCT 2021-001275-16 AstraZeneca + University of Oxford / Novavax / Moderna + NIAID Stuart A, Lancet, 2021 a Com-COV2 Full text Commentary Commentary |
Protein subunit |
1 dose ChAdOx1 followed by 1 dose NVX-CoV2373 1 dose ChAdOx1 followed by 1 dose mRNA-1273 |
2 doses ChAdOx1 |
RCTPhase 2 | Healthy adults over 50 years previously vaccinated with one dose of ChAdOx1 nCoV-19 in 9 centres in the UK | N=540 |
Some concerns Details |
|
|
NCT04368728 Pfizer/BioNTech+Fosun Pharma Thomas S, N Engl J Med, 2021 Full text Commentary Commentary |
RNA based vaccine |
BNT162b2 |
Placebo |
RCTPhase 2-3 | Children (>=12Y yo), adolescentes and adults, with no history or SARS-CoV 2 infection at 152 sites in Argentina, Brazil, Germany, South Africa, Turkey and USA | N=44165 |
Some concerns Details |
|
|
NCT04368728 Pfizer/BioNTech+Fosun Pharma Walsh E, N Engl J Med, 2020 Full text Commentary |
RNA based vaccine |
RNA-based COVID-19 vaccine BNT162b1 - 10mcg x 2 doses on day 1/22 |
Normal saline placebo (0.9% sodium chloride) x 2 doses on day 1/21 |
RCTPhase 1 | Healthy SARS-CoV-2 serology/DNA negative adults in four centres in USA | N=195 |
Low Details |
|
|
NCT04816643 Pfizer/BioNTech+Fosun Pharma Walter E, N Engl J Med, 2021 Full text Commentary |
RNA based vaccine |
BNT162b2 10 mcg |
Placebo |
RCTPhase 2-3 | Children aged 5-11 years with or without stable co-morbidities with no history of COVID-19 in 81 centres in the USA, Spain, Finland, and Poland | N=2285 |
Some concerns Details |
|
|
NCT04523571 ; ChiCTR Pfizer/BioNTech + Fosun Pharma Zhu F, ResearchSquare, 2021 Full text Commentary ; Commentary |
RNA based vaccine |
BNT126b1 30 mcg/0.5 ml 2-dose Days 0,21 |
Saline 0.5 m l Days 0,21 |
RCTPhase 1 | Healthy SARS-CoV-2 infection-free adults aged 18-55 and 65-85 at a single center in China | N=144 |
Low Details |
|