The following is a summary of “Comparative efficacy and safety of COVID-19 vaccines in phase III trials: a network meta-analysis,” published in the February 2024 issue of Infectious Diseases by Wu et al.
Since the WHO declared COVID-19 a pandemic, an exceptional number of vaccines, totaling over a dozen, have rapidly progressed through or completed phase III trials.
Researchers conducted a retrospective study to conduct a network meta-analysis to compare and rank COVID-19 vaccines indirectly based on their efficacy and safety profiles.
They conducted a comprehensive search across Embase, MEDLINE, and the Cochrane Library for phase III randomized controlled trials (RCTs) dating from their inception to September 30, 2023. Two researchers independently screened articles, extracted data, and evaluated bias risk. Assessments encompassed efficacy in preventing symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the occurrence of serious adverse events (SAEs) in both adult and elderly populations, categorized by vaccine type and individual vaccines. Bayesian network meta-analysis was employed to calculate these outcomes’ risk ratios and mean differences, accompanied by 95% CI.
The results showed that out of the 22 vaccines examined in 25 RCTs, none demonstrated a higher incidence of SAEs than the placebo. Inactivated virus vaccines appeared to be the safest, with a Surface Under the Cumulative Ranking Curve (SUCRA) value of 0.16. BIV1-CovIran exhibited the highest safety index (SUCRA value: 0.13), followed by BBV152, Soberana, Gam-COVID-Vac, and ZF2001. There were no significant disparities among the various vaccine types regarding efficacy in preventing symptomatic SARS-CoV-2 infection, although a trend toward higher efficacy was noted for mRNA vaccines (SUCRA value: 0.09). BNT162b2 demonstrated the highest efficacy (SUCRA value: 0.02) among the individual vaccines, followed by mRNA-1273, Abdala, Gam-COVID-Vac, and NVX-CoV2373. In the elderly population, BNT162b2 showed the highest efficacy (SUCRA value: 0.08), while CVnCoV, CoVLP + AS03, and CoronaVac did not significantly differ from the placebo.
Investigators concluded that though multiple vaccines displayed comparable effectiveness, mRNA options had fewer side effects, with BNT162b2 leading in efficacy and BIV1-CovIran boasting the lowest side effects. However, more research is needed for conclusive safety profiles.
Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-023-08754-3