J Res Health Sci. 2023;23(4): e00593.
doi: 10.34172/jrhs.2023.128
  Abstract View: 586
  PDF Download: 451

Review Article

Comparing the Efficacy and Adverse Events of Available COVID-19 Vaccines Through Randomized Controlled Trials: Updated Systematic Review and Network Meta-analysis

Shima Hossaini 1 ORCID logo, Fariba Keramat 2, Zahra Cheraghi 1,3, Bushra Zareie 1, Amin Doosti-Irani 1,4* ORCID logo

1 Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
2 Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
3 Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamedan, Iran
4 Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
*Corresponding Author: Amin Doosti-Irani, Email: a.doosti@umsha.ac.ir


Background: Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously.

Study Design: A systematic review.

Methods: Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score.

Results: In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88).

Conclusion: Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.

Please cite this article as follows: Hossaini S, Keramat F, Cheraghi Z, Zareie B, Doosti Irani A. Comparing the efficacy and adverse events of available COVID-19 vaccines through randomized controlled trials: updated systematic review and network meta-analysis. J Res Health Sci. 2023; 23(4):e00593. doi:10.34172/jrhs.2023.128
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Submitted: 30 Sep 2023
Revision: 05 Nov 2023
Accepted: 03 Dec 2023
ePublished: 29 Dec 2023
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