Efficacy and safety of COVID-19 vaccines: a systematic review.

OBJECTIVE: To evaluate systematically the efficacy and safety of COVID-19 vaccines. METHODS: PubMed, Embase, Cochrane Library, Clinicaltrial.gov, CNKI, Wanfang Data, China Biomedical Literature Service System, and China Clinical Trial Registry were searched for randomized controlled trials of COVID-19 vaccines published up to December 31, 2020. The Cochrane bias risk assessment tool was used to assess the quality of studies. A qualitative analysis was performed on the results of clinical trials. RESULTS: Thirteen randomized, blinded, controlled trials, which involved the safety and efficacy of 11 COVID-19 vaccines, were included. In 10 studies, the 28-day seroconversion rate of subjects exceeded 80%. In two 10 000-scale clinical trials, the vaccines were effective in 95% and 70.4% of the subjects, respectively. The seroconversion rate was lower than 60% in only one study. In six studies, the proportion of subjects who had an adverse reaction within 28 days after vaccination was lower than 30%. This proportion was 30%-50% in two studies and > 50% in the other two studies. Most of the adverse reactions were mild to moderate and resolved within 24 hours after vaccination. The most common local adverse reaction was pain or tenderness at the injection site, and the most common systemic adverse reaction was fatigue, fever, or bodily pain. The immune response and incidence of adverse reactions to the vaccines were positively correlated with the dose given to the subjects. The immune response to the vaccines was worse in the elderly than in the younger population. In 6 studies that compared single-dose and double-dose vaccination, 4 studies showed that double-dose vaccination produced a stronger immune response than single-dose vaccination. CONCLUSIONS: Most of the COVID-19 vaccines appear to be effective and safe. Double-dose vaccination is recommended. However, more research is needed to investigate the long-term efficacy and safety of the vaccines and the influence of dose, age, and production process on the protective efficacy.

Characterization of phosphorus leaching from phosphate waste rock in the Xiangxi River watershed, Three Gorges Reservoir, China.

Phosphate mining waste rocks dumped in the Xiangxi River (XXR) bay, which is the largest backwater zone of the Three Gorges Reservoir (TGR), are treated as Type I industry solid wastes by the Chinese government. To evaluate the potential pollution risk of phosphorus leaching from phosphate waste rocks, the phosphorus leaching behaviors of six phosphate waste rock samples with different weathering degrees under both neutral and acidic conditions were investigated using a series of column leaching experiments, following the Method 1314 standard of the US EPA. The results indicate that the phosphorus release mechanism is solubility-controlled. Phosphorus release from waste rocks increases as pH decreases. The phosphorus leaching concentration and cumulative phosphorus released in acidic leaching conditions were found to be one order of magnitude greater than that in neutral leaching conditions. In addition, the phosphorus was released faster during the period when environmental pH turned from weak alkalinity to slight acidity, with this accelerated release period appearing when L/S was in the range of 0.5-2.0 mL/g. In both neutral and acidic conditions, the average values of Total Phosphorus (TP), including orthophosphates, polyphosphates and organic phosphate, leaching concentration exceed the availability by regulatory (0.5 mg/L) in the whole L/S range, suggesting that the phosphate waste rocks stacked within the XXR watershed should be considered as Type II industry solid wastes. Therefore, the phosphate waste rocks deposited within the study area should be considered as phosphorus point pollution sources, which could threaten the adjacent surface-water environment.