Ask a Librarian - COVID-19 vaccines and the immunization roll-out

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Joule’s Ask a Librarian team is committed to curating free evidence-based resources related to the current COVID-19 pandemic. We continue to update the Ask a Librarian: COVID-19 post with current clinical summaries, article collections, guidance and more. For public health information and resources for physicians and patients, visit the CMA’s COVID-19 page.

Here we focus on information sources specific to COVID-19 vaccines and the immunization roll-out.

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Clinical summaries

DynaMed

(Included with membership. Access now)  - COVID-19 (Novel Coronavirus) - see Prevention and Screening Immunization section. Updated January 15, 2021.

Recent updates

12 Jan 2021: COVID-19 mRNA nucleoside modified vaccine (COVID-19 Vaccine Moderna dispersion for injection) authorized for temporary supply by United Kingdom Department of Health and Social Care and Medicines and Healthcare products Regulatory Agency (MHRA) for active immunization to prevent COVID-19 disease caused by SARS-CoV-2 in persons ≥ 18 years old (United Kingdom Medicines and Healthcare Products Regulatory Agency (MHRA) Information for UK Healthcare Providers 2021 Jan 8, MHRA Press Release 2021 Jan 8) View in topic

8 Jan 2021: Moderna mRNA vaccine (mRNA-1273) may be 94% effective against COVID-19 in adults (N Engl J Med 2020 Dec 30 early online) View in topic

6 Jan 2021: 2 standard doses of adenovirus-vectored vaccine expressing SARS-CoV-2 spike protein (ChAdOx1 nCoV-19) may be 62% effective against COVID-19 in adults (Lancet 2020 Dec 8 early online) View in topic

6 Jan 2021: COVID-19 Vaccine (ChAdOx1-S [recombinant]) (COVID-19 Vaccine AstraZeneca) authorized for temporary supply by United Kingdom Department of Health and Social Care and MHRA for active immunization to prevent COVID-19 disease caused by SARS-CoV-2 virus in persons ≥ 18 years old (United Kingdom MHRA Press Release 2020 Dec 30) View in topic

6 Jan 2021: mRNA-1273 SARS-CoV-2 Vaccine (Moderna COVID-19 Vaccine) receives authorization under interim order by Health Canada for use in persons ≥ 18 years old for active immunization to prevent COVID-19 (Health Canada Press Release 2020 Dec 23) View in topic

6 Jan 2021: COVID-19 mRNA Vaccine BNT162b2 authorized for temporary supply by United Kingdom Department of Health and Social Care and MHRA for active immunization to prevent COVID-19 disease caused by SARS-CoV-2 in persons ≥ 16 years old (United Kingdom MHRA Information for UK Healthcare Professionals 2020 Dec 31) View in topic

 

BMJ Best Practice

Coronavirus Disease (COVID-19). See “Vaccines”. Updated January 13, 2021.

 

UptoDate

Coronavirus disease 2019 (COVID-19): Vaccines to prevent SARS-CoV-2 infection

 Literature review current through December 2020. Updated: January 15th, 2021.

 

Clinical information hubs and toolkits

Elsevier - COVID-19 Healthcare Hub: Vaccines Toolkit

Center for Effective Practice - CEP Providers | COVID-19 Vaccines

 

Evidence reviews

American Family Physician

Coronavirus Disease 2019 (COVID-19) Daily Research Briefs

January 13, 2021, Research Update

Preliminary Data Show the Pfizer-BioNTech mRNA Vaccine Is Also Effective against Two Mutant Strains of SARS-CoV2. Two mutant strains of the SARS-CoV2 virus have emerged in the United Kingdom, South Africa, the United States, and probably elsewhere. These strains have slight alterations in the spike protein, which is part of the viral receptor binding site, and are the key targets for neutralizing antibodies. In this report from a preprint server (not peer-reviewed), researchers generated genome-specific antigens for these two mutant strains and tested them against the serum from 20 participants in the original randomized trial of the mRNA vaccine jointly developed by Pfizer and BioNTech. The outcome, neutralizing antibody generation as determined by a 50% plaque reduction neutralization assay, demonstrated the vaccine to be as effective against the mutant strains. Although reassuring, this is a fairly limited lab-based study, so we still need real-world performance data and ongoing monitoring.

Written by Henry C. Barry, MD, MS, on January 8, 2021. (Source: Xie X, Zou J, Fontes-Garfias CR, et al. Neutralization of N501Y mutant SARS-CoV-2 by BNT162b2 vaccine-elicited sera [published online January 7, 2021]. www.biorxiv.org/content/10.1101/2021.01.07.425740v1)

 

December 17, 2020, Research Update

Summary of FDA Report on Pfizer/BioNTech COVID-19 Vaccine Efficacy and Safety. This is the FDA report summarizing the application for emergency-use authorization for the Pfizer/BioNTech vaccine. It provides the most detailed data as of yet of a large COVID-19 vaccine trial. A total of 40,277 persons were randomized to vaccine or placebo. Only 2.6% were found to have antibodies due to a prior infection, and results presented in the Table below are for all patients who received two doses of vaccine regardless of prior infection. Participants were 49.4% women, with a mean age of 50 years. By age group, 58% were 16 to 55 years of age, 42% were older than 55 years of age, and 21% were older than 65 years of age. The population was fairly representative by race and ethnicity of the United States as a whole, with 82% White, 10% Black, 4.4% Asian, and 26% Hispanic or Latino. Efficacy data are summarized in the Table below, both overall and by key subgroups, and show the number of cases of COVID-19 beginning seven days after the second dose of vaccine. Efficacy was consistent regardless of age, race, ethnicity, sex, or the presence of comorbidities. In regard to safety, injection-site pain, fatigue, and headache were common. Lymphadenopathy was uncommon but occurred more often in the vaccine group (64 vs. six cases). Bell palsy occurred in four vaccine participants and no placebo participants. Severe adverse events were rare, and only 0.2% of vaccine participants withdrew because of them.

Cases of COVID-19

 

Vaccine group

Placebo group

Efficacy (95% CI)

All participants

9

169

94.6% (89.9% to 97.3%)

Age (years)

 

 

 

16 to 55

6

120

95.0% (88.7% to 98.2%)

> 55

3

49

93.8% (80.9% to 98.8%)

65 to 74

1

14

92.9% (53.2% to 99.8%)

≥ 75

0

5

100% (–12.1% to 100%)

Race

 

 

 

Black or African American (n = 3,516)

0

7

100% (30.4% to 100%)

White (n = 30,767)

7

153

95.4% (90.3% to 98.2%)

Ethnicity

 

 

 

Hispanic ethnicity (n = 10,164)

3

55

94.5% (83.2% to 98.9%)

Non-Hispanic (n = 26,889)

6

114

94.7% (88.1% to 98.1%)

Written by Mark H. Ebell, MD, MS, on December 8, 2020. Source: Food and Drug Administration. Vaccines and Related Biological Products Advisory Committee meeting; December 2020.

 

McMaster University

COVID-19 Evidence Alerts – weekly update of high-quality clinical studies with free email notifications

Recent reviews

Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine.
Baden LR, El Sahly HM, Essink B, et al.   N Engl J Med. Reviewed January 6, 2021

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.
Voysey M, Clemens SAC, Madhi SA, et al.   Lancet. Reviewed December 22, 2020.

Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine.
Polack FP, Thomas SJ, Kitchin N, et al.   N Engl J Med. Reviewed December 21, 2020.

 

Primer AI - COVID-19 primer

Vaccine Efficacy & Vaccine Hesitancy”  – dashboard for latest research and trending news and articles on vaccines

 

University of Pennsylvania Center for Evidence-based Practice

Penn Medicine COVID-19  Guidance Summaries

Recent reviews

Adverse Effects Of Messenger RNA Vaccines - 12/24/2020

COVID-19: Vaccination For Women Who Are Pregnant Or Lactating - 12/24/2020

 

Veterans Affairs (VA) Evidence Synthesis Program

COVID-19 Evidence Reviews

Recent reviews

Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review

Lin C, Tu P, Beitsch LM | Vaccines

Aim: To compare trends and synthesize findings in vaccination receptivity over time across US and international polls, assess survey design influences and evaluate context to inform policies and practices.

 

COVID-19 mRNA Vaccines for People with Cancer

Clark M, Loshak H, Farrah K | CADTH

Aim: To review the evidence on the use of COVID-19 mRNA vaccines on patients with cancer or who are immunocompromised.

 

Emerging role of artificial intelligence in therapeutics for COVID-19: a systematic review  

Kaushal K, Sarma P, Rana SV, et al. | J Biomol Struct Dyn

Aim: To evaluate the role of AI in drug repurposing, novel drug discovery, vaccine and antibody development for the therapeutics of COVID-19.

 

Deployment and vaccination plan for COVID-19

 | NSW Health COVID-19 Critical Intelligence Unit

 

COVID-19 and Child Vaccination: A Systematic Approach to Closing the Immunization Gap

Olorunsaiye CZ, Yusuf KK, Reinhart K, et al. | Int J MCH AIDS

Aim: To review the evidence on the immunization landscape since the COVID-19 pandemic.

 

Articles and article collections

CMAJ articles

Mandatory vaccination for health care workers: an analysis of law and policy

Colleen M. Flood, Bryan Thomas and Kumanan Wilson

CMAJ January 19, 2021 cmaj.202755; DOI: https://doi.org/10.1503/cmaj.202755

 

Key populations for early COVID-19 immunization: preliminary guidance for policy Shainoor J. Ismail, Linlu Zhao, Matthew C. Tunis, Shelley L. Deeks and Caroline Quach; for the National Advisory Committee on Immunization

CMAJ November 30, 2020 192 (48) E1620-E1632
 

Challenges in evaluating SARS-CoV-2 vaccines during the COVID-19 pandemic Bahaa Abu-Raya, Soren Gantt and Manish Sadarangani

CMAJ August 24, 2020 192 (34) E982-E985

 

More questions than answers as Canada’s immunity task force releases initial results

Terry Murray CMAJ August 10, 2020 192 (32) E933-E934

 

See links to additional articles and article collections in our COVID-19 post

 

Vaccine trials, monographs and tracking

Epocrates COVID-19 Drug Therapy Trial Updates – links to trials and resources focused on therapeutics.

Gold Standard – SARS-CoV-2 virus (COVID-19) Vaccine - Moderna COVID-19 | Pfizer-BioNTech COVID-19

Drug Information (login to ClinicalKey and find in “Drug Monographs”)

Government of Canada –  COVID-19 vaccines and treatments portal –  Information on vaccines and treatments authorized for COVID-19, as well as those currently under review.

Government of Canada –  COVID-19 Vaccination Tracker – Real-time reporting of doses administration across Canada.

Government of Canada –  Vaccines and treatments for COVID-19 – progress, clinical trials, rollout and safety. Updated December 16, 2020.

Health Canada –  COVID-19 Vaccines - Information on COVID-19 vaccines including authorized vaccines, types of vaccines and on-going safety monitoring. Updated December 23, 2020.

Lexicomp –  Lexi-Drugs COVID-19 Vaccine (mRNA) monograph

Lexicomp – Lexi-Drugs Coronavirus Disease 2019 Vaccine Tracker (includes links to trials)

Milken Institute – COVID-19 Treatment and Vaccine Tracker

Regulatory Affairs Professional Society (US) - COVID-19 vaccine tracker

 

Guidelines and other information

International

Centers for Disease Control and Prevention – Different COVID-19 Vaccines. Updated January 15, 2021.

International Coalition of Medicines Regulatory Authorities (ICMRA) - “expedite and streamline the development, authorisation and availability of COVID-19 treatments and vaccines worldwide.”

World Health Organization – Coronavirus disease (COVID-19): Vaccines - 28 October 2020 | Q&A. Updated December 12, 2020.

 

National

Public Health Agency of Canada – Guidance on the prioritization of initial doses of COVID-19 vaccine(s). Publication date: December 18, 2020.

Public Health Agency of Canada – Recommendations on the use of COVID-19 vaccines. Publication date: January 12, 2021.

Public Health Agency of Canada – Vaccines and treatments for COVID-19: Vaccine rollout. Updated January 13, 2021.

Indigenous Services Canada – COVID-19 vaccines and Indigenous peoples. Publication date: December 23, 2020

 

Provincial

British Columbia

BC Centre for Disease Control – COVID-19 vaccination at a glance. Updated: January 7, 2021

Doctors of BC -  Vaccine roll-out toolkit for doctors’ offices –- provides products for doctors and their staff to use to address questions from patients about the COVID-19 vaccine. Updated: December 2020.

Yukon

Government of Yukon – COVID_19 Vaccine – vaccine schedule and appointment booking, vaccine strategy and rollout schedule. No date.

Northwest Territories

Government of the Northwest Territories - COVID-19 Vaccine – includes vaccine information in multiple languages. Updated January 8, 2021.

Alberta

Government of Alberta - COVID-19 vaccine distribution. Updated January 13, 2021.

Alberta Health Services – Vaccine COVID-19 – Frequently asked questions. Updated January 11, 2021.

Saskatchewan

Government of Saskatchewan - COVID-19 Vaccine - delivery strategy, vaccine information, and information for health care workers. No date.

Manitoba

Province of Manitoba – COVID-19 Vaccines – includes Q &As, Information for Health Professionals, and eligibility criteria. No date.

Nunavut

Nunavut Department of Health - COVID-19 Vaccination – includes vaccine information, rollout and FAQs. No date.

Ontario

Government of Ontario - COVID-19 vaccines for Ontario – vaccination status, safety and rollout. Updated January 15, 2021.

Ontario College of Family Physicians - COVID-19 Vaccines – curated list of provincial and federal vaccine information. No date.

Public Health Ontario - COVID-19 Vaccines – Updated January 13, 2021.

Quebec

Government of Quebec - Progress of the COVID-19 vaccination – vaccine development, safety and priority groups. Updated January 14, 2021

New Brunswick

Government of New Brunswick – Vaccine – development, rollout and information for health professionals. No date.

Nova Scotia

Nova Scotia Health - COVID-19 Vaccine – vaccine information and distribution plan. No date.

Prince Edward Island

Government of Prince Edward Island - COVID-19 Vaccines and Immunization Program – vaccination status, rollout schedule, and safety. Updated January 12, 2021.

Newfoundland

Government of Newfoundland and Labrador – COVID-19 Immunization Plan for Newfoundland and Labrador – vaccine information, administration and resources for health care professionals. No date.

 

Ethics and medical-legal resources

Canadian Medical Protective Association (CMPA) – Vaccination - “As the COVID-19 vaccination rollout expands, there are a number of medical-legal considerations physicians will want to be aware of.”

National Collaborating Centre for Healthy Public Policy/ Institut national de santé publique (Québec) – Public Health Ethics and COVID-19: Vaccination – Selected Resources. Updated December 2020.

 

Webinars and podcasts

Association of Medical Microbiology and Infectious Disease Canada, Public Health Agency of Canada. COVID-19 vaccine foundations webinar for health care providers

National Collaborating Centre for Infectious Diseases. NCCID hosts the Public Health Agency of Canada COVID-19 vaccine webinars for health care providers

 

Patient information

Canadian Medical Association, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada. Questions and answers on COVID-19 – See Vaccines and Vaccination section (current as of January 5, 2021).

EBSCO - Patient decision aid for Covid-19 Vaccination. Updated December 21, 2020.

Immunize BC -  COVID-19 Vaccine Frequently Asked Questions

Lexicomp:

MayoClinic - COVID-19 vaccines: Get the facts

Ontario Ministry of Health - Vaccine safety.

 

Pre-populated literature searches

Vaccines in PubMed search by the SMHS & EMHS Library and Information Service

Google Scholar Pfizer or Moderna vaccines search  by Dean Giustini – Coronavirus Disease 2019 (COVID-19)—For Beginners to Experts - University of British Columbia.

 

Need more information or have a more focused clinical question on COVID-19 vaccines or any other clinical topic of interest? Contact the Ask a Librarian team to request a literature search.

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This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule.

About the author(s)

Joule’s medical librarians are the professionals behind “Ask a Librarian”, a service for all CMA members looking for clinical search expertise. This experienced team of librarians can support you by searching on your behalf, teaching you effective search strategies or training you to use our clinical resources.

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