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Effectiveness of heterologous and homologous covid-19 vaccine regimens: living systematic review with network meta-analysis

BMJ 2022; 377 doi: https://doi.org/10.1136/bmj-2022-069989 (Published 31 May 2022) Cite this as: BMJ 2022;377:e069989

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Re: Effectiveness of heterologous and homologous covid-19 vaccine regimens: living systematic review with network meta-analysis

Dear Editor

We would like to clarify that the table of the estimates extracted from each of the included studies as mentioned by Prof Cowling has been posted along with the codes in the GitHub link (folder Data), which we have already included in the original main text.

We thank Prof Cowling for pointing out the heterogeneity problem which has already been considered in our review planning and accounted for in our analysis. According to the Cochrane training handbook, source of heterogeneity can be explored by performing subgroup analyses. Hence, we performed subgroup analyses by re-analysing studies that investigated the variable of interest (age, ethnicity, immunocompromised or not, or covid-19 variant) with all other factors controlled. We controlled the co-factors in each subgroup to minimize bias induced in the final estimates, which addressed Prof Cowling’s concern of heterogeneity when pooling results.

We are now amidst the continuing process of updating our living systematic reviews with network meta-analysis with any new and carefully vetted publications in a timely fashion to serve the public.

Yours truly

Wing Ying Au
Peter Cheung

Competing interests: No competing interests

15 June 2022
Peter Pak Hang Cheung
Assistant Professor
Wing Ying AU
The Chinese University of Hong Kong
Li Ka Shing Medical Sciences Building, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong