Cochrane · systematic review · CD015477
Efficacy and safety of COVID‐19 vaccines
Graña, C, Ghosn, L, Evrenoglou, T, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Emergency and Critical CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
119
current version
GRADE rated
84
No studies
35
Included studies
NR
No studies 35 · 29.4%Ungraded 0 · 0%Very low 6 · 5%Low 28 · 23.5%Moderate 19 · 16%High 31 · 26.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
BNT162b2 – Pfizer/BioNTech + Fosun Pharma compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection BNT162b2 – Pfizer/BioNTech + Fosun Pharma vs placebo | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19b BNT162b2 – Pfizer/BioNTech + Fosun Pharma vs placebo | no estimate extracted | 2 studies · 44077 participants | High |
Severe or critical COVID‐19e BNT162b2 – Pfizer/BioNTech + Fosun Pharma vs placebo | no estimate extracted | 1 study · 46077 participants | High |
All‐cause mortalityg BNT162b2 – Pfizer/BioNTech + Fosun Pharma vs placebo | RR 1.07 [0.52, 2.22] | 1 study · 43847 participants | Low Downgraded: imprecision |
Systemic reactogenicity events BNT162b2 – Pfizer/BioNTech + Fosun Pharma vs placebo | no estimate extracted | NR | No studies |
Any adverse eventi BNT162b2 – Pfizer/BioNTech + Fosun Pharma vs placebo | no estimate extracted | 3 studies · 46149 participants | Low Downgraded: inconsistency |
Serious adverse eventsi BNT162b2 – Pfizer/BioNTech + Fosun Pharma vs placebo | RR 1.3 [0.55, 3.07] | 2 studies · 46107 participants | Low Downgraded: imprecision, inconsistency |
Local reactogenicity events BNT162b2 – Pfizer/BioNTech + Fosun Pharma vs placebo | no estimate extracted | NR | No studies |
mRNA‐1273 – ModernaTX compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infectionb mRNA‐1273 – ModernaTX vs placebo | no estimate extracted | 2 studies · 31632 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Confirmed symptomatic COVID‐19 b mRNA‐1273 – ModernaTX vs placebo | no estimate extracted | 2 studies · 31632 participants | High |
Severe or critical COVID‐19f mRNA‐1273 – ModernaTX vs placebo | no estimate extracted | 1 study · 28451 participants | High |
All‐cause mortalityf mRNA‐1273 – ModernaTX vs placebo | RR 1.06 [0.54, 2.1] | 1 study · 30346 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Systemic reactogenicity eventsi mRNA‐1273 – ModernaTX vs placebo | RR 1.28 [1.22, 1.34] | 2 studies · 34037 participants | High |
Any adverse eventk mRNA‐1273 – ModernaTX vs placebo | no estimate extracted | 2 studies · 32995 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Serious adverse eventsl mRNA‐1273 – ModernaTX vs placebo | RR 0.92 [0.78, 1.08] | 2 studies · 34072 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Local reactogenicity eventsi mRNA‐1273 – ModernaTX vs placebo | RR 3.3 [2.02, 5.4] | 2 studies · 34037 participants | High |
CVnCoV – CureVac AG compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection CVnCoV – CureVac AG vs placebo | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19b CVnCoV – CureVac AG vs placebo | no estimate extracted | 1 study · 25062 participants | Moderate Downgraded: risk of bias, indirectness |
Severe or critical COVID‐19f CVnCoV – CureVac AG vs placebo | no estimate extracted | 1 study · 25062 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
All‐cause mortalityh CVnCoV – CureVac AG vs placebo | RR 1.33 [0.46, 3.83] | 1 study · 39529 participants | Very low Downgraded: imprecision, indirectness |
Systemic reactogenicity eventsi CVnCoV – CureVac AG vs placebo | RR 1.48 [1.43, 1.53] | 1 study · 3982 participants | High |
Any adverse eventj CVnCoV – CureVac AG vs placebo | RR 1.42 [1.38, 1.47] | 1 study · 3982 participants | Moderate Downgraded: indirectness |
Serious adverse eventsk CVnCoV – CureVac AG vs placebo | RR 1.24 [0.9, 1.71] | 1 study · 39529 participants | Low Downgraded: imprecision, indirectness |
Local reactogenicity eventsi CVnCoV – CureVac AG vs placebo | RR 3.51 [3.24, 3.81] | 1 study · 3982 participants | High |
ChAdOx1 – AstraZeneca + University of Oxford compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infectionb ChAdOx1 – AstraZeneca + University of Oxford vs placebo | no estimate extracted | 5 studies · 43390 participants | Moderate Downgraded: risk of bias, inconsistency |
Confirmed symptomatic COVID‐19b ChAdOx1 – AstraZeneca + University of Oxford vs placebo | no estimate extracted | 5 studies · 43390 participants | High |
Severe or critical COVID‐19 ChAdOx1 – AstraZeneca + University of Oxford vs placebo | no estimate extracted | NR | No studies |
All‐cause mortalityf ChAdOx1 – AstraZeneca + University of Oxford vs placebo | RR 0.48 [0.2, 1.14] | 5 studies · 56727 participants | Low Downgraded: imprecision |
Systemic reactogenicity eventsi ChAdOx1 – AstraZeneca + University of Oxford vs placebo | RR 3.93 [2.11, 7.29] | 1 study · 256 participants | Moderate Downgraded: imprecision |
Any adverse eventl ChAdOx1 – AstraZeneca + University of Oxford vs placebo | no estimate extracted | 7 studies · 57580 participants | Low Downgraded: inconsistency |
Serious adverse eventso ChAdOx1 – AstraZeneca + University of Oxford vs placebo | RR 0.88 [0.72, 1.07] | 7 studies · 58182 participants | Moderate Downgraded: imprecision |
Local reactogenicity eventsi ChAdOx1 – AstraZeneca + University of Oxford vs placebo | RR 6.44 [2.98, 13.92] | 1 study · 256 participants | Moderate Downgraded: risk of bias, imprecision |
SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford compared to ChAdOx1 – University of Oxford for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford vs ChAdOx1 – University of Oxford | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19 SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford vs ChAdOx1 – University of Oxford | no estimate extracted | NR | No studies |
Severe or critical COVID‐19 SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford vs ChAdOx1 – University of Oxford | no estimate extracted | NR | No studies |
All‐cause mortality SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford vs ChAdOx1 – University of Oxford | no estimate extracted | NR | No studies |
Systemic reactogenicity eventsb SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford vs ChAdOx1 – University of Oxford | RR 0.73 [0.54, 0.98] | 1 study · 400 participants | Moderate Downgraded: imprecision |
Any adverse evente SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford vs ChAdOx1 – University of Oxford | RR 0.83 [0.52, 1.33] | 1 study · 400 participants | Low Downgraded: imprecision |
Serious adverse eventsg SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford vs ChAdOx1 – University of Oxford | RR 0.5 [0.08, 2.95] | 1 study · 400 participants | Low Downgraded: imprecision |
Local reactogenicity eventsb SII‐ChAdOx1 – Serum Institute of India/AstraZeneca + University of Oxford vs ChAdOx1 – University of Oxford | RR 0.76 [0.55, 1.05] | 1 study · 400 participants | Low Downgraded: imprecision |
AD26.COV2.S – Janssen Pharmaceutical Companies compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection AD26.COV2.S – Janssen Pharmaceutical Companies vs placebo | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19b AD26.COV2.S – Janssen Pharmaceutical Companies vs placebo | no estimate extracted | 1 study · 39058 participants | High |
Severe or critical COVID‐19b AD26.COV2.S – Janssen Pharmaceutical Companies vs placebo | no estimate extracted | 1 study · 39058 participants | High |
All‐cause mortalityb AD26.COV2.S – Janssen Pharmaceutical Companies vs placebo | RR 0.25 [0.09, 0.67] | 1 study · 43783 participants | High |
Serious adverse eventsb AD26.COV2.S – Janssen Pharmaceutical Companies vs placebo | RR 0.92 [0.69, 1.22] | 1 study · 43783 participants | Moderate Downgraded: imprecision |
Systemic reactogenicity eventse AD26.COV2.S – Janssen Pharmaceutical Companies vs placebo | RR 1.83 [1.29, 2.6] | 2 studies · 7222 participants | High |
Any adverse eventh AD26.COV2.S – Janssen Pharmaceutical Companies vs placebo | no estimate extracted | 2 studies · 7222 participants | Low Downgraded: risk of bias, inconsistency |
Gam‐COVID‐VAC – Sputnik V compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection Gam‐COVID‐VAC – Sputnik V vs placebo | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19b Gam‐COVID‐VAC – Sputnik V vs placebo | no estimate extracted | 1 study · 18695 participants | Moderate Downgraded: indirectness |
Severe or critical COVID‐19b Gam‐COVID‐VAC – Sputnik V vs placebo | no estimate extracted | 1 study · 19866 participants | Moderate Downgraded: indirectness |
All‐cause mortalityf Gam‐COVID‐VAC – Sputnik V vs placebo | RR 0.99 [0.1, 9.54] | 1 study · 21862 participants | Very low Downgraded: imprecision, indirectness |
Systemic reactogenicity events Gam‐COVID‐VAC – Sputnik V vs placebo | no estimate extracted | NR | No studies |
Any adverse event Gam‐COVID‐VAC – Sputnik V vs placebo | no estimate extracted | NR | No studies |
Serious adverse eventsf Gam‐COVID‐VAC – Sputnik V vs placebo | RR 0.65 [0.39, 1.07] | 1 study · 21862 participants | Low Downgraded: imprecision, indirectness |
Local reactogenicity events Gam‐COVID‐VAC – Sputnik V vs placebo | no estimate extracted | NR | No studies |
CoronaVac – Sinovac compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection CoronaVac – Sinovac vs placebo | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19b CoronaVac – Sinovac vs placebo | no estimate extracted | 2 studies · 19852 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Severe or critical COVID‐19b CoronaVac – Sinovac vs placebo | no estimate extracted | 2 studies · 19852 participants | Low Downgraded: risk of bias, imprecision |
All‐cause mortalityh CoronaVac – Sinovac vs placebo | RR 0.5 [0.05, 5.52] | 2 studies · 22610 participants | Low Downgraded: imprecision |
Systemic reactogenicity eventsj CoronaVac – Sinovac vs placebo | RR 1.19 [1, 1.42] | 6 studies · 23966 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Any adverse evento CoronaVac – Sinovac vs placebo | RR 1.09 [1.07, 1.11] | 6 studies · 23367 participants | High |
Serious adverse eventsr CoronaVac – Sinovac vs placebo | RR 0.97 [0.62, 1.51] | 4 studies · 23139 participants | Low Downgraded: risk of bias, imprecision |
Local reactogenicity eventsj CoronaVac – Sinovac vs placebo | RR 1.76 [1.69, 1.82] | 6 studies · 23962 participants | High |
WIBP‐CorV – Sinopharm‐Wuhan compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infectionb WIBP‐CorV – Sinopharm‐Wuhan vs placebo | no estimate extracted | 1 study · 25449 participants | High |
Confirmed symptomatic COVID‐19b WIBP‐CorV – Sinopharm‐Wuhan vs placebo | no estimate extracted | 1 study · 25480 participants | High |
Severe or critical COVID‐19 WIBP‐CorV – Sinopharm‐Wuhan vs placebo | no estimate extracted | NR | No studies |
All‐cause mortality WIBP‐CorV – Sinopharm‐Wuhan vs placebo | no estimate extracted | NR | No studies |
Systemic reactogenicity eventse WIBP‐CorV – Sinopharm‐Wuhan vs placebo | RR 0.99 [0.95, 1.03] | 2 studies · 27029 participants | High |
Any adverse eventh WIBP‐CorV – Sinopharm‐Wuhan vs placebo | RR 0.96 [0.93, 0.98] | 2 studies · 27029 participants | High |
Serious adverse eventsi WIBP‐CorV – Sinopharm‐Wuhan vs placebo | RR 0.83 [0.6, 1.15] | 2 studies · 27029 participants | Low Downgraded: risk of bias, imprecision |
Local reactogenicity eventsk WIBP‐CorV – Sinopharm‐Wuhan vs placebo | RR 0.88 [0.85, 0.92] | 2 studies · 27029 participants | High |
BBIBP‐CorV – Sinopharm‐Beijing compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infectionb BBIBP‐CorV – Sinopharm‐Beijing vs placebo | no estimate extracted | 1 study · 25435 participants | High |
Confirmed symptomatic COVID‐19b BBIBP‐CorV – Sinopharm‐Beijing vs placebo | no estimate extracted | 1 study · 25463 participants | High |
Severe or critical COVID‐19 BBIBP‐CorV – Sinopharm‐Beijing vs placebo | no estimate extracted | NR | No studies |
All‐cause mortality BBIBP‐CorV – Sinopharm‐Beijing vs placebo | no estimate extracted | NR | No studies |
Systemic reactogenicity eventse BBIBP‐CorV – Sinopharm‐Beijing vs placebo | RR 1.05 [0.86, 1.28] | 3 studies · 27540 participants | Moderate Downgraded: imprecision |
Any adverse eventh BBIBP‐CorV – Sinopharm‐Beijing vs placebo | no estimate extracted | 3 studies · 26924 participants | Low Downgraded: imprecision, inconsistency |
Serious adverse eventsk BBIBP‐CorV – Sinopharm‐Beijing vs placebo | RR 0.76 [0.54, 1.06] | 1 study · 26924 participants | Low Downgraded: imprecision |
Local reactogenicity eventse BBIBP‐CorV – Sinopharm‐Beijing vs placebo | no estimate extracted | 3 studies · 26924 participants | Low Downgraded: imprecision, inconsistency |
BBV152 – Bharat Biotech compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infectionb BBV152 – Bharat Biotech vs placebo | no estimate extracted | 1 study · 6289 participants | High |
Confirmed symptomatic COVID‐19b BBV152 – Bharat Biotech vs placebo | no estimate extracted | 1 study · 16973 participants | High |
Severe or critical COVID‐19b BBV152 – Bharat Biotech vs placebo | no estimate extracted | 1 study · 16976 participants | High |
All‐cause mortalitye BBV152 – Bharat Biotech vs placebo | RR 0.5 [0.17, 1.46] | 1 study · 25753 participants | Low Downgraded: imprecision |
Systemic reactogenicity eventsg BBV152 – Bharat Biotech vs placebo | RR 1.34 [1.15, 1.58] | 2 studies · 25925 participants | High |
Any adverse eventi BBV152 – Bharat Biotech vs placebo | RR 1 [0.94, 1.07] | 1 study · 25753 participants | High |
Serious adverse eventsi BBV152 – Bharat Biotech vs placebo | RR 0.65 [0.43, 0.97] | 1 study · 25928 participants | High |
Local reactogenicity eventsg BBV152 – Bharat Biotech vs placebo | RR 1.08 [0.95, 1.24] | 2 studies · 25750 participants | High |
NVX‐CoV2373 – Novavax compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection NVX‐CoV2373 – Novavax vs placebo | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19b NVX‐CoV2373 – Novavax vs placebo | no estimate extracted | 3 studies · 42175 participants | Moderate Downgraded: risk of bias, inconsistency |
Severe or critical COVID‐19 NVX‐CoV2373 – Novavax vs placebo | no estimate extracted | 1 study · 25452 participants | Moderate Downgraded: risk of bias, indirectness |
All‐cause mortalityh NVX‐CoV2373 – Novavax vs placebo | RR 0.9 [0.3, 2.68] | 1 study · 29582 participants | Low Downgraded: risk of bias, imprecision |
Systemic reactogenicity eventsj NVX‐CoV2373 – Novavax vs placebo | RR 1.21 [1.17, 1.25] | 3 studies · 31063 participants | High |
Any adverse eventm NVX‐CoV2373 – Novavax vs placebo | RR 1.15 [1.05, 1.26] | 5 studies · 46231 participants | Moderate Downgraded: risk of bias, inconsistency |
Serious adverse eventsm NVX‐CoV2373 – Novavax vs placebo | RR 0.92 [0.74, 1.14] | 4 studies · 38802 participants | Low Downgraded: risk of bias, imprecision |
Local reactogenicity eventsj NVX‐CoV2373 – Novavax vs placebo | RR 2.78 [1.99, 3.88] | 3 studies · 31063 participants | High |
FINLAY‐FR‐2 – Instituto Finlay de Vacunas compared to placebo for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection FINLAY‐FR‐2 – Instituto Finlay de Vacunas vs placebo | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19b FINLAY‐FR‐2 – Instituto Finlay de Vacunas vs placebo | no estimate extracted | 1 study · 28674 participants | Moderate Downgraded: risk of bias |
Severe or critical COVID‐19 FINLAY‐FR‐2 – Instituto Finlay de Vacunas vs placebo | no estimate extracted | NR | No studies |
All‐cause mortalitye FINLAY‐FR‐2 – Instituto Finlay de Vacunas vs placebo | RR 0.37 [0.17, 0.8] | 1 study · 28674 participants | Moderate Downgraded: risk of bias |
Systemic reactogenicity events FINLAY‐FR‐2 – Instituto Finlay de Vacunas vs placebo | no estimate extracted | NR | No studies |
Any adverse event FINLAY‐FR‐2 – Instituto Finlay de Vacunas vs placebo | no estimate extracted | NR | No studies |
Serious adverse events FINLAY‐FR‐2 – Instituto Finlay de Vacunas vs placebo | no estimate extracted | NR | No studies |
Local reactogenicity events FINLAY‐FR‐2 – Instituto Finlay de Vacunas vs placebo | no estimate extracted | NR | No studies |
Heterologous vaccination scheme compared to homologous vaccination scheme for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection Heterologous vaccination scheme vs homologous vaccination scheme | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19 Heterologous vaccination scheme vs homologous vaccination scheme | no estimate extracted | NR | No studies |
Severe or critical COVID‐19 Heterologous vaccination scheme vs homologous vaccination scheme | no estimate extracted | NR | No studies |
All‐cause mortality Heterologous vaccination scheme vs homologous vaccination scheme | no estimate extracted | NR | No studies |
Systemic reactogenicity eventsb Heterologous vaccination scheme vs homologous vaccination scheme | RR 1.96 [0.52, 7.41] | 1 study · 101 participants | Low Downgraded: risk of bias, imprecision |
Any adverse eventf Heterologous vaccination scheme vs homologous vaccination scheme | no estimate extracted | 3 studies · 3 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Serious adverse eventsk Heterologous vaccination scheme vs homologous vaccination scheme | no estimate extracted | 1 study · 229 participants | Very low Downgraded: risk of bias, imprecision |
Local reactogenicity eventsb Heterologous vaccination scheme vs homologous vaccination scheme | RR 11.76 [1.59, 87.14] | 1 study · 101 participants | Low Downgraded: risk of bias, imprecision |
Booster compared to placebo/no booster for vaccination against COVID‐19a
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Confirmed SARS‐CoV‐2 infection Booster vs placebo/no booster | no estimate extracted | NR | No studies |
Confirmed symptomatic COVID‐19 Booster vs placebo/no booster | no estimate extracted | NR | No studies |
Severe or critical COVID‐19 Booster vs placebo/no booster | no estimate extracted | NR | No studies |
All‐cause mortalityb Booster vs placebo/no booster | RR 1.27 [0.52, 3.05] | 1 study · 28254 participants | Very low Downgraded: risk of bias, imprecision |
Systemic reactogenicity eventsf Booster vs placebo/no booster | RR 1.8 [0.71, 4.56] | 1 study · 119 participants | Low Downgraded: imprecision |
Any adverse event Booster vs placebo/no booster | no estimate extracted | NR | No studies |
Serious adverse events Booster vs placebo/no booster | no estimate extracted | NR | No studies |
Local reactogenicity eventsf Booster vs placebo/no booster | RR 6.46 [3.18, 13.13] | 1 study · 119 participants | Moderate Downgraded: imprecision |