COVID-19: vaccine efficacy and safety

The map above shows the number of clinical trials conducted by vaccine manufactures around the world. See the tables below for the full details of the clinical trials.

How to be prepared next time:
perspectives on the global pandemic response

COVID-19 – vaccine efficacy and safety

The first vaccines against COVID-19 were approved in December 2020, just one year after the virus was first identified in China. Today, there is strong evidence that the vaccines are safe and highly effective – even against emerging new variants. Here Frontiers Policy Labs presents a new data resource, presenting detailed results from clinical trials and large-scale observational studies to date, including links to the original articles, and a downloadable file with the complete dataset.

To generate this dataset, the authors searched Google Scholar for journal articles, technical reports, and preprints referring to phase 3 clinical trials and post-deployment studies of the efficacy or real-life effectiveness and safety of vaccines against the SARS-Cov-2 virus. The search, conducted between 1 March 2021 and 31 March 31 2021, used the query (vaccination OR vaccine) AND (effectiveness OR efficacy) AND (covid-19 OR sars-cov-2). The team downloaded all articles that met the following inclusion criteria: the article reported a stage 3 clinical trial, or post-deployment study performed by the authors of the article, the article specified the location where the study was conducted, the characteristics of the study population, the start and end dates for the study, the size of the sample, and the efficacy or effectiveness of the vaccine against infection at least one specified end-point.

The survey was conceived and led by Richard Walker, with the collaboration of Cho Enriquez (team lead), Patricia Ilagan, Joseph Rasalan, and Nathan Afalla.

How to be prepared next time: perspectives on the global pandemic response

Luc Debruyne, Strategic Avdisor to the CEO, Coalition for Epidemic Preparedness Innovations (CEPI)

The severity of the coronavirus pandemic is far, far beyond anything we have seen before. COVID-19 hit everyone very hard and across several layers – the economy, social interaction, and of course, health. Nobody can escape it. 2020 was all about uncertainty – will there be vaccines? Luckily, BARDA in the US,  CEPI globally and many others stepped in and accelerated the development of vaccines. The ACT-Accelerator and COVAX were also created to help deal with the pandemic in an impressive multilateral effort.

The collection of clinical trial reports provided by Frontiers in these pages, shows the high level of efficacy, effectiveness and safety of the vaccines developed in record time. A testament to the scientific success of this effort.

Once vaccines were successfully developed, a new market emerged, and everybody wanted to do a deal - first for themselves, then leaving a bit on the side for the rest of the world. We cannot blame politicians for this behavior, as after all, it is their responsibility and duty to protect their people, and there were no global or regional pre-agreements on how we should deal with this situation. By 2021, the pandemic had become even more complex with the emergence of new variants of the virus and ensuing dilemmas on whether to reopen the economies. The good news is that the world has realized that we should deal with this situation on a global level, so we presently see a shift in the direction of global collaboration around vaccines.

I remain convinced that we were not prepared for the COVID-19 pandemic. There were no pre-existing agreements on how we should manage fair and equitable access to vaccination on a global scale. Unprecedented is an overused term, but this situation was unprecedented the truest sense. Essentially, we were building a boat in the middle of a storm. This had serious consequences on our ability to respond efficiently and fairly to the pandemic.

Another factor that hindered our response to the pandemic was that we underestimated its severity. The manufacturing and deployment infrastructure required to manage a crisis of this scale was not in place and has taken too long to develop.

An important issue that has come to light throughout the COVID-19 pandemic is the interface between policy and science. While scientists are now front and center when it comes to explaining the disease and the nature of vaccinations, the bridge between politicians, policymakers and science has been a fragile one.

The likely explanation for this is that a collaboration of this intensity has not been tested to this extent before. To bridge the gap between policy and science, trust between politicians and scientists is critical Relationships need to be fostered, roles and responsibilities recognized. Scientists do not know everything: science is about building a body of evidence; it is not an end in itself. Politicians on the other hand have to make decisions which enable harmony between society and the economy, both domestically and internationally.

 Moving forward, we should consider social and community engagement. We have the science and the politicians who make decisions, but ultimately, nothing will work if society at large is not engaged in this process. As we have seen  in this pandemic, that engagement was lacking; we did not prepare communities on a behavioral level. In the future, we cannot underestimate the preparedness required for community engagement in such a crisis, which is a prerequisite for building trust between the three parties involved – the public, the scientists, and the policy makers.

In terms of the future global approach, I think we need to learn from COVAX about what has worked, as well as do an honest appraisal of what has not. The next time we face a pandemic, we must ensure we have a fully configured system readiness to respond at a national, regional, and global level.

 At a national level, countries need to be ready to pay for an insurance policy for pandemics, and they should stimulate basic research in their research centers of excellence.

At a regional level, regions need to make sure sustainable financing is available to stockpile relevant resources. They need to build their research capacity to effectively develop vaccines in a collaborative effort with industry, establishing a public-private partnership towards this goal. Phase 3 trials of the vaccine should be implemented through a regional network and be ready to be ignited when needed. Additionally, regional preparedness should be reflected in its organization, having enough authority to effectively execute what needs to be done during a crisis.

Finally, at a global level, worldwide collaboration is essential. Ultimately, it is the G7 and G20 leadership that will need to agree on how to deal with pandemics, from a sustainable financial perspective, from an insurance policy perspective, and from an equitable distribution perspective. No international organization will solve everything on its own, and so preparedness at a country, region, and global levels are all required to be laid out with the appropriate responsibilities. CEPI will play an important enabling role. This approach may I believe allow us to respond far more effectively to the next pandemic.