COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

Primary Prevention Hayawi K, Shahriar S, Serhani MA, et al. Vaccine versus Variants (3Vs): Are the COVID-19 Vaccines Effective against the Variants? A Systematic Review. Vaccines (Basel). 2021 Nov 10;9(11). pii: vaccines9111305. doi: 10.3390/vaccines9111305.
PICO Terms
adult (P) alpha; B.1.1.7; variant of concern; VOC (P) any infection (O) beta; B.1.351; variant of concern; VOC (P) Comirnaty; Pfizer vaccine; BNT162b2; BioNTech/Fosun Pharma; mRNA (I/C) delta; B.1.617.2; variant of concern; VOC (P) gamma; P.1; variant of concern; VOC (P) Johnson & Johnson vaccine; Janssen Pharmaceutical Companies; Ad26.COV2.S; non-replicating viral vector (I/C) Novavax vaccine; NVX-CoV2373; protein subunit (I/C) Sinovac vaccine; CoronaVac; inactivated virus (I/C) Spikevax; Moderna vaccine; mRNA-1273 SARS-CoV-2; ModernaTX; mRNA (I/C) vaccine effectiveness (O) Vaxzevria; AstraZeneca vaccine; ChAd0x1 nCOV-19; Covishield; non-replicating viral vector; adenovirus; University of Oxford/AstraZeneca; AZD1222 (I/C)

BACKGROUND: With the emergence and spread of new SARS-CoV-2 variants, concerns are raised about the effectiveness of the existing vaccines to protect against these new variants. Although many vaccines were found to be highly effective against the reference COVID-19 strain, the same level of protection may not be found against mutation strains. The objective of this study is to systematically review relevant studies in the literature and compare the efficacy of COVID-19 vaccines against new variants.

METHODS: We conducted a systematic review of research published in Scopus, PubMed, and Google Scholar until 30 August 2021. Studies including clinical trials, prospective cohorts, retrospective cohorts, and test negative case-controls that reported vaccine effectiveness against any COVID-19 variants were considered. PRISMA recommendations were adopted for screening, eligibility, and inclusion.

RESULTS: 129 unique studies were reviewed by the search criteria, of which 35 met the inclusion criteria. These comprised of 13 test negative case-control studies, 6 Phase 1-3 clinical trials, and 16 observational studies. The study location, type, vaccines used, variants considered, and reported efficacies were highlighted.

CONCLUSION: Full vaccination (two doses) offers strong protection against Alpha (B.1.1.7) with 13 out of 15 studies reporting more than 84% efficacy. The results are not conclusive against the Beta (B.1.351) variant for fully vaccinated individuals with 4 out of 7 studies reporting efficacies between 22 and 60% and 3 out of 7 studies reporting efficacies between 75 and 100%. Protection against Gamma (P.1) variant was lower than 50% according to two studies in fully vaccinated individuals. The data on Delta (B.1.617.2) variant is limited but indicates lower protection compared to other variants.

Discipline / Specialty Area Score
Public Health
Infectious Disease
Comments from MORE raters

Infectious Disease rater

It needs updating.