COVID-19 vaccine effectiveness
(Randomized evidence)
Methods
Results of booster studies are available in the tables below and are updated on a daily basis.
As of December 14, 2022, the COVID-NMA revised its protocol and discontinued the inclusion of prime vaccination trials in its analysis. The analysis presented on this page for prime vaccines compared to placebo or other vaccines includes trials that were identified and included up to December 14, 2022. A list of studies that were eligible up to this date but not extracted is provided in detail here .
On December 7, 2022, we published results of the systematic review "Efficacy and safety of COVID‐19 vaccines" which included 41 preprints and published trials of 12 different COVID-19 used as prime vaccination and that were published before 5 November 2021.meta-COVID
Perform your own analysis using COVID-NMA data, create and download your forest plots by clicking below:
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: 2023-03-07)
- 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 antibodiesReference 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 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 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
Geometric mean titre neutralizing antibodiesReference 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) 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 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 - Safety
Serious adverse eventsReference 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 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 Li J, 2022 1 dose CoronaVac / 1 dose Ad5-vectored 2 doses CoronaVac 1 Healthy adults 0 / 51 0 / 50 NR
All-cause mortalityReference 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 vaccinationReference 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
Full text
Full textProtein 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 vaccinationReference 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 NR NR 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 NR NR 92.0
[80.4, 96.7] - Immunogenicity
Geometric mean titre specific antibodiesReference 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 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 neutralization assay against -wild typeReference 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 Zhang Y, 2022 Inactivated virus CoronaVac Boost ChAdTS-S Placebo 14 Adults 290
(48)5
(46)56.8 [43.6, 74.1] Micro-neutralisation assay Zhang Y, 2022 Inactivated virus CoronaVac Boost RQ3013 Placebo 14 Adults 950
(46)5
(46)190.9 [145.8, 249.9] Micro-neutralisation assay Zhang Y, 2022 Inactivated virus CoronaVac Boost ZR202-CoV Placebo 14 Adults 635
(47)5
(46)120.8 [92.6, 157.6] Micro-neutralisation assay Zhang Y, 2022 Inactivated virus CoronaVac Boost CoronaVac Placebo 14 Adults 75
(46)5
(46)15.1 [11.5, 19.8] Micro-neutralisation assay 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 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 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 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 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
Geometric mean titre neutralization assay- omicronReference 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 Zhang Y, 2022 Inactivated virus CoronaVac Boost ChAdTS-S Placebo 14 Adults 41
(48)4
(46)10.3 [7.6, 14.0] Micro-neutralisation assay Zhang Y, 2022 Inactivated virus CoronaVac Boost RQ3013 Placebo 14 Adults 247
(46)4
(46)62.4 [45.8, 85.1] Micro-neutralisation assay Zhang Y, 2022 Inactivated virus CoronaVac Boost ZR202-CoV Placebo 14 Adults 104
(47)4
(46)26.0 [19.1, 35.4] Micro-neutralisation assay Zhang Y, 2022 Inactivated virus CoronaVac Boost CoronaVac Placebo 14 Adults 8
(46)4
(46)2.0 [1.5, 2.7] Micro-neutralisation assay - Safety
Serious adverse eventsReference 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 Tabarsi P, 2022 Any COVID-19 vaccine Any Covid-19 vaccine Boost SpikoGen Placebo 0.5 Adults 0 / 250 0 / 50 NR Zhang Y, 2022 Inactivated virus CoronaVac Boost ChAdTS-S Placebo 3 Adults 0 / 48 3 / 47 0.14
[0.01 - 2.63]Zhang Y, 2022 Inactivated virus CoronaVac Boost RQ3013 Placebo 3 Adults 0 / 47 3 / 47 0.14
[0.01 - 2.69]Zhang Y, 2022 Inactivated virus CoronaVac Boost ZR202-CoV Placebo 3 Adults 0 / 47 3 / 47 0.14
[0.01 - 2.69]Zhang Y, 2022 Inactivated virus CoronaVac Boost CoronaVac Placebo 3 Adults 0 / 46 3 / 47 0.15
[0.01 - 2.74]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 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]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 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 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 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 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]Sung J, 2022 Any COVID-19 vaccine 2 doses BNT162b2 or BBIBP Boost Recombinant inactiv Bacillus subtilis spores Boost active adjuvant 1.2 Healthy adults 0 / 9 0 / 7 NR
All-cause mortalityReference 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 Any COVID-19 vaccine 2 doses BNT162b2 or BBIBP Boost Recombinant inactiv Bacillus subtilis spores Boost active adjuvant 1.2 Healthy adults 0 / 9 0 / 7 NR Zhang Y, 2022 Inactivated virus CoronaVac Boost ChAdTS-S Placebo 3 Adults 0 / 48 0 / 47 NR Zhang Y, 2022 Inactivated virus CoronaVac Boost RQ3013 Placebo 3 Adults 0 / 47 0 / 47 NR Zhang Y, 2022 Inactivated virus CoronaVac Boost ZR202-CoV Placebo 3 Adults 0 / 47 0 / 47 NR Zhang Y, 2022 Inactivated virus CoronaVac Boost CoronaVac Placebo 3 Adults 0 / 46 0 / 47 NR
Vaccine efficacy, immunogenicity and safety of booster VS booster (tables)
- Immunogenicity
Geometric mean titre specific antibodiesReference 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 48464.8 / 101 NR 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 1975.1 / 209 NR 1.19 [1.07, 1.31] ELISA Cao Y, 2021 Inactivated virus CoronaVac Boost ZF2001 Boost CoronaVac 14 Healthcare workers 10417 / 81 NR 1.38 [*, *] 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 9591 / 25 NR 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 8396 / 41 NR 0.93 [0.69, 1.24] 4-plex Mesoscale Discovery (MSD) 10-plex assay. Li J, 2022 Inactivated virus CoronaVac Boost Ad5-vectored Boost Coronavac 14 Healthy adults 3090.1 / 96 NR 8.37 [6.52, 10.75] ELISA Sablerolles R, 2022 Non replicating viral vector Ad26.COV2.S Boost m-RNA-1273 Boost Ad26.COV2.S 28 Healthcare workers 4379 / 112 NR 10.86 [8.22, 14.34] Liaison SARS CoV-2 TrimericS IgG Sablerolles R, 2022 Non replicating viral vector Ad26.COV2.S Boost BNT162b2 Boost Ad26.COV2.S 28 Healthcare workers 2671 / 111 NR 6.62 [4.93, 8.89] Liaison SARS CoV-2 TrimericS IgG Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901+boost MVC-COV1901 14 Adults including healthy or stable co-morbidities 28179.38 / 19 21078.01 / 21 1.33 [0.88, 2.01] ELISA Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901+boost MVC-COV1901 14 Adults including healthy or stable co-morbidities 21638.16 / 18 21078.01 / 21 1.02 [0.67, 1.55] ELISA Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901 14 Adults including healthy or stable co-morbidities 32938.41 / 12 25878.60 / 15 1.27 [0.70, 2.83] ELISA Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901 14 Adults including healthy or stable co-morbidities 43208.61 / 12 25878.60 / 15 1.66 [0.92, 3] ELISA
Geometric mean titre neutralization assay against -wild typeReference 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 Mok C K P, 2022 Inactivated virus CoronaVac Boost CoronaVac Boost BNT162b2 30 Adults 17
(40)207
(40)NR PRNT90 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 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 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) 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 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) 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 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 Niyomnaitham S, 2022 Inactivated virus CoronaVac Boost ChAdOx1 (1/5 dose ID) Boost BNT162b2 (1/6 dose ID) 14 Healthy adults 206
(45)288
(45)0.71 [0.48, 1.07] Plaque reduction neutralization test Sablerolles R, 2022 Non replicating viral vector Ad26.COV2.S Boost m-RNA-1273 Boost Ad26.COV2.S 28 Healthcare workers 5,686
(11)614
(12)9.26 [5.20, 16.48] PRNT Sablerolles R, 2022 Non replicating viral vector Ad26.COV2.S Boost BNT162b2 Boost Ad26.COV2.S 28 Healthcare workers 2,204
(12)614
(12)3.58 [1.11, 11.59] PRNT Al Kaabi N, 2022 b Inactivated virus BBIBP-CorV Boost NVSI-06-08 4-6 months Boost BBIBP-CorV 4-6 months 15 Healthy adults 3,142
(285)197
(289)15.96 [13.34, 19.08] Live-virus neutralization assay Al Kaabi N, 2022 b Inactivated virus BBIBP-CorV Boost NVSI-06-08 7-9 months Boost BBIBP-CorV 7-9 months 15 Healthy adults 4,908
(270)505
(270)9.72 [8.04, 11.77] Live-virus neutralization assay Al Kaabi N, 2022 b Inactivated virus BBIBP-CorV Boost NVSI-06-08 >9 months Boost BBIBP-CorV >9 months 15 Healthy adults 4,185
(286)375
(278)11.17 [9.44, 13.22] Live-virus neutralization assay Niyomnaitham S, 2022 Inactivated virus Coronavac Boost ChAdOx1 Boost BNT162b2 28 Healthy adults 575
(97)928
(99)0.61 [0.49, 0.77] Micro Neutralizing Antibody Titer Corominas J, 2023 RNA based vaccine BNT162b2 Boost PHH-1V Boost BNT162b2 14 Healthy adults 1,966
(500)3,309
(241)0.59 [0.51, 0.69] Pseudovirion-based neutralisation assay Tang R, 2023 Inactivated virus Coronavac Boost Coronovac/BoostAd5-nCoV IN Boost Coronovac/boost Coronavac 14 Healthy adults 292
(117)78
(116)3.7 [2.6, 5.1] Cytopathic effect-based microneutralization assay Tang R, 2023 Inactivated virus Coronavac Boost Coronovac/Ad5-nCoV INCoV IM Boost Coronovac/boost Coronavac 14 Healthy adults 746
(118)78
(116)9.5 [7.3, 12.3] Cytopathic effect-based microneutralization assay Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901+boost MVC-COV1901 28 Adults including healthy or stable co-morbidities 1,125
(19)868
(18)1.29 [0.82, 2.02] Plaque reduction neutralization test Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901+boost MVC-COV1901 28 Adults including healthy or stable co-morbidities 929
(18)868
(18)1.06 [0.68, 1.67] Plaque reduction neutralization test Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901 28 Adults including healthy or stable co-morbidities 1,805
(12)1,352
(14)1.33 [0.61, 2.89] Plaque reduction neutralization test Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901 28 Adults including healthy or stable co-morbidities 3,603
(12)1,352
(14)2.64 [1.22, 5.79] Plaque reduction neutralization test Amplify, 2023 b RNA based vaccine BNT162b2 Boost Ad26.COV2.S 1*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 14 Adults including elderly and stable co-morbidities 3,218
(88)4,439
(299)0.725 [0.570, 0.922] Virus neutralization assay (VNA) Amplify, 2023 b RNA based vaccine BNT162b2 Boost Ad26.COV2.S 2.5*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 14 Adults including elderly and stable co-morbidities 3,566
(295)4,439
(299)0.803 [0.696, 0.927] Virus neutralization assay (VNA) Amplify, 2023 a Non replicating viral vector Ad26.COV2.S Boost Ad26.COV2.S 1*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 14 Adults including elderly and stable co-morbidities 734
(93)1,130
(298)0.649 [0.484, 0.827] Virus neutralization assay (VNA) Amplify, 2023 a Non replicating viral vector Ad26.COV2.S Boost Ad26.COV2.S 2.5*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 14 Adults including elderly and stable co-morbidities 915
(297)1,130
(298)0.810 [0.665, 0.986] Virus neutralization assay (VNA)
Geometric mean titre neutralization assay- omicronReference 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 Al Kaabi N, 2023 Inactivated virus BBIBP-CorV Boost NVSI-06-09 Boost BBIBP-CorV 14 Healthy adults 1,714
(255)143
(249)11.96 [9.60, 14.90] Live-virus microneutralization assay 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 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 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 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 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 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 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 Launay 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 Chuang C-H, 2022 Non replicating viral vector ChAdOx1 Boost mRNA-1273 (half dose) Boost BNT162b2 28 Healthcare workers 204
(30)146
(30)5.51 [3.42, 8.90] Live virus neutralization Chuang C-H, 2022 Non replicating viral vector ChAdOx1 Boost mRNA-1273 Boost BNT162b2 28 Healthcare workers 250
(30)146
(30)6.75 [4.30, 10.61] Live virus neutralization Chuang C-H, 2022 Non replicating viral vector ChAdOx1 Boost MVC-COV1901 Boost BNT162b2 28 Healthcare workers 37
(30)146
(30)0.25 [0.16, 0.38] 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 Branche A, 2022 a 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 Branche A, 2022 a 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 Branche A, 2022 a 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 Branche A, 2022 a 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 Niyomnaitham S, 2022 Inactivated virus CoronaVac Boost ChAdOx1 (1/5 dose ID) Boost BNT162b2 (1/6 dose ID) 14 Healthy adults 46
(45)53
(45)0.87 [0.55, 1.38] Plaque reduction neutralization test Al Kaabi N, 2022 b Inactivated virus BBIBP-CorV Boost NVSI-06-08 7-9 months Boost BBIBP-CorV 7-9 months 15 Healthy adults 368
(270)45
(270)8.17 [6.03, 11.06] Live-virus neutralization assay Niyomnaitham S, 2022 Inactivated virus Coronavac Boost ChAdOx1 Boost BNT162b2 28 Healthy adults 119
(97)256
(99)0.46 [0.36, 0.59] Micro Neutralizing Antibody Titer Corominas J, 2023 RNA based vaccine BNT162b2 Boost PHH-1V Boost BNT162b2 14 Healthy adults 2,036
(500)1,211
(241)1.70 [1.41, 2] Pseudovirion-based neutralisation assay Tang R, 2023 Inactivated virus Coronavac Boost Coronovac/BoostAd5-nCoV IN Boost Coronovac/boost Coronavac 14 Healthy adults 63
(117)21
(116)3.0 [2.3, 3.8] Cytopathic effect-based microneutralization assay Tang R, 2023 Inactivated virus Coronavac Boost Coronovac/Ad5-nCoV INCoV IM Boost Coronovac/boost Coronavac 14 Healthy adults 117
(118)21
(116)5.6 [4.6, 7.3] Cytopathic effect-based microneutralization assay Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901+boost MVC-COV1901 28 Adults including healthy or stable co-morbidities 222
(19)137
(18)1.62 [0.86, 3.05] Plaque reduction neutralization test Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901+boost MVC-COV1901 28 Adults including healthy or stable co-morbidities 155
(18)137
(18)1.13 [0.67, 1.89] Plaque reduction neutralization test Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901 28 Adults including healthy or stable co-morbidities 240
(12)139
(14)1.72 [0.76, 3.91] Plaque reduction neutralization test Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901 28 Adults including healthy or stable co-morbidities 426
(12)139
(14)3.05 [1.44, 6.47] Plaque reduction neutralization test - Safety
Serious adverse eventsReference 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 Al Kaabi N, 2023 Inactivated virus BBIBP-CorV Boost NVSI-06-09 Boost BBIBP-CorV 1 Healthy adults 0 / 260 0 / 256 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]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]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]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, 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]Shinkai M, 2022 RNA based vaccine BNT162b2 Boost S-268019-b Boost BNT162b2 NR Adults 0 / 101 0 / 103 NR Poh XY, 2022 RNA based vaccine BNT162b2 Boost mRNA-1273 Boost BNT162b2 28 Adults 0 / 48 0 / 50 NR 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]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 CoronaVac or ChAdOx1/Boost BNT162b2 or mRNA-1273 Boost ChAdOx1 0.2 Kidney transplant recipients 0 / 40 0 / 37 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]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 Li J, 2022 Inactivated virus CoronaVac Boost Ad5-vectored Boost Coronavac 1 Healthy adults 0 / 96 0 / 102 NR 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]Sablerolles R, 2022 Non replicating viral vector Ad26.COV2.S Boost m-RNA-1273 Boost Ad26.COV2.S 1 Healthcare workers 0 / 112 0 / 106 NR Sablerolles R, 2022 Non replicating viral vector Ad26.COV2.S Boost BNT162b2 Boost Ad26.COV2.S 1 Healthcare workers 0 / 111 0 / 106 NR Niyomnaitham S, 2022 Inactivated virus Coronavac Boost ChAdOx1 Boost BNT162b2 3 Healthy adults 0 / 307 0 / 308 NR Corominas J, 2023 RNA based vaccine BNT162b2 Boost PHH-1V Boost BNT162b2 3.2 Healthy adults 1 / 513 0 / 252 1.48
[0.06 - 36.09]Tang R, 2023 Inactivated virus Coronavac Boost Coronovac/BoostAd5-nCoV IN Boost Coronovac/boost Coronavac 0.9 Healthy adults 0 / 117 0 / 119 NR Tang R, 2023 Inactivated virus Coronavac Boost Coronovac/Ad5-nCoV INCoV IM Boost Coronovac/boost Coronavac 0.9 Healthy adults 0 / 120 0 / 119 NR Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901+boost MVC-COV1901 0.9 Adults including healthy or stable co-morbidities 0 / 21 0 / 21 NR Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901+boost MVC-COV1901 0.9 Adults including healthy or stable co-morbidities 0 / 20 0 / 21 NR Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901 0.9 Adults including healthy or stable co-morbidities 0 / 15 0 / 15 NR Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901 0.9 Adults including healthy or stable co-morbidities 0 / 15 0 / 15 NR Amplify, 2023 b RNA based vaccine BNT162b2 Boost Ad26.COV2.S 1*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 4.5 Adults including elderly and stable co-morbidities 1 / 106 3 / 326 1.03
[0.11 - 9.75]Amplify, 2023 b RNA based vaccine BNT162b2 Boost Ad26.COV2.S 2.5*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 4.5 Adults including elderly and stable co-morbidities 1 / 326 3 / 326 0.33
[0.03 - 3.19]Amplify, 2023 a Non replicating viral vector Ad26.COV2.S Boost Ad26.COV2.S 1*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 4.5 Adults including elderly and stable co-morbidities 0 / 116 1 / 330 0.95
[0.04 - 23.05]Amplify, 2023 a Non replicating viral vector Ad26.COV2.S Boost Ad26.COV2.S 2.5*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 4.5 Adults including elderly and stable co-morbidities 3 / 328 1 / 330 3.02
[0.32 - 28.87]
All-cause mortalityReference 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 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 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 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 mRNA-1273 (half dose) Boost BNT162b2 5.9 Healthcare workers 0 / 85 0 / 83 NR Chuang C-H, 2022 Non replicating viral vector ChAdOx1 Boost mRNA-1273 Boost BNT162b2 5.9 Healthcare workers 0 / 85 0 / 83 NR Chuang C-H, 2022 Non replicating viral vector ChAdOx1 Boost MVC-COV1901 Boost BNT162b2 5.9 Healthcare workers 0 / 85 0 / 83 NR Shinkai M, 2022 RNA based vaccine BNT162b2 Boost S-268019-b Boost BNT162b2 * Adults 0 / 101 0 / 103 NR Mrak D, 2022 RNA based vaccine mRNA-1273 or BNT162b2 Boost ChAdOx1 Boost homologous mRNA-1273 or BNT162b2 0.9 Immunosuppressed adults 0 / 22 0 / 24 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]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 Al Kaabi N, 2022 b Inactivated virus BBIBP-CorV Boost NVSI-06-08 4-6 months Boost BBIBP-CorV 4-6 months 1 Healthy adults 0 / 299 0 / 301 NR Al Kaabi N, 2022 b Inactivated virus BBIBP-CorV Boost NVSI-06-08 7-9 months Boost BBIBP-CorV 7-9 months 1 Healthy adults 0 / 297 0 / 303 NR Al Kaabi N, 2022 b Inactivated virus BBIBP-CorV Boost NVSI-06-08 >9 months Boost BBIBP-CorV >9 months 1 Healthy adults 0 / 300 0 / 300 NR Niyomnaitham S, 2022 Inactivated virus Coronavac Boost ChAdOx1 Boost BNT162b2 3 Healthy adults 0 / 307 0 / 308 NR Corominas J, 2023 RNA based vaccine BNT162b2 Boost PHH-1V Boost BNT162b2 3.2 Healthy adults 0 / 513 0 / 252 NR Tang R, 2023 Inactivated virus Coronavac Boost Coronovac/BoostAd5-nCoV IN Boost Coronovac/boost Coronavac 0.9 Healthy adults 0 / 117 0 / 119 NR Tang R, 2023 Inactivated virus Coronavac Boost Coronovac/Ad5-nCoV INCoV IM Boost Coronovac/boost Coronavac 0.9 Healthy adults 0 / 120 0 / 119 NR Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901+boost MVC-COV1901 0.9 Adults including healthy or stable co-morbidities 0 / 21 0 / 21 NR Lien C, 2022 b Protein subunit MVC-COV1901 Boost MVC-COV1901+boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901+boost MVC-COV1901 0.9 Adults including healthy or stable co-morbidities 0 / 20 0 / 21 NR Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 15 mcg Boost MVC-COV1901 0.9 Adults including healthy or stable co-morbidities 0 / 15 0 / 15 NR Lien C, 2022 a Protein subunit MVC-COV1901 Boost MVC-COV1901-Beta 25 mcg Boost MVC-COV1901 0.9 Adults including healthy or stable co-morbidities 0 / 15 0 / 15 NR Amplify, 2023 b RNA based vaccine BNT162b2 Boost Ad26.COV2.S 1*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 4.5 Adults including elderly and stable co-morbidities 0 / 106 0 / 326 NR Amplify, 2023 b RNA based vaccine BNT162b2 Boost Ad26.COV2.S 2.5*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 4.5 Adults including elderly and stable co-morbidities 0 / 326 0 / 326 NR Amplify, 2023 a Non replicating viral vector Ad26.COV2.S Boost Ad26.COV2.S 1*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 4.5 Adults including elderly and stable co-morbidities 0 / 116 0 / 330 NR Amplify, 2023 a Non replicating viral vector Ad26.COV2.S Boost Ad26.COV2.S 2.5*10^10 vp Boost Ad26.COV2.S 5*10^10 vp 4.5 Adults including elderly and stable co-morbidities 0 / 328 0 / 330 NR
Trials reports under extraction
In addition to the below included trials, we have included and presently extracting 15 new vaccine randomized trials
Description of primary studies
In this table, we report the main characteristics of the COVID-19 vaccine candidates from RCTs identified, in addition to the overall risk of bias assessment.
For prime vaccination, early phase trials were extracted only when the dose has been selected. Results from phase 1-2 studies are included in forest plots for the chosen vaccine dose and schedule only. List of early phases included but not extracted are detailed on here .
Search studies
Trial | Type | Comparisons | Design | Participants | Sample size | Overall risk of bias Highest assessment |
Full description | |
---|---|---|---|---|---|---|---|---|
Intervention 1 | Intervention 2 | |||||||
NCT04400838 ; ISRCTN University of Oxford/AstraZeneca Ramasamy MN, Lancet, 2020 Full text Commentary (20)32481-8/fulltext ; Commentary ; Commentary |
Non replicating viral vector |
Non replicating viral vector ChAdOx1 nCoV-19 vaccine - 2·2 × 10¹? vp x 2 doses on day 0/28 |
Non replicating viral vector ChAdOx1 nCoV-19 vaccine - 2·2 × 10¹? vp x 2 doses on day 0/28 |
RCTPhase 2/3 | Healthy adults in two centres in the UK | N= NR | N/A | |
NCT04651790 Sinovac Research and Development Co., Ltd Abarca K, medRxiv, 2022 Full text Commentary Commentary Commentary |
Inactivated virus |
CoronaVac |
Coronavac D0/28 |
RCTPhase 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 |
|
NCT05033847 National Vaccine and Serum Institute, China; Sinopharm + China National Biotec Group Co + Beijing Institute of Biological Products Al Kaabi N, Signal Transduct Ther, 2022 Full text Commentary |
Heterologous booster |
BBIBP-CorV/Boost NVSI-06-07 at 1-3 months BBIBP-CorV/Boost NVSI-06-07 at 4-6 months BBIBP-CorV/Boost NVSI-06-07 at >6 months |
BBIBP-CorV/Boost BBIBP-CorV at 1-3 months BBIBP-CorV/Boost BBIBP-CorV at 4-6 months BBIBP-CorV/Boost BBIBP-CorV at >6 months |
RCTPhase 2 | Healthy adults with no history of SARS-CoV-2 infection who had previously received a primary series (two doses) of BBIBP-CorV at a single center in United Arab Emirates | N= 1800 |
Some concerns Details |
|
NCT04510207, ChiCTR2000034780 Sinopharm-Beijing Al Kaabi N, JAMA, 2021 Full text Commentary Commentary |
Inactivated virus |
BBIBP-CorV |
Adjuvant |
RCTPhase 3 | Healthy adults free of known COVID-19 or HIV infection at 3 centres in United Arab Emirates and Bahrain | N= 40411 |
Some concerns Details |
|
NCT05293548 National Vaccine and Serum Institute, China, Beijing Zhong Sheng Heng Pharmaceutical Technology, Lanzhou Institute of Biological Products; Sinopharm-Beijing Al Kaabi N, Signal Transduct. Ther., 2023 Full text Commentary Commentary |
Protein subunit |
BBIBP-CorV/Boost NVSI-06-09 |
BBIBP-CorV/Boost BBIBP-CorV |
RCTPhase 2 | Healthy adults previously vaccinated with two or three doses of BBIBP-CorV at least 6 months prior to enrollment at a single center in United Arab Emirates | N= 516 |
Some concerns Details |
|
NCT05069129 Sinopharm-Beijing/ National Vaccine and Serum Institute, China Al Kaabi N, Nat Commun, 2022 b New Full text Commentary Commentary |
Heterologous booster |
BBIBP-CorV/boostNVSI-06-08 4-6m BBIBP-CorV/boostNVSI-06-08 7-9m BBIBP-CorV/boostNVSI-06-08 >9m |
BBIBP-CorV/boostBBIBP-CorV 4-6 months BBIBP-CorV/boostBBIBP-CorV 7-9m BBIBP-CorV/boostBBIBP-CorV >9m |
RCTPhase 2 | Healthy adults that were HIV-negative and with no previous history of COVID-19 in a single centre in the United Arab Emirates. | N= 1833 |
Some concerns Details |
|
NCT04510207, ChiCTR2000034780 Sinopharm-Wuhan Al Kaabi N, JAMA, 2021 Full text Commentary Commentary |
Inactivated virus |
WIBP-CorV |
Adjuvant |
RCTPhase 3 | Healthy adults free of known COVID-19 or HIV infection at 3 centres in United Arab Emirates and Bahrain | N= 40411 |
Some concerns Details |
|
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 |
|
NCT04999111 Janssen Pharmaceutical Companies Amplify, Unpublished, 2023 a New Full text |
Homologous booster |
Ad26.COV2.S/Boost Ad26.COV2.S 1*10^10 vp Ad26.COV2.S/Boost Ad26.COV2.S 2.5*10^10 vp |
Ad26.COV2.S//Boost Ad26.COV2.S |
RCTPhase 2 | Adults including elderly and stable co-morbidities with no history of COVID-19 in 21 centres in USA. | N= 777 |
Some concerns Details |
|
NCT04999111 Janssen Pharmaceutical Companies Amplify, Unpublished, 2023 b New Full text |
Heterologous booster |
BNT162b2/ Boost Ad26.COV2.S 1*10^10 vp BNT162b2/ Boost Ad26.COV2.S 2.5*10^10 vp |
BNT162b2/ Boost Ad26.COV2.S |
RCTPhase 2 | Adults including elderly and stable co-morbidities with no history of COVID-19 in 21 centres in USA. | N= 764 |
Some concerns Details |