The efficacy and effectiveness of the COVID-19 vaccines in reducing infection, severity, hospitalization, and mortality: a systematic review

Mohammed, Ibrahim; Nauman, Areej; Paul, Pradipta; Ganesan, Sanjith; Chen, Kuan-Han; Jalil, Syed Muhammad Saad; Jaouni, Shahd H; Kawas, Hussam; Khan, Wafa; Vattoth, Ahamed Lazim; Al-Hashimi, Yasmeen Alavi; Fares, Ahmed; Zeghlache, Rached; Zakaria, Dalia

doi:10.1080/21645515.2022.2027160

Cited by 251 publications

(203 citation statements)

References 80 publications

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“…In fact, at present, barely half of the population in Spain have vaccine booster shots as a result of lower incidence, as official data have showed [ 3 ]. Additionally, while COVID-19 vaccines have successfully reduced the rates of infections, severity, hospitalization, and mortality among different populations [ 20 ], the vaccine effect on reducing transmission appears to be minimal in the context of omicron and delta variant circulation [ 21 ]. During data collection, the most prevalent variants were Delta in El Salvador and Spain and Mu in Colombia [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Citizen Stance towards Mandatory COVID-19 Vaccination and Vaccine Booster Doses: A Study in Colombia, El Salvador and Spain

et al. 2022

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The infections and deaths resulting from Coronavirus Disease 2019 (COVID-19) triggered the need for some governments to make COVID-19 vaccines mandatory. The present study aims to analyze the position of 3026 adults in Colombia, El Salvador, and Spain regarding the possibility of making COVID-19 vaccine mandatory and the intention to be vaccinated with the booster or possible successive doses. Data from an online survey conducted from August to December 2021 among a non-representative sample of Spanish-speaking countries were collected. Multinomial Logistic Regression Models were used. A total of 77.4% of Colombians were in favor of mandatory vaccination compared to 71.5% of Salvadorians and 65.4% of Spaniards (p < 0.000). Women and people over 65 years of age were the groups most in favor of making the vaccine mandatory (p < 0.000). A total of 79.4% said they had received a third dose or would intend to receive the third dose or future doses, if necessary, compared with 9.4% who expressed doubts and 9.9% who refused to be vaccinated or did not intend to be vaccinated. Among the measures that could be taken to motivate vaccination, 63.0% and 60.6% were in favor of requiring a negative test to enter any place of leisure or work, respectively, compared to 16.2% in favor of suspension from work without pay. The acceptance of mandatory vaccination and of third or future doses varies greatly according to sociodemographic characteristics and work environment. As such, it is recommended that policy makers adapt public health strategies accordingly.

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Section: Discussionmentioning

confidence: 99%

Citizen Stance towards Mandatory COVID-19 Vaccination and Vaccine Booster Doses: A Study in Colombia, El Salvador and Spain

et al. 2022

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“…WHO has authorised the emergency use of 10 vaccines developed by Janssen, Bharat Biotech, Pfizer-BioNTech, Oxford-AstraZeneca, Moderna, Sinopharm, Sinovac, Novavax, and Serum Institute of India 3. Despite a rapid decline in the number of covid-19 symptomatic infections and deaths, several studies have raised concerns about waning vaccine induced immunity in vaccinated populations due to time and the emergence of covid-19 variants, which prompts the urgent need for a booster dose 45678. Furthermore, heterologous vaccine regimens could be an alternative strategy to homologous regimens when supplies are limited.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of heterologous and homologous covid-19 vaccine regimens: living systematic review with network meta-analysis

Cheung

2022

BMJ

104

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Objective To evaluate the effectiveness of heterologous and homologous covid-19 vaccine regimens with and without boosting in preventing covid-19 related infection, hospital admission, and death. Design Living systematic review and network meta-analysis. Data sources World Health Organization covid-19 databases, including 38 sources of published studies and preprints. Study selection Randomised controlled trials, cohort studies, and case-control studies. Methods 38 WHO covid-19 databases were searched on a weekly basis from 8 March 2022. Studies that assessed the effectiveness of heterologous and homologous covid-19 vaccine regimens with or without a booster were identified. Studies were eligible when they reported the number of documented, symptomatic, severe covid-19 infections, covid-19 related hospital admissions, or covid-19 related deaths among populations that were vaccinated and unvaccinated. The primary measure was vaccine effectiveness calculated as 1−odds ratio. Secondary measures were surface under the cumulative ranking curve (SUCRA) scores and the relative effects for pairwise comparisons. The risk of bias was evaluated by using the risk of bias in non-randomised studies of interventions (ROBINS-I) tool for all cohort and case-control studies. The Cochrane risk of bias tool (version 2; ROB-2) was used to assess randomised controlled trials. Results The first round of the analysis comprised 53 studies. 24 combinations of covid-19 vaccine regimens were identified, of which a three dose mRNA regimen was found to be the most effective against asymptomatic and symptomatic covid-19 infections (vaccine effectiveness 96%, 95% credible interval 72% to 99%). Heterologous boosting using two dose adenovirus vector vaccines with one mRNA vaccine has a satisfactory vaccine effectiveness of 88% (59% to 97%). A homologous two dose mRNA regimen has a vaccine effectiveness of 99% (79% to 100%) in the prevention of severe covid-19 infections. Three dose mRNA is the most effective in reducing covid-19 related hospital admission (95%, 90% to 97%). The vaccine effectiveness against death in people who received three doses of mRNA vaccine remains uncertain owing to confounders. In the subgroup analyses, a three dose regimen is similarly effective in all age groups, even in the older population (≥65 years). A three dose mRNA regimen works comparably well in patients who are immunocompromised and those who are non-immunocompromised. Homologous and heterologous three dose regimens are effective in preventing infection by covid-19 variants (alpha, delta, and omicron). Conclusion An mRNA booster is recommended to supplement any primary vaccine course. Heterologous and homologous three dose regimens work comparably well in preventing covid-19 infections, even against different variants. The effectiveness of three dose vaccine regimens against covid-19 related death remains uncertain. Systematic review registration This review was not registered. The protocol is included in the supplementary document. Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.

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“…Last, concerning vaccination for SARS-CoV-2, it has been reported that vaccination uptake is closely associated with elderly people saved, independently of the vaccine type administered [ 16 ]. Emerging data further support the efficacy and effectiveness of COVID-19 vaccines in terms of public health consequences [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Vaccination Coverage and Key Public Health Indicators May Explain Disparities in COVID-19 Country-Specific Case Fatality Rate Within European Economic Area

Papadopoulos¹,

Emmanouilidou²,

Yerou³

et al. 2022

Cureus

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To investigate the reasons for disparity regarding the country-specific COVID-19-related case fatality rate (CFR) within the 30 countries of the European Economic Area (EEA). Materials and methodsData regarding population, area, COVID-19-associated infections/deaths, vaccination, life expectancy, elderly population, infant mortality, gender disparity, urbanization, gross domestic product (GDP), income per capita, health spending per capita, physicians, nursing personnel, hospital beds, ICU beds, hypertension, diabetes, obesity, and smoking from all EEA countries were collected from official sources on January 16, 2022. Correlation coefficients were computed, and optimal scaling using ridge regression was used to reach the most parsimonious multivariate model assessing any potential independent correlation of public health parameters with COVID-19 CFR. ResultsCOVID-19 CFR ranges from 0.1% (Iceland) to 4.0% (Bulgaria). All parameters but population density, GDP, total health spending (% of GDP), ICU beds, diabetes, and obesity were correlated with COVID-19 CFR. In the most parsimonious multivariate model, elderly population rate (P = 0.018), males/total ratio (P = 0.013), nurses/hospital beds (P = 0.001), physicians/hospital beds (P = 0.026), public health spending (P = 0.013), smoking rate (P = 0.013), and unvaccinated population rate (P = 0.00005) were demonstrated to present independent correlation with COVID-19 CFR. In detail, the COVID-19 CFR is estimated to increase by 1.24 times in countries with vaccination rate of <0.34, 1.11 times in countries with an elderly population rate of ≥0.20, 1.14 times in countries with male ratio values ≥0.493, 1.12 times in countries spending <2,000$ annually per capita for public health, 1.14 and 1.10 times in countries with <2.30 nurses and <0.88 physicians per hospital bed, respectively, and 1.12 in countries with smoking ratio ≥0.22, while holding all other independent variables of the model constant. ConclusionCOVID-19 CFR varies substantially among EEA countries and is independently linked with low vaccination rates, increased elderly population rate, diminished public health spending per capita, insufficient physicians and nursing personnel per hospital bed, and prevalent smoking habits. Therefore, public health authorities are awaited to consider these parameters in prioritizing actions to manage the SARS-CoV-2 pandemic.

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The efficacy and effectiveness of the COVID-19 vaccines in reducing infection, severity, hospitalization, and mortality: a systematic review

Cited by 251 publications

References 80 publications

Citizen Stance towards Mandatory COVID-19 Vaccination and Vaccine Booster Doses: A Study in Colombia, El Salvador and Spain

Citizen Stance towards Mandatory COVID-19 Vaccination and Vaccine Booster Doses: A Study in Colombia, El Salvador and Spain

Effectiveness of heterologous and homologous covid-19 vaccine regimens: living systematic review with network meta-analysis

SARS-CoV-2 Vaccination Coverage and Key Public Health Indicators May Explain Disparities in COVID-19 Country-Specific Case Fatality Rate Within European Economic Area

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