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Comparative systematic review and meta-analysis of reactogenicity, immunogenicity and efficacy of vaccines against SARS-CoV-2.
McDonald, Ian; Murray, Sam M; Reynolds, Catherine J; Altmann, Daniel M; Boyton, Rosemary J.
  • McDonald I; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
  • Murray SM; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
  • Reynolds CJ; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
  • Altmann DM; Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK. d.altmann@imperial.ac.uk.
  • Boyton RJ; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK. r.boyton@imperial.ac.uk.
NPJ Vaccines ; 6(1): 74, 2021 May 13.
Article in English | MEDLINE | ID: covidwho-1228259
ABSTRACT
As SARS-CoV-2 vaccines are deployed worldwide, a comparative evaluation is important to underpin decision-making. We here report a systematic literature review and meta-analysis of Phase I/II/III human trials and non-human primates (NHP) studies, comparing reactogenicity, immunogenicity and efficacy across different vaccine platforms for comparative evaluation (updated to March 22, 2021). Twenty-three NHP and 32 human studies are included. Vaccines result in mostly mild, self-limiting adverse events. Highest spike neutralizing antibody (nAb) responses are identified for the mRNA-1273-SARS-CoV and adjuvanted NVX-CoV2373-SARS-CoV-2 vaccines. ChAdOx-SARS-CoV-2 produces the highest T cell ELISpot responses. Pre-existing nAb against vaccine viral vector are identified following AdH-5-SARS-CoV-2 vaccination, halving immunogenicity. The mRNA vaccines depend on boosting to achieve optimal immunogenicity especially in the elderly. BNT162b2, and mRNA-1273 achieve >94%, rAd26/5 > 91% and ChAdOx-SARS-CoV-2 > 66.7% efficacy. Across different vaccine platforms there are trade-offs between antibody binding, functional nAb titers, T cell frequency, reactogenicity and efficacy. Emergence of variants makes rapid mass rollout of high efficacy vaccines essential to reduce any selective advantage.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Reviews / Systematic review/Meta Analysis Topics: Vaccines / Variants Language: English Journal: NPJ Vaccines Year: 2021 Document Type: Article Affiliation country: S41541-021-00336-1

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Reviews / Systematic review/Meta Analysis Topics: Vaccines / Variants Language: English Journal: NPJ Vaccines Year: 2021 Document Type: Article Affiliation country: S41541-021-00336-1