Before the U.S. Food and Drug Administration (FDA) determines whether to approve a vaccine or authorize a vaccine for emergency use, clinical trials are conducted to determine vaccine efficacy.
After FDA approves a vaccine or authorizes a vaccine for emergency use, it continues to be studied to determine how well it works under real-world conditions. CDC and other federal partners will be assessing COVID-19 vaccine effectiveness under real-world conditions.
Such evaluations will help us understand if vaccines are performing as expected outside the more controlled setting of a clinical trial. As vaccine uptake increases nationally, we will also try to understand how well the vaccines:
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Perform in specific subpopulations
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Reduce the risk of infection (including infection without symptoms)
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Protect against milder COVID-19 illness
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Prevent more serious outcomes, including hospitalization
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Prevent spread of illness (e.g., whether people who have been vaccinated can still spread COVID-19 to others)
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Provide long-term protection (i.e., assess duration of protection)
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Protect against changes in the virus (new variants)
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Protect against COVID-19 when the vaccine is administered using a single dose or when the second dose is delayed, if these dosing regimens occur under real-world conditions
Several factors can affect real-world vaccine effectiveness, including:
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Population host factors (e.g., people not included in clinical trials who may respond differently to the vaccine)
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Virus factors (e.g., variants)
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Programmatic factors (e.g., adherence to dosing schedules or storage/handling of vaccines)
CDC will use several methods to study all of these factors, as they can all contribute different information about how a vaccine is working. Descriptions of planned evaluations CDC is conducting with partners, and, where relevant, links to protocols that detail the evaluation designs may be found below.
Select a study design below to get more information about the evaluation's name, population, outcome, protocol and participating sites.
Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel (RECOVER)pdf icon
Outcome
Symptomatic and asymptomatic SARS-CoV-2 infections
Population
Healthcare providers/first responders
Design
Prospective cohort
Participating Sites
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Baylor Scott and White Health, Temple, TX
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Kaiser Permanente Northwest, Portland, OR
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St. Luke's Hospital, Duluth, MN
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University of Arizona, Tucson, AZ
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University of Miami, Miami, FL
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University of Utah, Salt Lake City, UT
Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel (RECOVER) SARS-CoV-2 Household Transmission Studypdf icon
Outcome
Household transmission among healthcare workers with SARS-CoV-2
Population
Households of healthcare providers/first responders
Design
Prospective cohort
Participating Sites
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Baylor Scott and White Health, Temple, TX
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Kaiser Permanente Northwest, Portland, OR
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St. Luke's Hospital, St. Louis, MO
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University of Arizona, Tucson, AZ
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University of Miami, Miami, FL
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University of Utah, Salt Lake City, UT
Vaccine Safety Datalink (VSD)
Outcome
Hospitalization and severe disease with SARS-CoV-2
Population
Hospitalized adults
Design
Prospective cohort
Participating Sites
The health care organizations participating in VSD that will contribute data to this project will be confirmed soon.
Using COVID-NET and Immunization Registries to assess VE
Outcome
Hospitalization with SARS-CoV-2
Population
Hospitalized adults and children
Design
Screening method
Participating Sites
COVID-NET Sites
Evaluating SARS-CoV-2 Vaccine Effectiveness Among Health Care Personnel During Early Phase Vaccinationpdf icon
Outcome
Symptomatic SARS-CoV-2 infections
Population
Healthcare providers
Design
Test-negative prospective case control
Participating Sites
PREVENT Sites
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Baystate Medical Center, Springfield, MA
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Brigham and Women's Hospital, Boston, MA
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Jackson Memorial Hospital, Miami, FL
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Olive View-UCLA Medical Center, Los Angeles, CA
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Thomas Jefferson University Hospital, Philadelphia, PA
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Truman Medical Centers, Kansas City, MO
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University of Alabama Hospital, Birmingham, AL
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Community Regional Medical Center/ UCSF, Fresno, CA
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University of Chicago Medical Center, Chicago, IL
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University of Iowa Hospitals and Clinics, Iowa City, IA
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University of Massachusetts Memorial Medical Center, Worcester, MA
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LCMC Health Hospitals, New Orleans, LA
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University of Mississippi Medical Center, Jackson, MS
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University of Texas Southwestern Medical Center and Parkland Hospital, Dallas, TX
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University of Washington Hospitals, Seattle, WA
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Valleywise Health Medical Center, Phoenix, AZ.
SHEPheRD sites
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Duke University, Durham, NC
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Johns Hopkins University, Baltimore, MD
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Rush University, Chicago, IL
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University of Utah, Salt Lake City, UT
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Washington University, St. Louis, MO
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University of Wisconsin, Madison, WI
Emerging Infection Program Sites
CDC Artic Investigations Program sites
US Influenza Vaccine Effectiveness Network Protocol for Influenza and Other Respiratory Viruses (including COVID-19)pdf icon
Outcome
Symptomatic infection with SARS-CoV-2
Population
Outpatient adults and children ≥6 months of age
Design
Test-negative prospective case control
Participating Sites
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Group Health Cooperative, Seattle, WA
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Marshfield Clinic Research Institute, Marshfield, WI
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University of Michigan, Ann Arbor, MI
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Henry Ford Health Systems, Detroit, MI
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University of Pittsburgh Medical Center, Pittsburgh, PA
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Scott & White Healthcare, Temple, TX