Background: During the COVID-19 pandemic, there was urgent demand from the global public health community for up-to-date information on real-world vaccine effectiveness (VE). Although traditional systematic reviews provide robust evidence, during a rapidly evolving health crisis, limited time and resources necessitated a more pragmatic, yet still systematic, approach. Landscape surveillance, the ongoing systematic mapping of available evidence, can help monitor the growing evidence on an emerging pathogen to quickly identify studies on key research questions.
Objectives: To report our experience using continual landscape surveillance to identify observational studies of COVID-19 VE against SARS CoV-2 variants of concern (VOCs).
Methods: As part of a living systematic review of COVID-19 randomized controlled trials (covid-nma.org), non-randomized COVID-19 vaccine studies were searched and screened weekly with ongoing data extraction. Observational studies evaluating one or more COVID-19 vaccines that reported VE (e.g., COVID infection, severe disease, hospital admission, COVID-19 related death) were included. Results were updated online weekly.
Results: Landscape surveillance provided easy and rapid availability of data for addressing questions requiring real-world COVID-19 VE evidence. Mapping informed the scientific community about the type, quality, and scale of COVID-19 vaccine research being conducted worldwide, including gaps and limitations. The data also informed policymakers in a time critical manner. In addition, the landscape results supported ongoing living systematic reviews on the effectiveness of different COVID-19 vaccine platforms (e.g., mRNA, non-replicating vector, inactivated virus, booster, etc.) against VOCs by identifying studies with the most relevant data for analysis.
Conclusions: Use of regular landscape surveillance and mapping continues to be effective in meeting immediate evidence needs of the global scientific and public health community during the COVID-19 pandemic. The landscape surveillance approach within a living systematic review could be used for future emerging pathogens to quicky identify studies when a new clinical question arises. Lessons learned regarding the need to anticipate possible research questions as knowledge about the pathogen changes are currently being implemented. Patient, public, and/or healthcare consumer involvement: This work has the potential to improve patient outcomes by advancing research methods that provide robust, yet timely, evidence to policymakers during a public health emergency.