As SARS-CoV-2 vaccines are deployed worldwide, a comparative evaluation is important to underpin decision-making. We here report a systematic literature review and meta-analysis of Phase I/II/III human trials and non-human primates (NHP) studies, comparing reactogenicity, immunogenicity and efficacy across different vaccine platforms for comparative evaluation (updated to March 22, 2021). Twenty-three NHP and 32 human studies are included. Vaccines result in mostly mild, self-limiting adverse events. Highest spike neutralizing antibody (nAb) responses are identified for the mRNA-1273-SARS-CoV and adjuvanted NVX-CoV2373-SARS-CoV-2 vaccines. ChAdOx-SARS-CoV-2 produces the highest T cell ELISpot responses. Pre-existing nAb against vaccine viral vector are identified following AdH-5-SARS-CoV-2 vaccination, halving immunogenicity. The mRNA vaccines depend on boosting to achieve optimal immunogenicity especially in the elderly. BNT162b2, and mRNA-1273 achieve >94%, rAd26/5 > 91% and ChAdOx-SARS-CoV-2 > 66.7% efficacy. Across different vaccine platforms there are trade-offs between antibody binding, functional nAb titers, T cell frequency, reactogenicity and efficacy. Emergence of variants makes rapid mass rollout of high efficacy vaccines essential to reduce any selective advantage.
【저자키워드】 Adaptive immunity, Infectious diseases, Vaccines, 【초록키워드】 neutralizing antibody, Meta-analysis, Viral vector, Efficacy, Vaccine, vaccination, reactogenicity, Trial, mRNA vaccine, mRNA-1273, variant, SARS-CoV-2 vaccine, BNT162b2, adverse events, T cell, Antibody binding, emergence, response, Mild, ELISPOT, vaccine platform, non-human primate, NAb, Frequency, phase, literature review, selective, trade-off, NHP, responses, highest, functional, reduce, 【제목키워드】 Meta-analysis, SARS-CoV-2, Efficacy, Vaccine, reactogenicity, systematic review, Comparative,