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)
Overall efficacy and safety of all vaccines vs placebo - Charts (Last update:2022-04-14)
- Forest plots (last update: 2021-11-19)
- Studies included
- Forest plots (last update: 2022-11-04)
- Studies included
- Forest plots (last update: 2022-11-04)
- Studies included
- Forest plots (last update: 2022-10-06)
- Studies included
- Forest plots (last update: 2023-01-06)
- Studies included
- Forest plots (last update: 2022-07-07)
- Studies included
- Forest plots (last update: 2022-08-04)
- Studies included
Vaccine effectiveness over time
RNA based vaccine
Non replicating viral vector
Inactivated virus
Protein subunit
Virus-Like particle
DNA based vaccine
Vaccine efficacy and safety for vaccine vs vaccine (forest plots)
- BECOV2 vs ChAdOx1 - Forest plots (last update: 2022-06-25)
- BNT162b2 vs mRNA-1273 - Forest plots (last update: 2022-11-18)
- MVC-COV1901 vs ChAdOx1 - Forest plots (last update: 2022-10-06)
- SII-ChAdOx1 nCoV-19 vs ChAdOx1 - Forest plots (last update: 2021-11-26)
- TURKOVAC vs CoronaVac - Forest plots (last update: 2023-01-06)
- VLA2001 vs ChAdOx1 - Forest plots (last update: 2022-11-04)
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
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 2Reference Intervention 1 Intervention 2 Follow up
daysParticipants 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 Chen C, 2022 1 dose ChAdOx1 / 1 dose MVC-COV1901 ChAdOx1 10 Healthy adults 8
(50)5
(50)1.5 [1.2, 1.9] ELISA
Geometric mean titre neutralizing antibodies
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 2Reference Intervention 1 Intervention 2 Follow up
daysParticipants 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 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 5
(30)4
(30)1.3 [1.0, 2.9] Microneutralization assay against Omicron BA.1.1 variant Chen C, 2022 1 dose ChAdOx1 / 1 dose MVC-COV1901 ChAdOx1 10 Healthy adults 202
(50)78
(50)2.6 [1.7, 4.0] Plaque reduction neutralization - Safety
Serious adverse events
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.Reference Intervention 1 Intervention 2 Follow up
monthsParticipants 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]Bánki Z, 2022 1 dose ChAdOx1/ 1 dose BNT162b2 ChAdOx1 1 Healthy adults 1 / 114 0 / 108 2.84
[0.12 - 69.03]Chen C, 2022 1 dose ChAdOx1 / 1 dose MVC-COV1901 ChAdOx1 0.9 Healthy adults 0 / 50 0 / 50 NR
All-cause mortality
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.Reference Intervention 1 Intervention 2 Follow up
monthsParticipants r1/N1 r2/N2 RR [95% CI] Risk of bias A B C D E Overall Chen C, 2022 1 dose ChAdOx1 / 1 dose MVC-COV1901 ChAdOx1 0.9 Healthy adults 0 / 50 0 / 50 NR
Vaccine efficacy, immunogenicity and safety of booster vs no booster (tables)
- Efficacy
Severe or critical COVID-19 after complete vaccination
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.Reference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
monthsParticipants 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]
Confirmed symptomatic COVID-19 after complete vaccination
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.Reference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
monthsParticipants r1/N1 r2/N2 VE [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 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
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 ratioReference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
daysParticipants 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 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 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
Geometric mean titre neutralizing antibodies
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 ratioReference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
daysParticipants 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. 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 Vadrevu KM, 2022 Inactivated virus BBV152 Boost BBV152 Placebo 28 Adolescents and adults 746
(80)101
(87)7.41 [2.96, 18.51] PRNT - Safety
Serious adverse events
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.Reference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
monthsParticipants 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]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]Vadrevu KM, 2022 Inactivated virus BBV152 Boost BBV152 Placebo 1 Adolescents and adults 0 / 80 0 / 87 NR Tabarsi P, 2022 Any COVID-19 vaccine Any Covid-19 vaccine Boost SpikoGen Placebo 0.5 Adults 0 / 250 0 / 50 NR
All-cause mortality
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.Reference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
monthsParticipants 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
Vaccine efficacy, immunogenicity and safety of booster VS booster (tables)
- Immunogenicity
Geometric mean titre specific antibodies
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 ratioReference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
daysParticipants GMT Boost1 (N1) GMT Boost2 (N2) GMR [95% CI] Evaluated by Risk of bias A B C D E Overall 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 Puthanakit T, 2022 b Any COVID-19 vaccine 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 Any COVID-19 vaccine 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 Launay O, 2022 RNA based vaccine BNT162b2 Boost MV B.1.351 Boost BNT162b2 15 Adults including healthy or stable co-morbidities 2,241
(71)2,405
(76)0.93 [0.77, 1.13] ELISA Launay O, 2022 RNA based vaccine BNT162b2 Boost MV D614 Boost BNT162b2 15 Adults including healthy or stable co-morbidities 1,875
(76)2,405
(76)0.78 [0.65, 0.94] 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 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 Anderson E, 2022 RNA based vaccine mRNA-1273 Boost 50 mcg mRNA-1273.351 Boost 25 mcg mRNA-1273.351 and 25 mcg mRNA-1273 14 Healthy volunteers 9,591
(25)9,046
(22)1.06 [0.78, 1.43] 4-plex Mesoscale Discovery (MSD) 10-plex assay. Anderson E, 2022 RNA based vaccine mRNA-1273 Boost 100 mcg mRNA-1273 Boost 25 mcg mRNA-1273.351 and 25 mcg mRNA-1273 14 Healthy volunteers 8,396
(41)9,046
(22)0.93 [0.69, 1.24] 4-plex Mesoscale Discovery (MSD) 10-plex assay. Fadlyana E, 2023 Inactivated virus CoronaVac boost BNT162b2 boost CoronaVac 28 Healthy adults 18,289
(192)1,324
(190)13.81 [11.54, 16.54] Chemiluminescent microparticle immunoassay (CMIA) Fadlyana E, 2023 Inactivated virus CoronaVac boost BNT162b2 boost BNT162b2 28 Healthy adults 18,289
(192)18,289
(192)13.81 [11.54, 16.54] Chemiluminescent microparticle immunoassay (CMIA) Fadlyana E, 2023 Inactivated virus CoronaVac boost BNT162b2 (half dose) boost CoronaVac 28 Healthy adults 14,455
(185)1,324
(190)10.92 [9.00, 13.24] Chemiluminescent microparticle immunoassay (CMIA) Fadlyana E, 2023 Inactivated virus CoronaVac boost ChAdOx1 (half dose) boost CoronaVac 28 Healthy adults 7,267
(191)1,324
(190)5.49 [4.56, 6.11] Chemiluminescent microparticle immunoassay (CMIA)
Geometric mean titre neutralizing antibodies
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 ratioReference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
daysParticipants GMT Boost1 (N1) GMT Boost2 (N2) GMR [95% CI] Evaluated by Risk of bias A B C D E Overall 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 Toledo-Romani ME, 2022 a 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 Branche A, 2022 Any COVID-19 vaccine Completed primary and booster COVID-19 vaccine series, either homologous or heterologous Boost mRNA Omicron + Beta vaccine Boost Original mRNA-1273 vaccine 15 Adults 4,784
(198)2,699
(97)1.77 [1.24, 2.53] Pseudovirion-based neutralisation assay against Omicron BA.1 variant Branche A, 2022 Any COVID-19 vaccine Completed primary and booster COVID-19 vaccine series, either homologous or heterologous Boost mRNA Omicron + Delta vaccine Boost Original mRNA-1273 vaccine 15 Adults 4,503
(99)2,699
(97)1.67 [1.09, 2.54] Pseudovirion-based neutralisation assay against Omicron BA.1 variant Branche A, 2022 Any COVID-19 vaccine 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 5,322
(96)2,699
(97)1.97 [1.31, 2.95] Pseudovirion-based neutralisation assay against Omicron BA.1 variant Branche A, 2022 Any COVID-19 vaccine Completed primary and booster COVID-19 vaccine series, either homologous or heterologous Boost mRNA Omicron vaccine Boost Original mRNA-1273 vaccine 15 Adults 6,011
(96)2,699
(97)2.23 [1.52, 3.26] Pseudovirion-based neutralisation assay against Omicron BA.1 variant Jin P, 2022 a Inactivated virus CoronaVac Boost Ad5-vectored 5×10^10 vp Boost CoronaVac 14 Elderly 33
(50)4
(50)7.5 [3.5, 18.0] Microneutralization assay against Omicron BA.1.1 variant Launay O, 2022 RNA based vaccine BNT162b2 Boost MV B.1.351 Boost BNT162b2 15 Adults including healthy or stable co-morbidities 253
(71)140
(76)1.81 [1.34, 2.44] Microneutralization test
against Omicron BA.1 variantLaunay O, 2022 RNA based vaccine BNT162b2 Boost MV D614 Boost BNT162b2 15 Adults including healthy or stable co-morbidities 124
(76)140
(76)0.88 [0.67, 1.17] Microneutralization test
against Omicron BA.1 variantChuang C-H, 2022 Non replicating viral vector ChAdOx1 Boost BNT162b2 Boost mRNA-1273 (half dose) 28 Healthcare workers 146
(30)204
(30)3.95 [2.57, 6.05] Live virus neutralization against Omicron BA.1 variant Chuang C-H, 2022 Non replicating viral vector ChAdOx1 Boost BNT162b2 Boost mRNA-1273 28 Healthcare workers 146
(30)250
(30)3.95 [2.57, 6.05] Live virus neutralization against Omicron BA.1 variant Chuang C-H, 2022 Non replicating viral vector ChAdOx1 Boost BNT162b2 Boost MVC-COV1901 28 Healthcare workers 146
(30)37
(30)3.95 [2.57, 6.05] Live virus neutralization against Omicron BA.1 variant 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 293
(96)38
(96)7.71 [5.42, 10.97] Live-virus neutralizationn against Omicron variant Costa Clemens SA, 2022 Inactivated virus CoronaVac Boost BNT162b2 Boost CoronaVac 28 Healthy adults 223
(20)17
(20)13.12 [5.66, 30.40] Pseudovirus neutralisation titres against Omicron variant. Costa Clemens SA, 2022 Inactivated virus CoronaVac Boost ChAdOx1 Boost CoronaVac 28 Healthy adults 102
(20)17
(20)6 [2.91, 12.36] Pseudovirus neutralisation titres against Omicron variant. Costa Clemens SA, 2022 Inactivated virus CoronaVac Boost AD26.COV2-S Boost CoronaVac 28 Healthy adults 138
(20)17
(20)8.12 [3.72, 17.69] Pseudovirus neutralisation titres against Omicron variant. Jin L, 2022 Inactivated virus CoronaVac Boost Ad5-vectored high dose Boost CoronaVac 28 Healthy adults 23
(37)4
(40)5.63 [3.83, 8.29] CPE-based microneutralisation against Omicron variant. Jin L, 2022 Inactivated virus CoronaVac Boost Ad5-vectored low dose Boost CoronaVac 28 Healthy adults 52
(40)4
(40)12.68 [9.06, 17.75] CPE-based microneutralisation against Omicron variant. Anderson E, 2022 RNA based vaccine mRNA-1273 Boost 50 mcg mRNA-1273.351 Boost 25 mcg mRNA-1273.351 and 25 mcg mRNA-1273 15 Healthy volunteers 2,111
(25)2,435
(22)0.87 [0.60, 1.24] Neutralization assay (PsVN) Anderson E, 2022 RNA based vaccine mRNA-1273 Boost 100 mcg mRNA-1273 Boost 25 mcg mRNA-1273.351 and 25 mcg mRNA-1273 15 Healthy volunteers 2,842
(41)2,435
(22)1.17 [0.84, 1.62] Neutralization assay (PsVN) Al Kaabi N, 2023 Inactivated virus BBIBP-CorV Boost NVSI-06-09 Boost BBIBP-CorV 14 Healthy adults 2,349
(255)506
(249)4.64 [3.93, 5.47] Live-virus microneutralization assay Corominas J, 2022 RNA based vaccine BNT162b2 Boost PHH-1V Boost BNT162b2 14 Healthy adults 1,966
(500)3,309
(241)0.59 [0.51, 0.76] Pseudovirion-based neutralisation assay - Safety
Serious adverse events
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.Reference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
monthsParticipants r1/N1 r2/N2 RR [95% CI] Risk of bias A B C D E Overall 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]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 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 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]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]Launay O, 2022 RNA based vaccine BNT162b2 Boost MV B.1.351 Boost BNT162b2 0.5 Adults including healthy or stable co-morbidities 1 / 80 0 / 82 3.07
[0.13 - 74.36]Launay O, 2022 RNA based vaccine BNT162b2 Boost MV D614 Boost BNT162b2 0.5 Adults including healthy or stable co-morbidities 1 / 85 0 / 82 2.89
[0.12 - 70.04]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]Jin L, 2022 Inactivated virus CoronaVac Boost Ad5-vectored high dose Boost CoronaVac 12 Healthy adults 1 / 137 1 / 137 1
[0.06 - 15.83]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]Anderson E, 2022 RNA based vaccine mRNA-1273 Boost 50 mcg mRNA-1273.351 Boost 25 mcg mRNA-1273.351 and 25 mcg mRNA-1273 1 Healthy volunteers 0 / 25 1 / 23 0.31
[0.01 - 7.16]Anderson E, 2022 RNA based vaccine mRNA-1273 Boost 100 mcg mRNA-1273 Boost 25 mcg mRNA-1273.351 and 25 mcg mRNA-1273 1 Healthy volunteers 0 / 48 1 / 23 0.16
[0.01 - 3.81]Al Kaabi N, 2023 Inactivated virus BBIBP-CorV Boost NVSI-06-09 Boost BBIBP-CorV 1 Healthy adults 0 / 260 0 / 256 NR Kho M, 2022 RNA based vaccine mRNA-1273 or BNT162b2 Boost mRNA-1273 (2 doses) Boost mRNA-1273 0.9 Adult kidney transplant recipients 0 / 75 3 / 71 0.14
[0.01 - 2.57]Kho M, 2022 RNA based vaccine mRNA-1273 or BNT162b2 Boost Ad26.COV2-S Boost mRNA-1273 0.9 Adult kidney transplant recipients 1 / 78 3 / 71 0.3
[0.03 - 2.85]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 Corominas J, 2022 RNA based vaccine BNT162b2 Boost PHH-1V Boost BNT162b2 3.2 Healthy adults 1 / 513 0 / 252 1.48
[0.06 - 36.09]Fadlyana E, 2023 Inactivated virus CoronaVac boost BNT162b2 boost CoronaVac 28 Healthy adults 1 / 193 0 / 191 2.97
[0.12 - 72.43]Fadlyana E, 2023 Inactivated virus CoronaVac boost BNT162b2 boost BNT162b2 28 Healthy adults 1 / 193 1 / 193 1
[0.06 - 15.87]Fadlyana E, 2023 Inactivated virus CoronaVac boost BNT162b2 (half dose) boost CoronaVac 28 Healthy adults 0 / 186 0 / 191 NR Fadlyana E, 2023 Inactivated virus CoronaVac boost ChAdOx1 (half dose) boost CoronaVac 28 Healthy adults 1 / 192 0 / 191 2.98
[0.12 - 72.8]
All-cause mortality
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.Reference Type of prime vaccination Prime schedule Intervention 1 Intervention 2 Follow up
monthsParticipants 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 Toledo-Romani ME, 2022 a 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 Launay O, 2022 RNA based vaccine BNT162b2 Boost MV B.1.351 Boost BNT162b2 0.5 Adults including healthy or stable co-morbidities 0 / 80 0 / 82 NR Launay O, 2022 RNA based vaccine BNT162b2 Boost MV D614 Boost BNT162b2 0.5 Adults including healthy or stable co-morbidities 0 / 85 0 / 82 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 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 Corominas J, 2022 RNA based vaccine BNT162b2 Boost PHH-1V Boost BNT162b2 3.2 Healthy adults 0 / 513 0 / 252 NR
Search studies
| Trial | Type | Comparisons | Design | Participants | Sample size | Overall risk of bias Highest assessment |
Full description | |
|---|---|---|---|---|---|---|---|---|
| Intervention 1 | Intervention 2 | |||||||
|
NCT04636697 Medicago Inc Hager K, N Engl J Med, 2022 Full text Full text Commentary |
Virus-Like particle |
CoVLP 3.75mcg +AS03 D0/21 |
Placebo |
RCTPhase 3 | Adults including elderly with and without comorbidities, with no previous history of virologically confirmed COVID-19, both seronegative and seropositive, at 85 centers in Argentina, Brazil, Canada, Mexico, the UK, and the USA. | N=24141 |
Some concerns Details |
|