Table 2.

Overview of the COVID-19 vaccine research landscape and evidence from Africa: COVID-19 vaccines authorized or under clinical evaluation in Africa^a

Vaccine/ Manufacturer	Platform	Dose (route)	Storage Temperature a	Efficacy (symptomatic COVID-19)a	Efficacy (hospitalization and death) a	Regulatory status	Evaluation in Africa (Country)	Trial No/Phase	Target population/sample sizeb	Efficacy against B.1.351 variant (Beta)	Efficacy against B. 1.1.7 variant (Alpha)	Efficacy against B. 1.617.2 variant (Delta)
BNT162 /Comirnaty	mRNA	2 doses (Injectable)	6 months at −70°C	95%	100%	WHO/EMA/FDA emergency use	South Africa	NCT04368728	16-85 years	Reduced neutralizing Ab titers in vitro (by 4.9)	Reduced neutralizing Ab titers in vitro (by 2.6)	Reduced neutralizing Ab titers in vitro (by 5.8)
(Pfizer BioNtech)			2 weeks at −15 to −25°C
								Phase 2/3	n = 43,548 (across 152 sites and 6 countries)	75% (in Qatar)	89,5% (in Qatar)	96% (in UK)
			5 days up to 1 month at 2 −8°C (undiluted)
											95;3% (in Israel, setting with 94·5% 501Y.V1)
ChAdOx1 /Vaxzevria	Viral vector	2 doses	6 months at 2 −8°C	63%	100%	WHO/EMA/FDA emergency use	South Africa	PACTR202006922165132/NCT04444674	18-65 years n = 2130	10,4% (among 39 participants with Beta infection in South Africa)	74.6%	92% (in Qatar)
		(Injectable)									Reduced neutralizing Ab titers in vitro (by 9)
(AstraZeneca & University of Oxford)
								phase 1b/2
			6 h at 30°C				Kenya	PACTR202005681895696	45-64 years
								phase 1b/2	n = 400
Ad26.COV2.S	Viral vector	1 dose	2 years at −20°C	66% overall	100%	WHO/EMA/FDA emergency use	South Africa	NCT04505722	≥ 18 years	57% (setting with 95% Beta in South Africa)	/
(Johnson & Johnson)		(Injectable)	3 months at 2-8°C	85% against severe disease				Phase 3	n = 6,576
mRNA-1273	mRNA	2 doses	−25 to −15°C	94.1%	100%	WHO/EMA/FDA emergency use	No	/	/	Reduced neutralizing Ab titers in vitro (by 6) Elevated neutralizing Ab titers upon boosting 6 to 8 months after the primary series	No impact in vitro
(Moderna)		(Injectable)	30 days at 2–8°C
			24 h at 25°C
Sputnik V	Viral vector	2 doses (Injectable)		91.6%	100%	/	Guinea Conakry	(pre deployment pilot)	Older adults	Reduced neutralizing Ab titers in vitro (by 6.1)	No impact in vitro
(Gamaleya Institute)									n = 60
BBIBP-CorV/Vero Cell	Inactivated	2 doses (Injectable)	2 years at 2-8°C	78.1%	78,1% (hospitalization)	WHO emergency use	Egypt	NCT04510207/ChiCTR2000034780	≥ 18 years	Reduced neutralizing Ab titers in vitro (by 1.5)	No impact in vitro
(Sinopharm)					/ (death)			Phase 3	n = 45000 (across 4 countries)
							Morocco	ChiCTR2000039000	≥ 18 years
								Phase 3	n = 600
CoronaVacc	Inactivated virus	2 doses	1 to 2 years at 2-8°C	51% – 84% across trial sites	85%-100%	WHO emergency use	/	/	/	Reduced neutralizing Ab titers in vitro (by 3.3)	Reduced neutralizing Ab titers in vitro (by 2)
(Sinovac)		(Injectable)
Covaxinc	Inactivated virus	2 doses	2-8°C	78%	100%	/	No	/	/	/	No impact in vitro
(Barhat Biotech)		(Injectable)	28 days open vial policy
SARS-CoV-2 rS/Matrix-M1 Adjuvant	Protein subunit	2 doses	2-8°C	90.4%	100%	/	South Africa	NCT04533399	18-84 years	60.1% in HIV-	85.6%
(Novavax)		(Injectable)						Phase 2	n = 4400	50.1% overall (setting with 92.7% Beta)
GRAd-COV2	Viral vector	1 or 2 doses		/	/	/	South Africa	EUCTR2020-005915-39	≥ 18 years	/	/
(ReiThera		(Injectable)						Phase 2/3
hAd5-S+N	Viral vector	1 dose	room temperature (oral formulation)	/	/	/	South Africa	NCT04710303	18-50 years	/	/
(ImmunityBio)		(Injectable or oral)						phase 1	n = 35

^aReferences are included in supplementary appendix. If data unavailable from peer reviewed literature, efficacy endpoint data were obtained from WHO strategic advisory group of experts (SAGE) public evidence assessment reports, or from manufacturer’s press releases.

^bDetails obtained from listed clinical trial registers

^cVaccines currently in use but which have not been evaluated in Africa