Efficacy, Immunogenicity, and Safety of COVID-19 Vaccines in Randomized Control Trials in the Pre-Delta Era: A Systematic Review and Network Meta-Analysis
SuA Oh,
Sujata Purja,
Hocheol Shin,
Min Seo Kim,
Seoyeon Park,
Andreas Kronbichler,
Lee Smith,
Michael Eisenhut,
Jae Il Shin,
Eunyoung Kim
Affiliations
SuA Oh
Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Sujata Purja
Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Hocheol Shin
Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Min Seo Kim
Genomics and Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 03063, Korea
Seoyeon Park
Yonsei University College of Medicine, Seoul 03722, Korea
Andreas Kronbichler
Department of Medicine, University of Cambridge, Cambridge CB2 2QQ, UK
Lee Smith
Center for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB2 1TN, UK
Michael Eisenhut
Luton & Dunstable University Hospital, NHS Foundation Trust, Luton LU40DZ, UK
Jae Il Shin
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Eunyoung Kim
Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
The most effective method of limiting the coronavirus disease pandemic of 2019 (COVID-19) is vaccination. For the determination of the comparative efficacy and safety of COVID-19 vaccines and their platforms during the pre-Delta era, a systematic review and network meta-analysis was conducted. The MEDLINE, Embase, and MedRxiv databases were searched, and the gray literature was manually searched up to 8 July 2021. The review includes the phase II and III randomized controlled trials (RCTs) that assessed the efficacy, immunogenicity, and safety of the COVID-19 vaccines. The network meta-analysis used a Bayesian model and used the surface under the cumulative ranking to rank the comparisons between the vaccines. All included studies were quality appraised according to their design, and the heterogeneity of the analyses was assessed using I2. In terms of vaccine efficacy, the mRNA-1273 vaccine ranked the highest, and the CoronaVac vaccine ranked the lowest. The mRNA-1273 ranked the highest for neutralizing antibody responses to live SARS-CoV-2. The WIV04 vaccine was associated with the lowest incidence of both local and systemic adverse reactions. All studies except one had a low to moderate risk of bias. The mRNA platform vaccines showed higher efficacy and more adverse reactions than the other vaccines.
