In our first virtual journal club, we look at data on heterologous COVID booster shots or COVID booster jabs. Can you mix and match different version of the COVID vaccine?

COV-BOOST is a multicenter phase-II RCT from the U.K. that was published in December in the Lancet. Ref: Munro et al. Lancet . 2021 Dec 18;398(10318):2258-2276. doi: 10.1016/S0140-6736(21)02717-3 https://bit.ly/COV-Boost

For patients who had received Oxford/AstraZeneca or Pfizer/BioNTech, it compared the the following boosters Oxford/AstraZeneca, Pfizer/BioNTech, Moderna/NIH (100μg dose only), Johnson&Johnson/Janssen, CureVac, Novavax, and Valneva to active control groups.

Endpoints were biological activity/preliminary efficacy (anti-spike IgG at 28d - mean geometric ratios compared to pre-booster, neutralizing Abs against wild-type, pseudoviral neutralization, and T-cell response) as well as reactogenicity (solicited and unsolicited moderate and/or severe adverse events).

We go through what was known before, describe the study, summarize its results, critically appraise the methods, and mention what has been published since, in particular:

-Atmar et al NEJM 2022: D-MID-21-12 https://bit.ly/D-MID-21-12

-Clemens et al Lancet 2022: RHH-001 https://bit.ly/rhh-001

-Mayr et al NEJM 2022: VA research letter https://bit.ly/3I0CP1B

0:00 Intro and outline

1:10 What Was Known Before the Study?

2:31 Nuts and Bolts on COV-BOOST

3:57 What Was the Study Goal?

4:59 Which Combos of Boosters and Primary Series Were Studied?

9:02 Methods

10:32 (Some) baseline characteristics

11:12 Results - Antibody and T-cell concentrations

15:59 Results - Adverse Events

19:43 Results Summary

20:49 Critical Appraisal

22:44 What Has Been Published Since?

27:48 Q&A

35:00 Outro

Speaker: Ben Geisler

Video editor: Fernando Tábora

Date of recording: Feb 25, 2022

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