The efficacy and effectiveness of COVID-19 vaccines around the world: a mini-review and meta-analysis

Marzieh Soheili; Sorour Khateri; Farhad Moradpour; Pardis Mohammadzedeh; Mostafa Zareie; Seyede Maryam Mahdavi Mortazavi; Sima Manifar; Hamed Gilzad Kohan; Yousef Moradi

doi:10.1186/s12941-023-00594-y

The efficacy and effectiveness of COVID-19 vaccines around the world: a mini-review and meta-analysis

Ann Clin Microbiol Antimicrob. 2023 May 19;22(1):42. doi: 10.1186/s12941-023-00594-y.

Authors

Marzieh Soheili¹, Sorour Khateri², Farhad Moradpour³, Pardis Mohammadzedeh⁴, Mostafa Zareie⁴, Seyede Maryam Mahdavi Mortazavi⁵, Sima Manifar⁶, Hamed Gilzad Kohan⁷, Yousef Moradi⁸

Affiliations

¹ Department of Pharmaceutical and Administrative Sciences, College of Pharmacy, Western New England University, 1215 Wilbraham Road, Springfield, MA, 01119, USA.
² Department of Physical Medicine and Rehabilitation, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran.
³ Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
⁴ Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
⁵ Pediatric Gastroenterology Fellowship, Department of Pediatrics, School of Medicine, Namazi teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
⁶ Massachusetts College of Pharmacy and Health Sciences (MCPHS), 179 Longwood Avenue, Boston, MA, 02115, USA.
⁷ Department of Pharmaceutical and Administrative Sciences, College of Pharmacy, Western New England University, 1215 Wilbraham Road, Springfield, MA, 01119, USA. hamed.gilzadkohan@wne.edu.
⁸ Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. Yousef.Moradi@muk.ac.ir.

Abstract

Objectives: This meta-analysis evaluated the Efficacy and Effectiveness of several COVID-19 vaccines, including AstraZeneca, Pfizer, Moderna, Bharat, and Johnson & Johnson, to better estimate their immunogenicity, benefits, or side effects.

Methods: Studies reporting the Efficacy and Effectiveness of COVID-19 vaccines from November 2020 to April 2022 were included. The pooled Effectiveness/Efficacy with a 95% confidence interval (95% CI) with Metaprop order was calculated. The results were presented in forest plots. Predefined subgroup analyses and sensitivity analyses were also performed.

Results: A total of twenty articles were included in this meta-analysis. After the first dose of the vaccine, the total effectiveness of all COVID-19 vaccines in our study was 71% (95% CI 0.65, 0.78). The total effectiveness of vaccines after the second dose was 91% (95% CI 0.88, 0.94)). The total efficacy of vaccines after the first and second doses was 81% (95% CI 0.70, 0.91) and 71% (95% CI 0.62, 0.79), respectively. The effectiveness of the Moderna vaccine after the first and second dose was the highest among other studied vaccines ((74% (95% CI, 0.65, 0.83) and 93% (95% CI, 0.89, 0.97), respectively). The highest first dose overall effectiveness of the studied vaccines was against the Gamma variant (74% (95% CI, 0.73, 0.75)), and the highest effectiveness after the second dose was observed against the Beta variant (96% (95% CI, 0.96, 0.96)). The Efficacy for AstraZeneca and Pfizer vaccines after the first dose was 78% (95% CI, 0.62, 0.95) and 84% (95% CI, 0.77, 0.92), respectively. The second dose Efficacy for AstraZeneca, Pfizer, and Bharat was 67% (95% CI, 0.54, 0.80), 93% (95% CI, 0.85, 1.00), and 71% (95% CI, 0.61, 0.82), respectively. The overall efficacy of first and second dose vaccination against the Alfa variant was 84% (95% CI, 0.84, 0.84) and 77% (95% CI, 0.57, 0.97), respectively, the highest among other variants.

Conclusion: mRNA-based vaccines against COVID-19 showed the highest total efficacy and effectiveness than other vaccines. In general, administering the second dose produced a more reliable response and higher effectiveness than a single dose.

Keywords: COVID-19; Effectiveness; Efficacy; SARS-CoV-2; Vaccine.

Publication types

Review
Meta-Analysis

MeSH terms

COVID-19 Vaccines* / adverse effects
COVID-19 Vaccines* / therapeutic use
COVID-19* / prevention & control
Humans
SARS-CoV-2

Substances

COVID-19 Vaccines

Supplementary concepts

SARS-CoV-2 variants