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
Liu X, 2021	1 dose ChAdOx1/ 1 dose BNT162b2	2 doses ChAdOx1	28	Adults	12,995 (108)	1,387 (105)	9.3 [7.7, 11]	SARS-CoV-2 anti-spike IgG, ELISA -ELU/mL
Liu X, 2021	1 dose BNT162b2 /1 dose ChAdOx1	2 doses BNT162b2	28	Adults	7,133 (109)	13,938 (110)	0.51 [0.41, 0.6]	SARS-CoV-2 anti-spike IgG, ELISA -ELU/mL
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]	RBD-specific IgG ELISA
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

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	Risk of bias
									A	B	C	D	E	Overall
Liu X, 2021	1 dose ChAdOx1/ 1 dose BNT162b2	2 doses ChAdOx1	28	Adults	515 (101)	61 (101)	8.5 [6.5, 11]	Pseudotype virus neutralising antibody, NT50
Liu X, 2021	1 dose BNT162b2 /1 dose ChAdOx1	2 doses BNT162b2	28	Adults	383 (104)	574 (102)	0.67 [0.51, 0.88]	Pseudotype virus neutralising antibody, NT50
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
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)

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

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
Liu X, 2021	1 dose ChAdOx1/ 1 dose BNT162b2	2 doses ChAdOx1	NR	Adults	0 / 114	1 / 115	0.34 [0.01 - 8.17]
Liu X, 2021	1 dose BNT162b2 /1 dose ChAdOx1	2 doses BNT162b2	NR	Adults	0 / 115	0 / 119	NR
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]
Li J, 2022	1 dose CoronaVac / 1 dose Ad5-vectored	2 doses CoronaVac	1	Healthy adults	0 / 51	0 / 50	NR
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

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, 2021	Protein subunit	FINLAY-FR-2-25 mcg	Boost FINLAY-FR-1-50 mcg	Placebo	1.7	Adults	0 / 13883	6 / 14303	100.0 [, ]

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]
Toledo-Romani ME, 2021	Protein subunit	FINLAY-FR-2-25 mcg	Boost FINLAY-FR-1-50 mcg	Placebo	1.7	Adults	15 / 13883	155 / 14303	92.4 [86.9, 95.6]
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]

Reference	Type of prime vaccination	Prime schedule	Intervention 1	Intervention 2	Follow up days	Participants	GMT1(N1)	GMT2(N2)	GMR [95% CI]	Evaluated by
	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

Immunogenicity
Geometric mean titre specific antibodies
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. A CPE assay was used to determine the 50% neutralization titer to live SARS-CoV-2. The neutralizing titer was set as the dilution number of the 50% protective condition using the Reed and Muench method. The neutralizing activity against ancestral strain was quantified by micro-dose cytopathogenic effect assays, with a limit of detection (LOD) of 10. Neutralizing activity against ancestral strain was quantified at the Wuhan Institute of Virology, Chinese Academy of Sciences by conducting micro-dose cytopathogenic effect assays, with a limit of detection (LOD) of 10.
Vadrevu KM, 2022	Inactivated virus	BBV152	Boost BBV152	Placebo	28	Adolescents and adults	746 (80)	101 (87)	7.41 [2.96, 18.51]	Plaque reduction neutralisation test

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

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

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, 2021	Protein subunit	FINLAY-FR-2-25 mcg	Boost FINLAY-FR-1-50 mcg	Placebo	5.2	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

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
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	0 (267)	0 (270)	NR	ELISA
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
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)	NR	ELISA
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 anti-spike IgG, LLOQ: 100
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]	RBD-specific IgG ELISA
Li JX, 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
Li JX, 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
Toledo-Romani ME, 2021	Protein subunit	FR-1-50 mcg	Boost FINLAY-FR-2	Boost FR-1	14	Healthy adults	72 (51)	99 (58)	NR	ELISA
Cao Y, 2021	Inactivated virus	CoronaVac	Boost ZF2001	Boost CoronaVac	14	Healthcare workers	10,417 (81)	7,496 (40)	*1.38 [, ]*	ELISA
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost m-RNA-1273	Boost BNT162b2	28	Healthcare workers	4,379 (112)	2,671 (111)	40.95 [23.33, 71.78]	Liaison SARS CoV-2 TrimericS IgG
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Boost m-RNA-1273	28	Healthcare workers	403 (106)	4,379 (112)	3.76 [2.11, 6.69]	Liaison SARS CoV-2 TrimericS IgG
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Boost BNT162b2	28	Healthcare workers	403 (106)	2,671 (111)	3.76 [2.11, 6.69]	Liaison SARS CoV-2 TrimericS IgG

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
Mok C K P, 2022	Inactivated virus	CoronaVac	Boost CoronaVac	Boost BNT162b2	30	Adults	17 (40)	207 (40)	NR	PRNT90
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
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
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)	NR	Surrogate virus neutralization test (sVNT)
Shinkai M, 2022	RNA based vaccine	BNT162b2	Boost S-268019-b	Boost BNT162b2	14	Adults	128 (101)	139 (101)	1.14 [0.94, 1.39]	Cytopathic effect-based virus neutralization test, LLOQ: 5
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
Li JX, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored high dose	Boost CoronaVac	14	Healthy adults	714 (140)	79 (140)	9.09 [5.65, 14.76]	CPE-based microneutralisation
Li JX, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored low dose	Boost CoronaVac	14	Healthy adults	744 (140)	79 (140)	*9.48 [6.09, ]**	CPE-based microneutralisation
Toledo-Romani ME, 2021	Protein subunit	FR-1-50 mcg	Boost FINLAY-FR-2	Boost FR-1	28	Healthy adults	33 (51)	43 (55)	NR	Conventional virus neutralization test
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
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost m-RNA-1273	Boost BNT162b2	28	Healthcare workers	2,007 (54)	1,446 (53)	27.49 [15.23, 49.60]	PRNT
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Boost m-RNA-1273	28	Healthcare workers	235 (50)	2,007 (54)	3.21 [1.74, 5.93]	PRNT
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Boost BNT162b2	28	Healthcare workers	235 (50)	1,446 (53)	3.21 [1.74, 5.93]	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
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]
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
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]
Poh XY, 2022	RNA based vaccine	BNT162b2	Boost mRNA-1273	Boost BNT162b2	28	Adults	0 / 48	0 / 50	NR
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
Li JX, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored high dose	Boost CoronaVac	1	Healthy adults	0 / 140	0 / 140	NR
Li JX, 2022	Inactivated virus	CoronaVac	Boost Ad5-vectored low dose	Boost CoronaVac	1	Healthy adults	0 / 140	0 / 140	NR
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost m-RNA-1273	Boost BNT162b2	1	Healthcare workers	0 / 112	0 / 111	NR
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Boost m-RNA-1273	1	Healthcare workers	0 / 106	0 / 112	NR
Sablerolles R, 2022	Non replicating viral vector	Ad26.COV2.S	Boost Ad26.COV2.S	Boost BNT162b2	1	Healthcare workers	0 / 106	0 / 111	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]

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]
	A	B	C	D	E	Overall
Shinkai M, 2022	RNA based vaccine	BNT162b2	Boost S-268019-b	Boost BNT162b2	*	Adults	0 / 101	0 / 103	NR
Toledo-Romani ME, 2021	Protein subunit	FR-1-50 mcg	Boost FINLAY-FR-2	Boost FR-1	1	Healthy adults	0 / 55	0 / 58	NR
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]

Trials reports under extraction

In addition to the below included trials, we have included and presently extracting 26 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.

As of January 2022, we will extract and present results of early phase trials 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.

Search studies

Sort by: Most recent studiesFirst Author
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Trial	Type	Comparisons		Design	Participants	Sample size	Overall risk of bias Highest assessment	Full description
		Intervention 1	Intervention 2
NCT05011526 Medigen; AstraZeneca + University of Oxford Torales J, medRxiv, 2022 New Full text Commentary Commentary	Protein subunit	MVC-COV1901 15 mcg D0/28	ChAdOx1	RCT Phase 3	Healthy adults or adults with pre-existing medical conditions who are in stable condition and with no known SARS-CoV-2 infection in the 3 months prior at 2 centers in Paraguay.	N=1030	Low Details	Full description
NCT04651790 Sinovac Research and Development Co., Ltd Abarca K, medRxiv, 2022 Full text Commentary Commentary Commentary	Inactivated virus	CoronaVac	Coronavac D0/28	RCT Phase 3	Healthy adults including health care workers with no history of confirmed symptomatic SARS CoV-2 infection at eight centres in Chile	N=2302	Some concerns Details	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
NCT04712110 Novavax Masuda T, Vaccine, 2022 b Full text Commentary Commentary Commentary	Protein subunit	NVX-CoV2373	Placebo	RCT Phase 1-2	Healthy Japanese adults aged ≥ 20 years with no history/risk of SARS-CoV-2 infection and no prior exposure to other approved/investigational SARS-CoV-2 vaccines or treatments at 2 centers in Japan.	N=200	Some concerns Details	Full description
NCT04864561 Valneva Lazarus, SSRN, 2022 Full text Commentary Commentary	Inactivated virus	VLA2001 (33 AU)	ChAdOx1	RCT Phase 3	Medically stable adults, 30 years and older, at 26 centers in the UK.	N=2975	Some concerns Details	Full description
NCT04649021 Pfizer/BioNTech+Fosun Pharma Hui AH, SSRN, 2022 Full text Commentary Commentary	RNA based vaccine	BNT162b2	Placebo	RCT Phase 2	Healthy adults and those with a pre-existing stable condition, at 2 centers in China.	N=960	Low Details	Full description
NCT04646590 Anhui Zhifei Longcom Biopharmaceutical Dai L, N Engl J Med, 2022 Full text Commentary Commentary	Protein subunit	ZF2001	Placebo	RCT Phase 3	Adults 18 years of age or older with no history of Covid-19, positive tests for SARS-CoV-2 exposure or vaccination, or of congenital or acquired immune deficiency or autoimmune disease at 32 clinical centers across Uzbekistan, Indonesia, Pakistan, Ecuador and China.	N=28904	Some concerns Details	Full description
NCT04796896 ModernaTX Creech CB, N Engl J Med, 2022 KidCOVE Full text Commentary	RNA based vaccine	mRNA-1273 (50 mcg D0/28)	Placebo	RCT Phase 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	Full description
ISRCTN73765130 ; EudraCT 2021-002175-19 Pfizer/BioNTech;ModernaTX Munro APS, Lancet Infect Dis, 2022 COV-BOOST Full text Commentary Commentary (22)00282-1/fulltext	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	RCT Phase 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	Full description
NCT05096832 Livzon Pharmaceutical Wang X-Y, Emerg Microbes Infec, 2022 Full text Commentary Commentary	Protein subunit	Prime vaccination BBIBP-CorV or CoronaVac/ boost V-01	Prime vaccination BBIBP-CorV or CoronaVac/ Placebo	RCT Phase 3	Healthy adults or those with stable chronic conditions, with no previous history of COVID-19, at 15 centers in Pakistan and Malaysia.	N=10241	Some concerns Details	Full description

Achiron A, J Neurol, 2022	Immune response to the third COVID-19 vaccine dose is related to lymphocyte count in multiple sclerosis patients treated with fingolimod.
Al Kaabi N, medRxiv, 2022	Safety and immunogenicity of a hybrid-type vaccine booster in BBIBP-CorV recipients: a randomized controlled phase 2 trial
Anderson E, Research Square, 2022	Safety and Immunogenicity of a Third Dose of SARS-CoV-2 mRNA Vaccine An Interim Analysis
Barrios L, , medRxiv, 2022	An Evaluation of the Safety and Immunogenicity of MVC-COV1901: Results of an interim analysis of a phase III, parallel group, randomized, double-blind, active-controlled study
Branche AR, medRxiv, 2022	SARS-CoV-2 Variant Vaccine Boosters Trial: Preliminary Analyses
Bruminhent J, Am J Transplant, 2022	An additional dose of viral vector COVID-19 vaccine and mRNA COVID-19 vaccine in kidney transplant recipients: a randomized controlled trial (CVIM 4 study).
Corominas J, medRxiv, 2022	Safety and immunogenicity of the protein-based PHH-IV compared to BNT162b2 as a heterologous SARS-CoV-2 booster vaccine in adults vaccinated against COVID-19: a multicentre, randomised, double-blind, non-inferiority phase IIb trial.
Costa Clemens SA, medrxiv, 2022	Homologous and heterologous boosting of the ChAdOx1-S1-S COVID-19 vaccine with the SCB-2019 vaccine candidate: a randomized, observer-blinded, controlled, phase 2 study
El Sahly HM, J Infect Dis, 2022	Humoral Immunogenicity of the mRNA-1273 Vaccine in the Phase 3 COVE Trial.
Fadlyana E, SSRN, 2022	Immunogenicity and Safety in Healthy Adults of Full-Dose Versus Half Doses of COVID-19 Vaccine (ChAdOx1-S or BNT162b2) or Full-Dose CoronaVac Administered as a Booster Dose after Priming with Coronavac: A Randomized, Observer-Blinded, Contr
Hernandez-Bernal F, SSRN, 2022	A Phase 3, Randomised, Double-Blind, Placebo-Controlled Clinical Trial for Adult Evaluation of the Efficacy and Safety of a Sars-Cov-2 Recombinant Spike Rbd Protein Vaccine (Abdala-3 Study)
Jin P, medrxiv, 2022	Heterologous CoronaVac plus Ad5-nCOV versus homologous CoronaVac vaccination among elderly: a phase 4, non-inferiority, randomized study
Kelliher MT, Arch Pathol Lab Med, 2022	Comparison of Symptoms and Antibody Response Following Administration of Moderna or Pfizer SARS-CoV-2 Vaccines.
Kulkarni PS, SSRN, 2022	Safety and Immunogenicity of SII-NVX-CoV2373 (COVID-19 Vaccine) In Adults in a Phase 2/3, Observer-Blind, Randomised, Controlled Study
LAUNAY O, medrxiv, 2022	Immunogenicity and Safety of Beta Adjuvanted Recombinant Booster Vaccine
Lien CE, SSRN, 2022	A Phase I, Prospective, Randomized, Open-Labeled Study to Evaluate the Safety, Tolerability, and Immunogenicity of Booster Dose with MVC-COV1901 or MVC-COV1901(Beta) SARS-CoV-2 Vaccine in Adults
Madhi SA, Lancet, 2022	Immunogenicity and safety of a SARS-CoV-2 recombinant spike protein nanoparticle vaccine in people living with and without HIV-1 infection: a randomised, controlled, phase 2A/2B trial.
Nantanee R, Vaccine, 2022	A Randomized Clinical Trial of a Fractional Low Dose of BNT162b2 Booster in Adults Following AZD1222.
Niyomnaitham S, Hum Vaccin Immunother, 2022	Immunogenicity and reactogenicity against the SARS-CoV-2 variants following heterologous primary series involving CoronaVac, ChAdox1 nCov-19 and BNT162b2 plus BNT162b2 booster vaccination: An open-label randomized study in healthy Thai adul
Puthanakit T; Vaccine: X; 2022	Heterologous Prime-boost of SARS-CoV-2 Inactivated Vaccine and mRNA BNT162b2 among Healthy Thai Adolescents.
Rose W, SSRN, 2022	Immunogenicity and Safety of Homologous and Heterologous Booster Vaccination of ChAdOx1 nCoV-19 (COVISHIELDTM) and BBV152 (COVAXINÂ®) in Previous Recipients of COVISHIELDTM or COVAXINÂ®: A Phase 4, Participant and Observer Blinded, Randomis
Sung JC, Vaccines, 2022	Safety and Immunogenicity of Inactivated Bacillus subtilis Spores as a Heterologous Antibody Booster for COVID-19 Vaccines.
Tabarsi P, Immunology, 2022	Immunogenicity and Safety of SpikoGenÂ®, an Adjuvanted Recombinant SARS-CoV-2 Spike Protein vaccine as a Homologous and Heterologous Booster Vaccination: A Randomized Placebo-Controlled Trial.
Thuluva S, medRxiv, 2022	Selection of optimum formulation of RBD-based protein sub-unit covid19 vaccine (Corbevax) based on safety and immunogenicity in an open-label, randomized Phase-1 and 2 clinical studies
Zeng G, Lancet Infect Dis, 2021	Immunogenicity and safety of a third dose of CoronaVac, and immune persistence of a two-dose schedule, in healthy adults: interim results from two single-centre, double-blind, randomised, placebo-controlled phase 2 clinical trials
Zhu F, Lancet Respir Med, 2022	Safety and immunogenicity of a live-attenuated influenza virus vector-based intranasal SARS-CoV-2 vaccine in adults: randomised, double-blind, placebo-controlled, phase 1 and 2 trials.

COVID-19 vaccine effectiveness(Randomized evidence)

Methods

meta-COVID

Vaccine types

Trials reports under extraction

Description of primary studies

Search studies

COVID-19 vaccine effectiveness
(Randomized evidence)