Efficacy and effectiveness of COVID-19 vaccines in Africa: A systematic review

PLoS One. 2024 Jun 28;19(6):e0306309. doi: 10.1371/journal.pone.0306309. eCollection 2024.

Abstract

Background: Data on COVID-19 vaccine effectiveness to support regional vaccine policy and practice are limited in Africa. Thus, this review aimed to evaluate the efficacy and effectiveness of COVID-19 vaccines administered in Africa.

Methods: We systematically searched peer-reviewed randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies that reported on VE in Africa. We carried out a risk of bias assessment, and the findings of this review were synthesized and presented in a narrative form, including tables and figures. The synthesis was focused on COVID-19 VE against various levels of the disease condition and outcomes (infection, hospitalization or critical, and death), time points, and variants of concern.

Results: A total of 13 studies, with a total sample size of 913,285 participants, were included in this review. The majority (8/13) of studies were from South Africa and 38.5% (5/13) were randomized clinical trials. The studies reported that a full dose of Pfizer-BioNTech vaccine had a VE of 100% against COVID-19 infection by Beta (B.1.351) and Delta variants and 96.7% against hospitalization by Delta variant. The Johnson and Johnson vaccine had VE ranging from 38.1%-62.0% against hospitalization and 51.9%- 86% against critical disease by Beta (B 1.351) variant. The Oxford-AstraZeneca vaccine had a VE of 89.4% against hospitalization by the Omicron variant but was not effective against the B.1.351 variant (10.4%). The Sinopharm vaccine had a VE of 67% against infection and 46% against hospitalization by Delta variant.

Conclusions: COVID-19 vaccines administered in Africa were effective in preventing infections, hospitalization, and death. These review findings underscore the need for concerted efforts of all stakeholders to enhance the access and availability of COVID-19 vaccines and reinforce public awareness to reach the high-risk, unvaccinated group of the African population.

Publication types

  • Systematic Review

MeSH terms

  • Africa / epidemiology
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19 Vaccines* / immunology
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Hospitalization / statistics & numerical data
  • Humans
  • Randomized Controlled Trials as Topic
  • SARS-CoV-2* / immunology
  • Vaccine Efficacy

Substances

  • COVID-19 Vaccines

Supplementary concepts

  • SARS-CoV-2 variants

Grants and funding

This research was conducted in partnership with Mastercard Foundation. However, the authors alone are responsible for the contents of this article and they do not necessarily represent the decisions, policies, or views of Africa CDC or Mastercard Foundation.