With input from Dr Monica Vasudev

1351: Alternating Vaccines Trial Starts in the UK

1. The UK has started recruiting people for a first of its kind study to determine if using different COVID-19 vaccines for first and second doses is as effective as using the same vaccine for both the doses.
2. A heterologous prime-boost vaccination approach might be associated with better protection against COVID-19 in comparison with the use of the same vaccine for two doses. The study will be conducted for over a year.
3. Work has started on the enrolment of 820 participantsfor the randomized control study that will be conducted over 13 months, conducted by the National Immunisation Schedule Evaluation Consortium.
4. The ‘COVID-19 Heterologous Prime Boost study (Com-Cov)’ will initially include two vaccines which are being used in the community in the UK: Pfizer/BioNTech and AstraZeneca/Oxford.
5. Immunological evidence will be collected on different intervals (28 days v 12 weeks) between the first and second dose for a mixed-vaccine approach compared with control groups (same vaccine for both doses).
6. The trial will be conducted at eight different sites in England and will investigate eight different combinations:

• Two doses of the AstraZeneca/Oxford vaccine, 28 days apart
• Two doses of the AstraZeneca/Oxford vaccine, 12 weeks apart (as a control group)
• Two doses of the Pfizer/BioNTech vaccine, at a gap of 28 days
• Two doses of the Pfizer/BioNTech vaccine, at a gap of 12 weeks (as a control group)
• The AstraZeneca/Oxford vaccine first dose; Pfizer/BioNTech vaccine second dose, 28 days apart
• The AstraZeneca/Oxford vaccine first dose; Pfizer/BioNTech vaccine second dose, 12 weeks apart
• The Pfizer/BioNTech vaccine first dose; AstraZeneca/Oxford vaccine second dose, at a gap of 28 days
• The Pfizer/BioNTech vaccine first dose; AstraZeneca/Oxford vaccine second dose, 12 weeks apart

7. Dr Mary Ramsay, head of immunization at Public Health England, stated that it was vital to establish proof of principle that a heterologous prime-boost vaccination approach would protect people from COVID-19.

 (Source: Medscape)

1352: Worse COVID-related outcomes in people with HIV compared to those without HIV

1. Individuals living with HIV had worse COVID-related outcomes compared to those without HIV, including higher rates of severe disease requiring hospitalization, reported a study published in JAMA Network Open.
2. Overall, 2.8% (2,988 of 108,062) of the individuals living with HIV in New York State were diagnosed with COVID-19 through June 7, 2020. This was around 40% higher than that observed among persons without diagnosed HIV. Of the patients with COVID-19, 896 were hospitalized and 207 died through June 15, 2020.
3. Risk of hospitalization was found to increase with disease progression to HIV stage 2 and stage 3, in comparison with stage 1. (SOURCE: DG Alerts)

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA