Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis

Abstract New Coronavirus Disease 2019 (COVID-19) vaccines are available to prevent the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We compared the efficacy of new COVID-19 vaccines to prevent symptomatic and severe disease in the adult population and to prevent sym...

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Autores principales:	Victoria Rotshild, Bruria Hirsh-Raccah, Ian Miskin, Mordechai Muszkat, Ilan Matok
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e32526d72aa54d488b97df19c29488f1
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spelling	oai:doaj.org-article:e32526d72aa54d488b97df19c29488f12021-11-28T12:16:49ZComparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis10.1038/s41598-021-02321-z2045-2322https://doaj.org/article/e32526d72aa54d488b97df19c29488f12021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02321-zhttps://doaj.org/toc/2045-2322Abstract New Coronavirus Disease 2019 (COVID-19) vaccines are available to prevent the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We compared the efficacy of new COVID-19 vaccines to prevent symptomatic and severe disease in the adult population and to prevent symptomatic COVID-19 among the elderly. Leading medical databases were searched until August 30, 2021. Published phase 3 randomized controlled trials (RCTs) evaluated efficacy of the vaccine to prevent symptomatic and sever COVID-19 in adults were included. Two reviewers independently evaluated the literature search results and independently extracted summary data. The risk of bias was evaluated using the Cochrane Risk of Bias Assessment Tool. We performed a network meta-analysis (NMA) according to PRISMA-NMA 2015 to pool indirect comparisons between different vaccines regarding their relative efficacy. The primary outcomes were the efficacy of the vaccine against symptomatic COVID-19 in adults (PROSPERO registration number: CRD42021235364). Above 200,000 adult participants from eight phase 3 RCTs were included in NMA, of whom 52% received the intervention (active COVID-19 vaccine). While each of nine vaccines was tested in the unique clinical trial as compared to control, based on indirect comparison, BNT162b2 and mRNA-1273 vaccines were ranked with the highest probability of efficacy against symptomatic COVID-19 (P-scores 0.952 and 0.843, respectively), followed by Gam-COVID-Vac (P-score 0.782), NVX-CoV23730 (P-score 0.700), CoronaVac (P-score 0.570), BN02 (P-score 0.428), WIV04 (P-score 0.327), and Ad26.COV2.S (P-score 0.198). No statistically significant difference was seen in the ability of the vaccines to prevent symptomatic disease in the elderly population. No vaccine was statistically significantly associated with a decreased risk for severe COVID-19 than other vaccines, although mRNA-1273 and Gam-COVID-Vac have the highest P-scores (0.899 and 0.816, respectively), indicating greater protection against severe disease than other vaccines. In our indirect comparison, the BNT162b2 and mRNA-1273 vaccines, which use mRNA technology, were associated with the highest efficacy to prevent symptomatic COVID-19 compared to other vaccines. This finding may have importance when deciding which vaccine to use, together with other important factors as availability of the vaccines, costs, logistics, side effects, and patient acceptability.Victoria RotshildBruria Hirsh-RaccahIan MiskinMordechai MuszkatIlan MatokNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Victoria Rotshild Bruria Hirsh-Raccah Ian Miskin Mordechai Muszkat Ilan Matok Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis
description	Abstract New Coronavirus Disease 2019 (COVID-19) vaccines are available to prevent the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We compared the efficacy of new COVID-19 vaccines to prevent symptomatic and severe disease in the adult population and to prevent symptomatic COVID-19 among the elderly. Leading medical databases were searched until August 30, 2021. Published phase 3 randomized controlled trials (RCTs) evaluated efficacy of the vaccine to prevent symptomatic and sever COVID-19 in adults were included. Two reviewers independently evaluated the literature search results and independently extracted summary data. The risk of bias was evaluated using the Cochrane Risk of Bias Assessment Tool. We performed a network meta-analysis (NMA) according to PRISMA-NMA 2015 to pool indirect comparisons between different vaccines regarding their relative efficacy. The primary outcomes were the efficacy of the vaccine against symptomatic COVID-19 in adults (PROSPERO registration number: CRD42021235364). Above 200,000 adult participants from eight phase 3 RCTs were included in NMA, of whom 52% received the intervention (active COVID-19 vaccine). While each of nine vaccines was tested in the unique clinical trial as compared to control, based on indirect comparison, BNT162b2 and mRNA-1273 vaccines were ranked with the highest probability of efficacy against symptomatic COVID-19 (P-scores 0.952 and 0.843, respectively), followed by Gam-COVID-Vac (P-score 0.782), NVX-CoV23730 (P-score 0.700), CoronaVac (P-score 0.570), BN02 (P-score 0.428), WIV04 (P-score 0.327), and Ad26.COV2.S (P-score 0.198). No statistically significant difference was seen in the ability of the vaccines to prevent symptomatic disease in the elderly population. No vaccine was statistically significantly associated with a decreased risk for severe COVID-19 than other vaccines, although mRNA-1273 and Gam-COVID-Vac have the highest P-scores (0.899 and 0.816, respectively), indicating greater protection against severe disease than other vaccines. In our indirect comparison, the BNT162b2 and mRNA-1273 vaccines, which use mRNA technology, were associated with the highest efficacy to prevent symptomatic COVID-19 compared to other vaccines. This finding may have importance when deciding which vaccine to use, together with other important factors as availability of the vaccines, costs, logistics, side effects, and patient acceptability.
format	article
author	Victoria Rotshild Bruria Hirsh-Raccah Ian Miskin Mordechai Muszkat Ilan Matok
author_facet	Victoria Rotshild Bruria Hirsh-Raccah Ian Miskin Mordechai Muszkat Ilan Matok
author_sort	Victoria Rotshild
title	Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis
title_short	Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis
title_full	Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis
title_fullStr	Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis
title_full_unstemmed	Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis
title_sort	comparing the clinical efficacy of covid-19 vaccines: a systematic review and network meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e32526d72aa54d488b97df19c29488f1
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Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis

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