A review of the safety and efficacy of current COVID-19 vaccines
Zehong Huang, Yingying Su, Tianying Zhang, Ningshao Xia()
State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen 361102, China
Vaccination is the most effective and feasible way to contain the coronavirus disease 2019 (COVID-19) pandemic. The rapid development of effective COVID-19 vaccines is an extraordinary achievement. This study reviewed the efficacy/effectiveness, immunogenicity, and safety profile of the 12 most progressed COVID-19 vaccines and discussed the challenges and prospects of the vaccine-based approaches in a global crisis. Overall, most of the current vaccines have shown safety and efficacy/effectiveness during actual clinical trials or in the real-world studies, indicating a development of pandemic control. However, many challenges are faced by pandemic control in terms of maximizing the effect of vaccines, such as rapid vaccine coverage, strategies to address variants with immune escape capability, and surveillance of vaccine safety in the medium- and long-terms.
. [J]. Frontiers of Medicine, 2022, 16(1): 39-55.
Zehong Huang, Yingying Su, Tianying Zhang, Ningshao Xia. A review of the safety and efficacy of current COVID-19 vaccines. Front. Med., 2022, 16(1): 39-55.
97 countries including Argentina, Mexico, Saudi Arabia, Canada, USA, UK, etc.
7 days after dose 2
43 548
Symptomatic diseases: 95.0 (90.3–97.6) (USA) Severe diseases: 88.9 (20.1–99.7) (USA)b
mRNA-1273 [14]
Moderna/National Institute of Allergy and Infectious Diseases (NIAID)
Stable at –50 °C to –15°C; 2–8 °C for 30 days; 8–25 °C for 24 h
2 doses, 0/28 days
65 countries Canada, Israel, Switzerland, USA, UK, etc.
14 days after dose 2
30 420
Symptomatic diseases: 94.1 (89.3–96.8) (USA) Severe diseases: 100 (NE–100) (USA)a
CVnCoV [16]
CureVac AG
Stable at 2–8 °C
2 doses, 0/28 days
Not approved
NA
Approximately 40 000
Symptomatic diseases: 48 Moderate to severe diseases: 77c,d
NVX-CoV2373 [26,27,94]
Novavax
Protein subunit
Stable at 2–8 °C
2 doses, 0/21 days
Not approved
7 days after dose 2
14 039 (GBR); 2684 (RSA) 29 960 (USA/MEX)
Symptomatic diseases: 89.7 (80.2–94.6) (GBR) 90.4 (82.9–94.6) (USA/MEX) 49.4 (6.1–72.8) (RSA) Moderate or severe disease: 100 (87–100) (USA/MEX) Severe diseases: 100 (GBR)a 100 (RSA)a
Tab.1
Fig.1
Vaccine (reference)
VOC
VOI
Alpha (B.1.1.7)
Gamma (P.1)
Beta (B.1.351)
Delta (B.1.617.2)
Epsilon (B.1.429)
Iota (B.1.526) (E484K)
Iota (B.1.526) (S477N)
Neutralization
Gam-COVID-Vac [76]
Increase by 1.8×
NA
Decrease by 6.1×
NA
NA
NA
NA
BBIBP-CorV [78,82]
Increase by 1.4×
NA
Decrease by 1.55× Decrease by 2.5 ×
NA
NA
NA
NA
BNT162b2 [75,79,85–88]
Increase by 1.3×
Decrease by 3.8×
Decrease by 10.3×
Decrease by 1.4×
NA
Decrease by 3.6×
similar to D614G
Decrease by 3.3×
Decrease by 2.6×
Decrease by 7.6×
Decrease by 3.4×
Decrease by 5.8×
mRNA-1273 [77,79,84–86,89]
Increase by 1.6×
Decrease by 4.8×
Decrease by 9.7×
Decrease by 2.1×
Decrease by 2.0×
Decrease by 3.6×
similar to D614G
Decrease by 2.0×
Decrease by 12.4×
Decrease by 1.2×
Decrease by 3.2×
Decrease by 3.8×
AZD-1222 [75,83,90]
Decrease by 2.3×
Decrease by 2.9×
Decrease by 11× Decrease by 9×
Decrease by 3.2×
NA
NA
NA
COVAXIN [80]
Decrease by 1.06×
NA
NA
Decrease by 1.95×
NA
NA
NA
CoronaVac [78,81]
Decrease by 2×
Decrease by 3.92×
Decrease by 3.3×
NA
Decrease by 1.25×
Decrease by 4.03×a
Decrease by 1.51×
Decrease by 5.27×
WIV04
NA
NA
NA
NA
NA
NA
NA
Ad5-nCoV
NA
NA
NA
NA
NA
NA
NA
Ad26.COV2.S [117]
Decrease by 0.9×
Decrease by 3.4×
Decrease by 3.6×
Decrease by 1.6×
NA
NA
NA
NVX-CoV2373 [77,84]
Decrease by 2.1×
NA
Decrease by 14.5×
NA
Decrease by 2.5×
NA
NA
CVnCoV
NA
NA
NA
NA
NA
NA
NA
Efficacy/effectiveness
Ad26.COV2.S [19]
NA
NA
Moderate to severe COVID-19: 64.0% (95% CI 41.2%– 78.7%) Severe COVID-19: 81.7% (95% CI 46.2%– 95.4%)
NA
NA
NA
NA
NVX-CoV2373 [94,118]
Symptomatic COVID-19:86.3% (95% CI 71.3%–93.5%)
NA
Symptomatic COVID-19: 60.1% (95% CI 19.9%–80.1%)c
NA
NA
NA
NA
AZD-1222 [35,36,83,91]
Symptomatic COVID-19:70.4% (95% CI 43.6%–84.5%) Hospitalization: 86% (95% CI 53%–96%)
NA
Mild-to-moderate COVID-19:10.4% (95% CI –76.8% to 54.8%)
Symptomatic COVID-19: 59.8% (95% CI 28.9%–77.3%) Hospitalization: 92% (95% CI 75%–97%)
NA
NA
NA
CoronaVac [95]
NA
Symptomatic COVID-19: 49.6% (95% CI 11.3%–71.4%)b
NA
NA
NA
NA
NA
BNT162b2 [35,36,92]
SARS-CoV-2 infection: 89.5% (95% CI 85.9%–92.3%) Symptomatic COVID-19: 92% (95% CI 88%–94%) Severe, critical, or fatal COVID-19: 100.0% (95% CI 81.7%– 100.0%) Hospitalization: 95% (95% CI 78%–99%)
NA
SARS-CoV-2 infection: 75.0% (95% CI 70.5%–78.9%) Severe, critical, or fatal COVID-19: 100.0% (95% CI 73.7%–100.0%)
Symptomatic COVID-19: 87.9% (95% CI 78.2%–93.2%) Hospitalization: 96% (95% CI 86%–99%)
NA
NA
NA
mRNA-1273[93]
SARS-CoV-2 infection: 100% (95% CI 91.8%–100%)
NA
NA
SARS-CoV-2 infection: 96.4% (95% CI 91.9%–98.7%)
NA
NA
NA
COVAXIN ([21])
NA
NA
NA
Symptomatic COVID-19: 65.2% (95% CI 33·1%–83·0%)
NA
NA
NA
CVnCoV [16]
Symptomatic COVID-19: 55% (95% CI 24%–74%)d
Symptomatic COVID-19: 67% (95% CI 30%–85%)d
NA
NA
NA
NA
NA
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