Comparative Benefits and Risks Associated with Currently Authorized COVID-19 Vaccines

Area of Science:

• Vaccinology
• Clinical Trials
• Epidemiology

Background:

• Publicly available data from major COVID-19 vaccine trials are crucial for assessing vaccine performance.
• Understanding the efficacy and safety profiles of different vaccine platforms is essential for public health strategies.

Purpose of the Study:

• To systematically assess the efficacy, risks, and methodological quality of evidence from five major COVID-19 vaccine trials.
• To compare the relative and absolute effects of these vaccines using a standardized approach.

Main Methods:

• Systematic assessment of five publicly available vaccine trials: Pfizer-BioNTech, Moderna, AstraZeneca-Oxford, Gamaleya (Sputnik V), and Johnson & Johnson.
• Data extraction on benefits and risks, summarized using the GRADE approach to determine the certainty of evidence.
• Analysis of relative and absolute risk reduction for symptomatic COVID-19 and serious adverse events.

Main Results:

• Relative risk reduction ranged from 45% to 96% across the five vaccine trials.
• Absolute risk reduction in symptomatic COVID-19 was 6 to 17 per 1000 participants.
• No significant increase in serious adverse events was observed for any vaccine compared to placebo.
• Overall certainty of evidence ranged from low to moderate, with risk of bias impacting ratings.

Conclusions:

• All five assessed COVID-19 vaccines demonstrate effectiveness and safety.
• There is a need for improved transparency and thoroughness in the conduct and reporting of large-scale vaccine trials.
• Enhancing trial methodology can mitigate bias and increase the certainty of evidence for vaccine efficacy and safety.