A Comprehensive Review on Various Aspects of SARS‑CoV‑2 (COVID‑19) Vaccines

Sajjad Rahimi Pordanjani, Ali Rahimi Pordanjani, Hasan Askarpour, Mehrdad Arjmand, Masoudeh Babakhanian, Masoud Amiri, Elaheh Mazaheri


This is a comprehensive review based on the published papers in the field of COVID‑19 vaccines and vaccination. Many efforts have been made to develop vaccines to combat this pandemic. Since December 2020, more than 200 vaccines have been tested in various research stages and in clinical trials on humans, of which eight vaccines reached phase four clinical trials in humans and approved by FDA and EUA. After the Pfizer–BioNTech vaccine that had the highest efficacy (95%), the efficacy of the other vaccines are as follows: Moderna 94.5%, Sputnik V 91%, Novavax 89.7%, Sinopharm 79.3%, Oxford/AstraZenaca 70.4%, Johnson and Johnson 66.9%, and Sinovac 50.7%. At present, protein‑based vaccines, with 35% of all available COVID‑19 vaccines, are the most common technique in the vaccine production, and then there are vaccines of non‑replicating viral vector (13.3%), mRNA1 (12.1%), DNA (10.2%), replicating viral vector (9.8%), and inactivated vaccines (8.2%). The most frequently recognized adverse effects within 7 days of each vaccine dose involved fever, fatigue, headache, chill, and myalgia. The mRNA‑based vaccines were associated with a higher occurrence of local side effects (78.3 vs. 70.4%; Sig. = 0.064), whereas the viral vector‑based vaccine was associated with a higher prevalence of systemic side effects (87.2 vs. 61%; Sig. < 0.001). Based on the evidence and articles in the field of vaccination, AstraZeneca‑Oxford and Sinopharm vaccines reported the highest and lowest side effects, respectively. Because of being emerging, pathogenicity, and high infectivity of COVID‑19, vaccination against the disease to prevent its incident rate and decrease the prevalence rate is recommended immediately. Being informed of various aspects of the existing vaccines such as efficacy, effectiveness, safety, etc.can accelerate to make effective and useful choices and consequently have a vaccinated community against the epidemic.


Comprehensive review; COVID‑19; efficacy; safety; vaccination; vaccines

Full Text:



Lai C‑C, Shih T‑P, Ko W‑C, Tang H‑J, Hsueh P‑R. Severe

acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) and

corona virus disease‑2019 (COVID‑19): The epidemic and the

challenges. IntJAntimicrobial Agents 2020;55:105924.

Kolifarhood G, Aghaali M, Mozafar Saadati H, Taherpour N,

Rahimi S, Izadi N, et al. Epidemiological and clinical aspects of

COVID‑19; Anarrative review. ArchAcad Emerg Med 2020;8:e41.

Lorusso A, Calistri P, Petrini A, Savini G, Decaro N. Novel

coronavirus (SARS‑CoV‑2) epidemic: Aveterinary perspective.

Vet Ital 2020;56:5‑10.

Khazaei Z, Mazaheri E, Hasanpour Dehkordi A, Rahimi

Pordanjani S, Naghibzadeh Tahami A, Naemi H, Goodarzi E.

COVID-19 Pandemic in the World and its Relation to Human

Development Index: A Global Study. Arch Clin Infect Dis.


Tavakoli A, Vahdat K, Keshavarz M. Novel Coronavirus Disease

(COVID‑19): An emerging infectious disease in the

st century. Iran South Med J 2020;22:432‑50.

Rahimi Pordanjani S, Hasanpour A, Askarpour H, Bastam D,

Rafiee M, Khazaei Z, et al. Aspects of epidemiology, pathology,

virology, immunology, transmission, prevention, prognosis,

diagnosis, and treatment of COVID‑19 pandemic: A narrative

review. IntJPrev Med 2021;12:38.

Ahammed T, Anjum A, Rahman MM, Haider N, Kock R,

Uddin MJ. Estimation of novel coronavirus (COVID‑19)

reproduction number and case fatality rate: A systematic review

and meta‑analysis. Health Sci Rep 2021;4:e274.

Alene M, Yismaw L, Assemie MA, Ketema DB, Gietaneh W,

Birhan TY. Serial interval and incubation period of COVID‑19:

Asystematic review and meta‑analysis. BMC Infect Dis


Chen J. Pathogenicity and transmissibility of 2019-nCoV-A quick

overview and comparison with other emerging viruses. Microbes

Infect. 2020;22:69-71.

Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al.

The incubation period of Coronavirus Disease 2019 (COVID‑19) from publicly reported confirmed cases: Estimation and application.

Ann Intern Med 2020. doi: 10.7326/M20‑0504.

Rafiee M, Parsaei F, Rahimi Pordanjani S, Amiri V, Sabour S.

A review on applicable and available paraclinical methods for

diagnosis of Coronavirus Disease‑19. AIM 2020;23:794‑800.

Park SE. Epidemiology, virology, and clinical features of severe

acute respiratory syndrome ‑coronavirus‑2 (SARS‑CoV‑2;

Coronavirus Disease‑19). Clin Exp Pediatr 2020;63:119‑24.

Zhou P, Yang X‑L, Wang X‑G, Hu B, Zhang L, Zhang W, et al.

Discovery of a novel coronavirus associated with the recent

pneumonia outbreak in humans and its potential bat origin.

BioRxiv 2020.doi: 10.1101/2020.01.22.914952.

DeRoo SS, Pudalov NJ, Fu LY. Planning for a COVID‑19

vaccination program. JAMA 2020;323:2458‑9.

Jalali Farahani A, Ashourzadeh Fallah S, Khashei Z,

Heidarzadeh F, Sadeghi F, Masoudi P, et al. Available effective

vaccines in preventing COVID‑19: A narrative review. J Marine

Med 2021;3:153‑62.

Available from: https://www.nytimes.com/interactive/2020/


Amanat F, Krammer F. SARS‑CoV‑2 vaccines: Status report.

Immunity 2020;52:583‑9.

Lee P, Kim C‑U, Seo SH, Kim D‑J. Current status of COVID‑19

vaccine development: Focusing on antigen design and clinical

trials on later stages. Immune Netw 2021;21:e4.

Li Y, Tenchov R, Smoot J, Liu C, Watkins S, Zhou Q.

A comprehensive review of the global efforts on COVID‑19

vaccine development. ACS Cent Sci 2021;7:512‑33.

Wu Q, Dudley MZ, Chen X, Bai X, Dong K, Zhuang T, et al.

Evaluation of the safety profile of COVID‑19 vaccines: Arapid

review. BMC Med 2021;19:1‑16.

Kelso JM. IgE‐mediated allergy to polyethylene glycol (PEG) as

a cause of anaphylaxis to mRNA COVID‐19 vaccines. Clin Exp


Thomas SJ, Moreira EDJr, Kitchin N, Absalon J, Gurtman A,

Lockhart S, et al. Safety and efficacy of the BNT162b2

mRNA Covid‑19 vaccine through 6 months. N Engl J Med


Hind B. A, Shinah A. M, Arshad M. A, Muayad A. M. Potential

adverse effects of COVID19 vaccines among Iraqi population;

a comparison between the three available vaccines in Iraq;

aretrospective cross‑sectional study. Diabetes Metab Syndr


Mahase E. Covid‑19: Moderna vaccine is nearly 95% effective,

trial involving high risk and elderly people shows. BMJ


Grau S, Ferrández O, Martín‑García E, Maldonado R. Accidental

interruption of the cold chain for the preservation of the Moderna

COVID‑19 vaccine. Vaccines 2021;9:512.

McMurry R, Lenehan P, Awasthi S, Silvert E, Puranik A,

Pawlowski C, et al. Real‑time analysis of a mass vaccination

effort confirms the safety of FDA‑authorized mRNA COVID‑19

vaccines. Med (N Y) 2021;2:965‑78.e5.

Knoll MD, Wonodi C. Oxford–AstraZeneca COVID‑19 vaccine

efficacy. Lancet 2021;397:72‑4.

Mallapaty S, Callaway E. What scientists do and don’t know about

the Oxford‑AstraZeneca COVID vaccine. Nature 2021;592:15‑7.

Chirico F, Teixeira da Silva JA, Tsigaris P, Sharun K. Safety &

effectiveness of COVID‑19 vaccines: A narrative review. Indian

J Med Res2022.doi: 10.4103/ijmr.IJMR_474_21.

Gomes de Matos AA, Cardoso GP, Rolim Neto ML. Sputnik V:

Is the Russian Vaccine Safe?. Clin Surg. 2021;6:3265.

Jones I, Roy P. Sputnik V COVID‑19 vaccine candidate appears

safe and effective. Lancet 2021;397:642‑3.

van Tulleken C. Covid‑19: Sputnik vaccine rockets, thanks to

Lancet boost. BMJ 2021;373:n1108.

Montalti M, Solda G, Di Valerio Z, Salussolia A, Lenzi J,

Forcellini M. ROCCA observational study: Early results on

safety of Sputnik V vaccine (Gam‑COVID‑Vac) in the Republic

of San Marino using active surveillance. EClinicalMedicine


Misra SK, Pathak K, Pathak D, Yadav R. Current updates on

COVID‑19 vaccines. Asian J Pharm 2021;14:17‑23.

Baraniuk C. What do we know about China’s covid‑19 vaccines?

BMJ 2021;373:n912.

Livingston EH, Malani PN, Creech CB. The Johnson & Johnson

vaccine for COVID‑19. JAMA 2021;325:1575.

Self WH, Tenforde MW, Rhoads JP, Gaglani M, Ginde AA,

Douin DJ, et al. Comparative effectiveness of Moderna,

Pfizer‑BioNTech, and Janssen (Johnson & Johnson) vaccines

in preventing COVID‑19 hospitalizations among adults without

immunocompromising conditions ‑ United States, March‑August

MorbMortal Wkly Rep 2021;70:1337‑43.

Sapkal GN, Yadav PD, Ella R, Deshpande GR, Sahay RR,

Gupta N, et al. Inactivated COVID‑19 vaccine BBV152/

COVAXIN effectively neutralizes recently emerged B. 1.1. 7

variant of SARS‑CoV‑2. J Travel Med 2021;28:taab051.

Thiagarajan K. What do we know about India’s Covaxin

vaccine? BMJ2021;373:n997.

Fathizadeh H, Afshar S, Masoudi MR, Gholizadeh P,

Asgharzadeh M, Ganbarov K, et al. SARS‑CoV‑2 (Covid‑19)

vaccines structure, mechanisms and effectiveness: A review. Int J

Biol Macromol 2021;188:740‑50.

Doroftei B, Ciobica A, Ilie OD, Maftei R, Ilea C. Mini‑review

discussing the reliability and efficiency of COVID‑19 vaccines.

Diagnostics 2021;11:579.

Sharma R, Tiwari S, Dixit A. Covaxin: An overview of its

immunogenicity and safety trials in India. Bioinformation


Mahase E. Covid‑19: Novavax vaccine efficacy is 86% against UK

variant and 60% against South African variant. BMJ 2021;372:n296.

Callaway E, Mallapaty S. Novavax offers first evidence that

COVID vaccines protect people against variants. Nature


Dunkle LM, Kotloff KL, Gay CL, Áñez G, Adelglass JM,

Barrat Hernández AQ, et al. Efficacy and safety of

NVX‑CoV2373in adults in the United States and Mexico.

N Engl J Med 2011;386;531‑43.

Griffin S. Covid‑19: China’s CoronaVac vaccine offers 83.5%

protection against symptomatic infection, interim analysis finds.

BMJ 2021;374:n1755.

Talukder A, Kalita C, Neog N, Goswami C, Sarma MK,

Hazarika I. A comparative analysis on the safety and efficacy

of Covaxin versus other vaccines against COVID‑19: Areview.

Z Naturforsch C J Biosci 2022.doi: 10.1515/znc‑2021‑0301.

Meo S, Bukhari I, Akram J, Meo A, Klonoff DJERMPS.

COVID‑19 vaccines: Comparison of biological, pharmacological

characteristics and adverse effects of Pfizer/BioNTech and

Moderna vaccines. Eur Rev Med Pharmacol Sci 2021;25:1663‑9.

Francis AI, Ghany S, Gilkes T, Umakanthan S. Review of

COVID‑19 vaccine subtypes, efficacy and geographical

distributions. Postgrad Med J 2022;98:389-394.

Rahimi Pordanjani S, Iranpour S, Sabour S. Pain location

and widespread pain in youth with orthopaedic conditions:

Methodological and statistical issues on reliability analysis. Eur

J Pain 2019;23:198.

Qi J, Cao F, Han Y, Xie D, Song H, Chen B, et al. Reliability

of cartilage digestion and FDA‑EB fluorescence staining for the

detection of chondrocyte viability in osteochondral grafts. Cell

Tissue Bank 2018;19:399‑404.

Houshmand B, Omid Keyhan S, Fallahi HR, Ramezanzade Sh,

Sadeghi E, Yousefi P. Vaccine‑associated complications: Acomparative

multicenter evaluation amongdental practitioners and dental

students—which candidate vaccine is more safe in SARS COV II,

Gam‑COVID‑Vac (SputnikV), ChAdOx1 nCoV‑19 (AstraZeneca),

BBV152 (Covaxin), or BBIBP‑CorV (Sinopharm)?Maxillofac Plast

Reconstr Surg 2022;44:3.

Taghavi H, Feyzollahi M, Moradi A, Azarmi S,

Alazmani Nodeh F, Baniyaghoobi F. Side effects of Covid‑19

vaccines: A systematic review. Journal of Military Health

Promotion 2021;2:365‑75.

Linyi Ch, Xianming C, Tianshuo Zh, Bingfeng H, Mingzhu X,

Jiahao C. Safety of global SARS‑CoV‑2 vaccines, a

meta‑analysis. Vaccines 2022;10:596.