Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis

Abstract Background To date, coronavirus disease 2019 (COVID-19) becomes increasingly fierce due to the emergence of variants. Rapid herd immunity through vaccination is needed to block the mutation and prevent the emergence of variants that can completely escape the immune surveillance. We aimed to...

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Autores principales:	Qiao Liu, Chenyuan Qin, Min Liu, Jue Liu
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	SARS-CoV-2 Vaccine Effectiveness Safety Meta-analysis Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/22c6af3b91b143b78edcbc4ad92d0893
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spelling	oai:doaj.org-article:22c6af3b91b143b78edcbc4ad92d08932021-11-21T12:28:47ZEffectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis10.1186/s40249-021-00915-32049-9957https://doaj.org/article/22c6af3b91b143b78edcbc4ad92d08932021-11-01T00:00:00Zhttps://doi.org/10.1186/s40249-021-00915-3https://doaj.org/toc/2049-9957Abstract Background To date, coronavirus disease 2019 (COVID-19) becomes increasingly fierce due to the emergence of variants. Rapid herd immunity through vaccination is needed to block the mutation and prevent the emergence of variants that can completely escape the immune surveillance. We aimed to systematically evaluate the effectiveness and safety of COVID-19 vaccines in the real world and to establish a reliable evidence-based basis for the actual protective effect of the COVID-19 vaccines, especially in the ensuing waves of infections dominated by variants. Methods We searched PubMed, Embase and Web of Science from inception to July 22, 2021. Observational studies that examined the effectiveness and safety of SARS-CoV-2 vaccines among people vaccinated were included. Random-effects or fixed-effects models were used to estimate the pooled vaccine effectiveness (VE) and incidence rate of adverse events after vaccination, and their 95% confidence intervals (CI). Results A total of 58 studies (32 studies for vaccine effectiveness and 26 studies for vaccine safety) were included. A single dose of vaccines was 41% (95% CI: 28–54%) effective at preventing SARS-CoV-2 infections, 52% (31–73%) for symptomatic COVID-19, 66% (50–81%) for hospitalization, 45% (42–49%) for Intensive Care Unit (ICU) admissions, and 53% (15–91%) for COVID-19-related death; and two doses were 85% (81–89%) effective at preventing SARS-CoV-2 infections, 97% (97–98%) for symptomatic COVID-19, 93% (89–96%) for hospitalization, 96% (93–98%) for ICU admissions, and 95% (92–98%) effective for COVID-19-related death, respectively. The pooled VE was 85% (80–91%) for the prevention of Alpha variant of SARS-CoV-2 infections, 75% (71–79%) for the Beta variant, 54% (35–74%) for the Gamma variant, and 74% (62–85%) for the Delta variant. The overall pooled incidence rate was 1.5% (1.4–1.6%) for adverse events, 0.4 (0.2–0.5) per 10 000 for severe adverse events, and 0.1 (0.1–0.2) per 10 000 for death after vaccination. Conclusions SARS-CoV-2 vaccines have reassuring safety and could effectively reduce the death, severe cases, symptomatic cases, and infections resulting from SARS-CoV-2 across the world. In the context of global pandemic and the continuous emergence of SARS-CoV-2 variants, accelerating vaccination and improving vaccination coverage is still the most important and urgent matter, and it is also the final means to end the pandemic. Graphical AbstractQiao LiuChenyuan QinMin LiuJue LiuBMCarticleSARS-CoV-2VaccineEffectivenessSafetyMeta-analysisInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENInfectious Diseases of Poverty, Vol 10, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	SARS-CoV-2 Vaccine Effectiveness Safety Meta-analysis Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	SARS-CoV-2 Vaccine Effectiveness Safety Meta-analysis Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Qiao Liu Chenyuan Qin Min Liu Jue Liu Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis
description	Abstract Background To date, coronavirus disease 2019 (COVID-19) becomes increasingly fierce due to the emergence of variants. Rapid herd immunity through vaccination is needed to block the mutation and prevent the emergence of variants that can completely escape the immune surveillance. We aimed to systematically evaluate the effectiveness and safety of COVID-19 vaccines in the real world and to establish a reliable evidence-based basis for the actual protective effect of the COVID-19 vaccines, especially in the ensuing waves of infections dominated by variants. Methods We searched PubMed, Embase and Web of Science from inception to July 22, 2021. Observational studies that examined the effectiveness and safety of SARS-CoV-2 vaccines among people vaccinated were included. Random-effects or fixed-effects models were used to estimate the pooled vaccine effectiveness (VE) and incidence rate of adverse events after vaccination, and their 95% confidence intervals (CI). Results A total of 58 studies (32 studies for vaccine effectiveness and 26 studies for vaccine safety) were included. A single dose of vaccines was 41% (95% CI: 28–54%) effective at preventing SARS-CoV-2 infections, 52% (31–73%) for symptomatic COVID-19, 66% (50–81%) for hospitalization, 45% (42–49%) for Intensive Care Unit (ICU) admissions, and 53% (15–91%) for COVID-19-related death; and two doses were 85% (81–89%) effective at preventing SARS-CoV-2 infections, 97% (97–98%) for symptomatic COVID-19, 93% (89–96%) for hospitalization, 96% (93–98%) for ICU admissions, and 95% (92–98%) effective for COVID-19-related death, respectively. The pooled VE was 85% (80–91%) for the prevention of Alpha variant of SARS-CoV-2 infections, 75% (71–79%) for the Beta variant, 54% (35–74%) for the Gamma variant, and 74% (62–85%) for the Delta variant. The overall pooled incidence rate was 1.5% (1.4–1.6%) for adverse events, 0.4 (0.2–0.5) per 10 000 for severe adverse events, and 0.1 (0.1–0.2) per 10 000 for death after vaccination. Conclusions SARS-CoV-2 vaccines have reassuring safety and could effectively reduce the death, severe cases, symptomatic cases, and infections resulting from SARS-CoV-2 across the world. In the context of global pandemic and the continuous emergence of SARS-CoV-2 variants, accelerating vaccination and improving vaccination coverage is still the most important and urgent matter, and it is also the final means to end the pandemic. Graphical Abstract
format	article
author	Qiao Liu Chenyuan Qin Min Liu Jue Liu
author_facet	Qiao Liu Chenyuan Qin Min Liu Jue Liu
author_sort	Qiao Liu
title	Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis
title_short	Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis
title_full	Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis
title_fullStr	Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis
title_full_unstemmed	Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis
title_sort	effectiveness and safety of sars-cov-2 vaccine in real-world studies: a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/22c6af3b91b143b78edcbc4ad92d0893
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Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis

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