COVID-19 vaccine effectiveness
(Randomized evidence)

Methods

Protocol

Latest news:Last search date July 30, 2023. No further screening is planned after this date. Extraction is ongoing for all pending studies.

  • Results of booster studies are available in the tables below and are updated on a monthly 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 .
  • The vaccine review "Efficacy and safety of COVID‐19 vaccines" 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 for prime vaccination (last search date 14/12/2022), create and download your forest plots by clicking below:

    go to metacovid

    COVID-19 BOOSTER DOSE VACCINATION: updated daily

    Vaccine efficacy, immunogenicity and safety of:

    First Boost

    • 1st booster VS no booster (tables)
    • 1st booster VS 1st booster (tables)

    Second Boost

    • 2nd booster VS 1st booster (tables)
    • 2nd booster VS 2nd booster (tables)

    COVID-19 PRIME VACCINATION: Last search date December 14, 2022.

    Click here to see Covid-19 prime vaccination studies

    Trials reports under extraction

    In addition to the below included trials, we have included and presently extracting 12 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

    Search by Vaccine name Author Registration number

    Your research ==> Vaccine name: 1273

    Trial Type Comparisons Design Participants Sample size Overall risk
    of bias
    Highest assessment
    Full description
    Intervention 1 Intervention 2
    NCT04649151
    ModernaTX
    Ali K, N Engl J Med, 2021

    Full text
    Commentary
    RNA based vaccine

    mRNA-1273

    Placebo

    RCT
    Phase 2-3
    Healthy adolescents in 26 centers in the USA N= 3732
    Some concerns
    Details

    Full description

    NCT04796896
    Moderna TX
    Anderson E, N Engl J Med, 2022 b

    Full text
    Commentary
    RNA based vaccine

    mRNA-1273

    Placebo

    RCT
    Phase 2-3
    Children 6 to 23 months of age, including healthy and those with stable chronic diseases in 87 centres in USA (79 sites) and Canada (8 sites). N= 2355
    Some concerns
    Details

    Full description

    NCT04283461; NCT04785144
    Moderna + National Institute of Allergy and Infectious Diseases (NIAID)
    Anderson E, SSRN, 2022

    Full text
    Commentary
    Commentary
    Homologous booster

    mRNA-1273/Boost 50 mcg of mRNA-1273.351

    mRNA-1273/Boost mRNA-1273

    mRNA-1273/Boost 25 mcg mRNA- 1273.351 and 25 mcg mRNA-1273

    RCT
    Phase 1
    Healthy adult volunteers who were SARS-CoV-2 infection-free in 3 sites in the USA N= 96
    Some concerns
    Details

    Full description

    NCT04796896
    Moderna TX
    Anderson E, N Engl J Med , 2022 a

    Full text
    Commentary
    RNA based vaccine

    mRNA-1273

    Placebo

    RCT
    Phase 2-3
    Children 2 to 5 years of age, including healthy and those with stable chronic diseases in 87 centres in USA (79 sites) and Canada (8 sites). N= 4048
    Some concerns
    Details

    Full description

    TCTR20220112002
    Moderna; Pfizer
    Assantachai P, J Infect Dis, 2023

    Full text
    Full text
    Commentary
    RNA based vaccine

    ChAdOx1/Boost mRNA1273-20 mcg ID

    ChAdOx1/Boost BNT162b2- 10MCG ID

    ChAd/Boost mRNA1273

    ChadOx1/boostBNT

    RCT
    4
    Adults 65 years of age or older in a single centre in Thailand N= 210
    Some concerns
    Details

    Full description

    EudraCT 2021-002348-57
    Pfizer-BioNTech; Moderna; Oxford-AstraZeneca
    Bonelli M, Ann Rheum Dis , 2022

    Full text
    Commentary
    Heterologous booster

    Boost ChAdOx1/prime vaccination BNT162b2 or mRNA-1273

    Boost BNT162b2 or mRNA-1273/prime vaccination BNT162b2 or mRNA-1273

    RCT
    2
    Adults under current rituximab therapy who did not develop humoral response against SARS-CoV-2 after their standard vaccination with Biontech/Pfizer or Moderna in a single center in Austria N= 60
    Some concerns
    Details

    Full description

    NCT05289037
    Moderna + National Institute of Allergy and Infections Diseases (NIAID); ModernaTX
    Branche A, medRxiv, 2022 a

    Full text
    Commentary
    Commentary
    Commentary
    RNA based vaccine

    Any COVID-19 vaccine prime and 1st boost/2nd boost mRNA-1273 Omicron + mRNA-1273 Beta

    Any COVID-19 vaccine prime and 1st boost/2nd boost mRNA-1273Omicron + mRNA-1273 Delta

    Any COVID-19 vaccine prime and 1st boost/2nd boost mRNA-1273 Omicron + mRNA-1273

    Any COVID-19 vaccine prime and 1st boost/2nd boost mRNA-1273 Omicron

    Any COVID-19 vaccine prime and 1st boost/2nd boost mRNA-1273

    RCT
    Phase 2
    Adults with completed primary and booster COVID-19 vaccine series, either homologous or heterologous, and in stable health at 22 centers in USA. N= 602
    Some concerns
    Details

    Full description

    TCTR20211102003
    Sinovac Research and Development Co., Ltd; Pfizer/BioNTech + Fosun Pharma; Moderna + National Institute of Allergy and Infectious Diseases (NIAID); AstraZeneca + University of Oxford
    Bruminhent J, Am J Transplant, 2022

    Full text
    Full text
    Commentary
    RNA based vaccine

    CoronaVac or ChAdOx1/Boost BNT162b2 or mRNA-1273

    CoronaVac or ChAdOx1/Boost ChAdOx1

    RCT
    Phase 3
    Adult kidney transplant recipients without a history of COVID-19 in a single centre in Thailand. N= 85
    Some concerns
    Details

    Full description

    NCT05132855
    Pfizer/BioNTech+Fosun Pharma; Moderna;Medigen Vaccine Biologics+Dynavax+NIAID
    Chuang C-H, J Clin Virol, 2022

    Full text
    Full text
    Commentary
    Commentary
    Heterologous booster

    ChadOx1/Boost BNT162b2

    ChadOx1/Boost mRNA-1273 (half dose)

    ChadOx1/Boost mRNA-1273

    ChadOx1/boost MVC-COV1901

    RCT
    1-2
    Health care worker with no history of COVID-19 who had received 2 prime doses of ChAdOx1 nCoV-19 in a single centre in Taiwan. N= 340
    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

    NCT04470427
    ModernaTX
    El Sahly H, N Engl J Med, 2021
    COVE

    Full text
    Full text
    Commentary
    Commentary
    RNA based vaccine

    mRNA-1273 100 mcg D1/28

    Placebo D1/28

    RCT
    Phase 3
    Healthy adults with no known history of SARS-CoV-2 infection in 99 centers in the US N= 30415
    Some concerns
    Details

    Full description

    NCT05197153
    AstraZeneca+University of Oxford; Moderna TX; Medigen Vaccine Biologics+Dynavax+NIAID
    Estephan L, Vaccine, 2023 a

    Full text
    Commentary
    Protein subunit

    MVC-COV1901/Boost 1/2 MVC-COV1901

    MVC-COV1901/Boost mRNA-127

    MVC-COV1901/Boost ChAdOx1

    MVC-COV1901/Boost MVC-COV1901

    RCT
    Phase 2
    Adults who received ChAdOx1, mRNA-1273, or MVC-COV1901 as prime vaccination with no history of COVID-19 , in 4 centers in Taiwan N= 313
    Some concerns
    Details

    Full description

    NCT05197153
    AstraZeneca+University of Oxford; Moderna TX; Medigen Vaccine Biologics+Dynavax+NIAID
    Estephan L, Vaccine, 2023 b

    Full text
    Commentary
    Protein subunit

    ChadOx1/boost MVC-COV1901

    ChadOx1/boostmRNA-1273 (half dose)

    ChadOx1/boostChadOx1

    RCT
    Phase 2
    Adults who received ChAdOx1, mRNA-1273, or MVC-COV1901 as prime vaccination with no history of COVID-19 , in 4 centers in Taiwan N= 323
    Some concerns
    Details

    Full description

    NCT05197153
    AstraZeneca+University of Oxford; Moderna TX; Medigen Vaccine Biologics+Dynavax+NIAID
    Estephan L, Vaccine, 2023 c

    Full text
    Commentary
    Protein subunit

    mRNA-1273/Boost MVC-COV1901

    mRNA-1273/Boost ChAdOx1

    mRNA-1273/Boost 1/2 MVC-COV1901

    mRNA-1273/Boost 1/2 mRNA-1273

    RCT
    Phase 2
    Adults who received ChAdOx1, mRNA-1273, or MVC-COV1901 as prime vaccination with no history of COVID-19 , in 4 centers in Taiwan N= 163
    Some concerns
    Details

    Full description

    NCT04885907
    ModernaTX
    Hall VG, N Engl J Med, 2021

    Full text
    Commentary
    Commentary
    RNA based vaccine

    mRNA-1273

    Placebo

    RCT
    Phase 4
    Solid organ transplant recipients with no previous diagnosis of COVID-19 who has previously received two doses of mRNA-1273 at a single center in Canada N= 120
    Some concerns
    Details

    Full description

    NCT04900467; EudraCT: 2021-002174-52
    Moderna;Pfizer/BioNTech
    Janssen C, EClinicalMedicine, 2022

    Full text
    Full text
    Commentary
    Heterologous vaccination scheme

    1 dose BNT162b2/1 dose mRNA-1273

    1 dose mRNA-1273 /1 dose BNT162b2

    2 doses BNT162b2

    2 doses mRNA-1273

    RCT
    Phase 2
    Adults with no known or suspected history of SARS-CoV-2 infection at 17 centers in France. N= 414
    Some concerns
    Details

    Full description

    NCT05030974
    Moderna ; Pfizer/BioNTech + Fosun Pharma ; Janssen Pharmaceutical
    Kho M, Lancet Infect Dis, 2022
    RECOVAC

    Full text
    Commentary
    Commentary
    Heterologous booster

    mRNA vaccine/Boost 2 doses mRNA-1273

    mRNA vaccine/Boost Ad26.COV2-S

    mRNAvaccine/Boost mRNA-1273

    RCT
    Phase 4
    Adult kidney transplant recipients without seroconversion after two doses of an mRNA vaccine and no history of COVID-19 at 4 centers in the Netherlands. N= 230
    Some concerns
    Details

    Full description

    EudraCT, 2022-000063-51; NCT05249829
    ModernaTX/ National Institute of Allergy and Infectious Diseases (NIAID)
    Lee I, medRxiv, 2023 a

    Full text
    Commentary
    Commentary
    Heterologous booster

    Any prime vaccine/Boost mRNA vaccine/ mRNA-1273.529

    Any prime vaccine/Boost mRNA vaccine/ mRNA-1273

    RCT
    Phase 2-3
    Healthy or stable co-morbidities, at least 16 years who had previously received 2 injections of an authorized Covid-19 primary series vaccine with or without an mRNA-based booster as the third dose in 28 centres in UK. N= 724
    Some concerns
    Details

    Full description

    EudraCT, 2022-000063-51; NCT05249829
    ModernaTX/National Institute of Allergy and Infectious Diseases (NIAID)
    Lee l, medRxiv, 2023 b

    Full text
    Commentary
    Commentary
    Heterologous booster

    Any prime vaccine/Boost mRNA vaccine/ mRNA-1273.214

    Any prime vaccine/Boost mRNA vaccine/ mRNA-1273

    RCT
    Phase 2-3
    Healthy or stable co-morbidities, at least 16 years who had previously received 2 injections of an authorized Covid-19 primary series vaccine with or without an mRNA-based booster as the third dose in 28 centres in UK. N= 2,824
    Some concerns
    Details

    Full description

    NCT04962906; NCT05027672
    Gamaleya Research Institute, AstraZeneca+University of Oxford;Moderna;Sinopharm
    Macchia A, Lancet Reg Health Am, 2022

    Full text
    Commentary
    Non replicating viral vector

    Gam-COVID-Vac rAd26-S

    Gam-COVID-Vac rAd26-S/BBIBP-CorV

    RCT
    Phase 2
    Adults who had received the first dose (rAd26) of the Sputnik V vaccine at least 30 days earlier and no history of SARS-CoV-2 at a single centre in Argentina N= 540
    Some concerns
    Details

    Full description

    NCT04677660
    ModernaTX
    Masuda T, Vaccine, 2022 a

    Full text
    Commentary
    RNA based vaccine

    mRNA-1273

    Placebo

    RCT
    Phase 1-2
    Healthy adults aged ≥ 20 years with no known history/risk of SARS-CoV-2 infection at 2 centers in Japan. N= 200
    Some concerns
    Details

    Full description

    EudraCT 2021-002693-10
    Moderna+NIAID; Pfizer/BioNTech+Fosun Pharma; AstraZeneca + University of Oxford
    Mrak D, Nat Commun, 2022

    Full text
    Commentary
    Commentary
    Homologous booster

    BNT162b2 or mRNA-1273/Boost ChAdOx1

    mRNA-1273 or BNT162b2/Homologous boost

    RCT
    Phase 2
    Immunosuppressed adults including elderly with no history of COVID-19 in a single centre in Austria. N= 51
    Low
    Details

    Full description

    ISRCTN73765130
    AstraZeneca + University of Oxford; Janssen Pharmaceutical; Novovax; Moderna + NIAID; Pfizer BioNTech + Fosun Pharma; CureVac AG; Valneva, NIHR, UK
    Munro A, Lancet, 2021 e
    COV-BOOST

    Full text
    Commentary
    Heterologous booster

    ChadOx1/Boost mRNA1273

    ChadOx1/Boost CVnCov

    ChadOx1/Boost BNT162b2 half dose

    ChadOx1/Boost placebo

    RCT
    Phase 2
    Adults aged ≥30 years in good physical health at 18 centers in the UK. N= 2883
    Some concerns
    Details

    Full description

    ISRCTN73765130
    AstraZeneca + University of Oxford; Janssen Pharmaceutical; Novovax; Moderna + NIAID; Pfizer BioNTech + Fosun Pharma; CureVac AG; Valneva, NIHR, UK
    Munro A, Lancet, 2021 b
    COV-BOOST

    Full text
    Commentary
    Heterologous booster

    BNT162b2/Boost ChAdOx1

    BNT162b2/Boost Novavax

    BNT162b2/Boost Novavax half dose

    BNT162b2/Boost placebo

    RCT
    Phase 2
    Adults aged ≥30 years in good physical health at 18 centers in the UK. N= 2883
    Some concerns
    Details

    Full description

    ISRCTN73765130
    AstraZeneca + University of Oxford; Janssen Pharmaceutical; Novovax; Moderna + NIAID; Pfizer BioNTech + Fosun Pharma; CureVac AG; Valneva, NIHR, UK
    Munro A, Lancet, 2021 f
    COV-BOOST

    Full text
    Commentary
    Heterologous booster

    BNT162b2/Boost mRNA1273

    BNT162b2/Boost CVnCov

    BNT162b2/Boost BNT162b2 half dose

    BNT162b2/Boos placebo

    RCT
    Phase 2
    Adults aged ≥30 years in good physical health at 18 centers in the UK. N= 2883
    Some concerns
    Details

    Full description

    ISRCTN73765130
    AstraZeneca + University of Oxford; Janssen Pharmaceutical; Novovax; Moderna + NIAID; Pfizer BioNTech + Fosun Pharma; CureVac AG; Valneva, NIHR, UK
    Munro A, Lancet, 2021 c
    COV-BOOST

    Full text
    Commentary
    Heterologous booster

    ChadOx1/Boost BNT162b2

    ChadOx1/Boost VLA2001

    ChadOx1/Boost VLA2001 half dose

    ChadOx1/Boost Ad26.COV2.S

    ChadOx1/Boost placebo

    RCT
    Phase 2
    Adults aged ≥30 years in good physical health at 18 centers in the UK. N= 2883
    Some concerns
    Details

    Full description

    ISRCTN73765130
    AstraZeneca + University of Oxford; Janssen Pharmaceutical; Novovax; Moderna + NIAID; Pfizer BioNTech + Fosun Pharma; CureVac AG; Valneva, NIHR, UK
    Munro A , Lancet, 2021 a
    COV-BOOST

    Full text
    Commentary
    Non replicating viral vector

    ChadOx1/Boost ChadOx1

    ChadOx1/Boost Novavax

    ChadOx1/Boost Novavax

    ChadOx1/Boost Novavax half dose

    ChadOx1/Boost Novavax half dose

    ChadOx1/Boost Placebo

    ChadOx1/Boost Placebo

    ChadOx1/Boost ChadOx1

    ChadOx1/Boost ChadOx1

    ChadOx1/Boost Placebo

    RCT
    Phase 2
    Adults aged ≥30 years in good physical health at 18 centers in the UK. N= 2883
    Some concerns
    Details

    Full description

    ISRCTN73765130
    AstraZeneca + University of Oxford; Janssen Pharmaceutical; Novovax; Moderna + NIAID; Pfizer BioNTech + Fosun Pharma; CureVac AG; Valneva, NIHR, UK
    Munro A, Lancet, 2021 d
    COV-BOOST

    Full text
    Commentary
    RNA based vaccine

    BNT162b2/Boost BNT162b2

    BNT162b2/Boost VLA2001

    BNT162b2/Boost VLA2001 half dose

    BNT162b2/Boost Ad26.COV2.S

    BNT162b2/Boost placebo

    RCT
    Phase 2
    Adults aged ≥30 years in good physical health at 18 centers in the UK. N= 2883
    Some concerns
    Details

    Full description

    ISRCTN73765130 ; EudraCT 2021-002175-19
    Pfizer/BioNTech;ModernaTX
    Munro APS, Lancet Infect Dis, 2022
    COV-BOOST

    Full text
    Commentary
    RNA based vaccine

    BNT162b2/1st boost BNT162b2/2nd boost BNT162b2

    ChadOx1/1st boost BNT162b2/2nd boost BNT162b2

    BNT162b2/1st boost BNT162b2/2nd boost half dose m-RNA 1273

    ChadOx1/1st boost BNT162b2/2nd boost 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

    NCT05142319
    Pfizer/BioNTech+Fosun Pharma; ModernaTX
    Poh XY, Clin. Infect. Dis., 2022
    PRIBIVAC

    Full text
    Commentary
    RNA based vaccine

    BNT162b2/Boost mRNA-1273

    BNT162b2/Boost BNT162b2

    RCT
    3
    Adults at a single center in Singapore with no previous history of COVID-19 who had received a primary series of BTN162b2 at least 6 months previously N= 100
    Some concerns
    Details

    Full description

    EudraCT021-002927-39
    Pfizer/BioNTech+Fosun Pharma/Moderna/Janssen Pharmaceutical Companies
    Reindl-Schwaighofer R, JAMA, 2021

    Full text
    Full text
    Commentary
    Commentary
    RNA based vaccine

    mRNA-1273 or BNT162b2/Homologous boost

    mRNA-1273 or BNT162b2/Boost Ad26COVS1

    RCT
    Phase 2
    Adult kidney transplant recipients with no history of COVID-19 infection and without an antibody response 4 weeks after a 2-dose mRNA vaccine schedule at a single center in Austria. N= 201
    Some concerns
    Details

    Full description

    NCT04927936
    Janssen Pharmaceutical;Moderna ;Pfizer/BionTech+Fosun Pharma
    Sablerolles R, Clin Infect Dis, 2022
    SWITCH

    Full text
    Full text
    Commentary
    Commentary
    Placebo

    Ad26.COV2.S/Boost m-RNA-1273

    Ad26.COV2.S/Boost BNT162b2

    Ad26.COV2.S/Boost Ad26.COV2.S

    RCT
    Phase 3
    Healthcare workers aged 18-65 years, without severe comorbidities, and no known history of SARS-CoV-2 infection who received a single Ad26.COV2.S primary vaccination at 4 centers in the Netherlands. N= 461
    Some concerns
    Details

    Full description

    NCT04805125
    Pfizer/BioNTech+Fosun Pharma; ModernaTX
    Speich B, Clin Infect Dis, 2022

    Full text
    Full text
    Commentary
    Commentary
    RNA based vaccine

    BNT162b2

    mRNA-1273

    RCT
    Phase 3
    Adult patients living with HIV (PLWH) or solid organ transplant recipients who were SARS-CoV-2 infection-free for the last 3 months in 3 centres in Switzerland. N= 430
    Some concerns
    Details

    Full description

    ISRCTN27841311; EudraCT 2021-001275-16
    AstraZeneca + University of Oxford / Novavax / Moderna + NIAID
    Stuart A, Lancet, 2021 a
    Com-COV2

    Full text
    Commentary
    Commentary
    Protein subunit

    1 dose ChAdOx1 followed by 1 dose NVX-CoV2373

    1 dose ChAdOx1 followed by 1 dose mRNA-1273

    2 doses ChAdOx1

    RCT
    Phase 2
    Healthy adults over 50 years previously vaccinated with one dose of ChAdOx1 nCoV-19 in 9 centres in the UK N= 540
    Some concerns
    Details

    Full description

    ISRCTN27841311; EudraCT 2021-001275-16
    Pfizer BioNTech + Fosun Pharma / Novavax / Moderna + NIAID
    Stuart A, Lancet, 2021 b
    Com-COV2

    Full text
    Commentary
    Commentary
    Protein subunit

    1 dose BNT162b2 followed by 1 dose NVX-CoV2373

    1 dose BNT162b2 followed by 1 dose mRNA-1273

    2 doses BNT162b2

    RCT
    Phase 2
    Adults over 50 years previously vaccinated with one dose of BNT162b2 at 9 centres in the UK N= 532
    Some concerns
    Details

    Full description