Characteristics, immunogenicity, and efficacy of the most advanced SARS-CoV-2 vaccines
For each vaccine, different methods were used to assess immunogenicity and reactogenicity; the data reported in the table are for reference only and not for comparison. Vaccines clinical trial data were retrieved from the World Health Organization COVID-19 vaccine tracker (http://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines). Vaccine approval status was retrieved from regulatory agencies websites and McGill University’s COVID-19 vaccine tracker (http://covid19.trackvaccines.org/vaccines/). Where available, vaccine efficacy estimates assessed in certain countries or against a specific variant are provided.
| Vaccine (Manufacturer) | Construct | Dose Schedule | Pivotal Clinical Trials | Approval Status | Vaccine Efficacy (%) | Neutralizing Antibodies (GMT) | T cell Response | References |
|---|---|---|---|---|---|---|---|---|
| Inactivated vaccines | ||||||||
| CoronaVac (Sinovac Biotech) | Whole virion inactivated Adj: Alum | 3 μg D0, 14 | Ph 3 in China, UAE, Turkey, Brazil | China (8-Feb-21) Approved in 41 countries | Brazil: 50.4% UAE: 86% Turkey: 91.25%a | Baseline: 2.0 Postvac: 27.6 | NA | (Zhang et al., 2021b) |
| BBIBP-CorV (Sinopharm) | 4 μg D0, 21 | Ph 3 in China | EUA in China (31-Dec-20), Approved in 66 countries | China: 79.34%b | Baseline: 2.0 Postvac: 282.7 | NA | (Xia et al., 2021) | |
| Viral vector vaccines | ||||||||
| ChAdOx1 (Astra Zeneca) | Chimpanzee Ad encoding full length S protein | 5x1010 vp D0, 28 D0, 72 | Ph 3 in UK, Brazil, RSA (N = 30,000) Ph 2: RSA | EUA in UK (30-Dec-20), EU (29-Jan-21) Approved in 124 countries | 70.4%i (interim analysis) 66.7%i (full analysis) RSA: 21.9% Alpha: 70.4% Beta: 10.4%c Delta: 67% | Baseline: 20 Postvac: 277 | IFNγ T cells | (Emary et al., 2021; Lopez Bernal et al., 2021; Madhi et al., 2021; Voysey et al., 2021a; Voysey et al., 2021b) |
| Gam-COVID-Vac (Gamaleya Research Institute) | Ad26 (prime) + Ad5 (boost) encoding full length S protein | 1x1011 vp D0, 21 | Ph 3 in Russia (N = 33,758) | Russia (5-Dec-20) Approved in 72 countries | 91.6%d | Baseline: 1.25 Postvac: 49.25 (frozen); 45.95 (lyophilized) | CD4+ CD8+ | (Logunov et al., 2021; Logunov et al., 2020) |
| Ad5-nCov (CanSino Biologics) | Ad5 encoding full length S protein | 5x1010 vp D0 | Ph 3 in Argentina, Chile, Mexico, Pakistan, Russia, Saudi Arabia (N = 40,000) | China (29-Jun-2020) Approved in 9 countries | 65.7%b | Baseline: 4.0 Postvac: 18.3 | Th1 biased | (Zhu et al., 2020a; Zhu et al., 2020b) |
| Ad26.COV2.S (Janssen/ Johnson & Johnson) | Ad5 encoding S-2P additional cleavage site stabilizing mutations | 5x1010 vp D0, 56 | Ph 3 in the US, Brazil, RSA (N = 43,783) | EUA in the US (27-Feb-21) Approved in 75 countries | over 14D postvac: 66.9% over 28D postvac: 66.1% US (96% D614G): 72.0% Brazil (69% Zeta; 31% D614G): 68.1% RSA (95% Beta): 64.0%e | Baseline: <LLoQ Postvac: 827 | Th1 biased | (Sadoff et al., 2021a; Sadoff et al., 2021b) |
| Nucleic acid-based vaccines | ||||||||
| BNT162b2 (BioNTech/Pfizer) | Nucleoside-modified mRNA encoding S-2P formulated in LNP | 30 μg D0, 21 | Ph 3 in US, EU, RSA, LATAM (N = 43,548) | EUA in the US (11-Dec-20), EU (21-Dec-20) Approved in 103 countries | 95.3%f Delta: 88% | Baseline: 10 Postvac: 361 | CD4+ Th1 biased CD8+ | (Chen et al., 2021b; Lopez Bernal et al., 2021; Walsh et al., 2020) |
| mRNA-1273 (Moderna) | 100 μg D0, 28 | Ph 3 in US (N = 30,420) | EUA in the US (18-Dec-20), EU (06-Jan-2021) Approved in 76 countries | 94.1%g Delta: 84.8% | Baseline: 4 Postvac: 654.3 | Th1 biased | (Baden et al., 2021; Jackson et al., 2020; Tang et al., 2021) | |
| CVnCoV (CureVac) | Sequence optimized mRNA encoding S-2P formulated in LNP | 12 ug D0, 28 | Ph 2b/3 in EU, LATAM (N = 39,693) | — | 47% | Baseline: 5 Postvac: 113 | NA | (CureVac, 2021; Kremsner et al., 2021) |
| Recombinant protein vaccines | ||||||||
| NVX-CoV2373 (Novavax) | Full length S-2P + additional cleavage site stabilizing mutations Adj: Matrix-M1 | 5 μg D0, 21 | Ph 3 in UK (N = 30,000; interim analysis:15,000); Ph 2b in RSA (N = 4,400) | — | UK (>50% Alpha): 89.3% RSA (>90% Beta): 49.4% wild-type: 95.6% Alpha: 85.6% Beta: 60%h | Baseline: 20 Postvac: 3906 | Th1 biased | (Keech et al., 2020; Novavax, 2021) |
| SCB-2019 (Clover Biopharmaceuticals) | Native-like trimeric S protein Adj: CpG/ Alum | 30 μg D0, 21 | Ph 2/3 in LATAM, Asia, Europe, Africa (N = 22,000) | — | 79% (>73% Delta) | Baseline: <5 Postvac: 1050 | Th1 biased | (Clover, 2021; Richmond et al., 2021) |
| CoVLP (Medicago/GSK) | Prefusion stabilized S protein displayed as self-assembling VLPs Adj: CpG/ AS03 | 3.75 μg D0, 21 | Ph 3 in US, Canada, UK (N = 30,000) | — | NA | Baseline: 20 Postvac: 56.6 (CpG) 811.3 (AS03) | IFNy IL4 | (Ward et al., 2021) |
Adj, adjuvant; D, day; postvac, postvaccination; vp; viral particles per vaccine dose; N, number of participants; NA, not available/applicable; UK, United Kingdom; RSA, Republic of South Africa; US, United States; UAE, United Arab Emirates; LATAM, Latin America; Ad, adenovirus; LLoQ, lower limit of quantitation; S-2P, SARS-CoV-2 spike protein with prefusion stabilizing mutation; LNP, lipid nanoparticle.
Endpoints for assessment of vaccine efficacy were:
aMild to severe cases of COVID-19.
bNot available.
cNucleic acid amplification test-confirmed COVID-19 combined with at least one qualifying symptom (fever ≥37.8°C, cough, shortness of breath, or anosmia or ageusia) more than 14 days after the second dose.
dProportion of participants with PCR-confirmed COVID-19 from day 21 after receiving the first dose.
ePrevention of moderate to severe/critical COVID-19 confirmed by real time PCR combined with at least one new worsening signs or symptoms.
fLaboratory-confirmed COVID-19 with onset at least 7 days after the second dose in participants who had been without serologic or virologic evidence of SARS-CoV-2 infection up to 7 days after the second dose.
gPrevention of COVID-19 illness with onset at least 14 days after the second injection in participants who had not previously been infected with SARS-CoV-2.
hFirst occurrence of PCR-confirmed symptomatic (mild, moderate, or severe) COVID-19 with onset at least 7 days after the second study vaccination in serologically negative (to SARS-CoV-2) adult participants at baseline.
iAverage of two regimens.