Comparative efficacy of leading COVID-19 vaccines: A network meta-analysis

In the fight against the COVID-19 virus, various vaccines using different technologies such as mRNA, viral vectors, protein subunits, and inactivated whole viruses have become primary defence strategies. This study aims to compare their effectiveness in controlling the spread of the pandemic. Using the comprehensive resources from three major databases-PubMed, EMBASE, and the Cochrane Library-we conducted an extensive literature review up to April 30, 2023. By employing a frequentist network meta-analysis, we analysed both direct and indirect estimates of vaccine efficacy, providing a clear comparison of the leading candidates in the global fight against COVID-19. Fifteen vaccines from 26 articles were used in our network meta-analysis. The statistically significant direct estimates were obtained by Spikevax [VE: 93.29 (91.31, 95.27); P<0.05], Pfizer BioNTech [VE: 92.07 (90.03, 94.12); P<0.05], Sputnik [VE: 91.60 (85.60, 97.60); P<0.05], Novavax [VE: 88.99 (83.55, 94.42); P<0.05], Sinovac [VE: 83.50 (65.40, 101.60); P<0.05], Covifenz [VE: 77.27 (68.48, 86.06); P<0.05], Zifivax [VE: 75.94 (70.86, 81.02); P<0.05], Covishield [VE: 72.34 (67.12, 77.56); P<0.05], S-Trimer [VE: 71.61 (56.23, 86.98); P<0.05], Covaxin [VE: 70.81 (65.33, 76.29); P<0.05], Soberna [VE: 69.70 (56.50, 82.90); P<0.05], Zydus Cadila [VE: 66.60 (47.60, 85.60); P<0.05], CVnCoV [VE: 63.70 (52.20, 75.20); P<0.05], Convidecia [VE: 57.50 (39.70, 75.30); P <0.05], and Jcovden [VE : 52.42 (47.28, 57.57); P<0.05]. Spikevax emerged triumphant with an unparalleled P score of 0.95, solidifying its status as a top ranking prevention tool against the COVID-19 in our investigation. Our analysis reveals a ranking of vaccine efficacy, with Spikevax emerging as the most effective, followed closely by Comirnaty, Sputnik, and others, collectively providing strong protection against the ongoing threat of COVID-19.