COVID-19 Update #113 for 12/8/2021

COVID-19 Vaccines

ISMP issued a warning regarding use of an incorrect dose of the Pfizer-BioNTech COVID-19 vaccine. The pediatric vaccine (10 mcg/0.2 ml) has been used in patients 12 and older and the adult dosage (30 mcg/0.3 ml) has been used in patients under 12. ISMP further warns against diluting the adult vaccine to make a pediatric vaccine. Due to the vaccine being a suspension and the small volume, it would not be possible to create an accurate dose. To avoid errors, ISMP recommends

• Storing the pediatric and adult vaccines in separate, labeled bins.
• Clearly labeling each prepared vaccine to differentiate adult and pediatric doses.
• Verifying each patient with two identifiers, such as name and age.
• Only bring one vaccine into the administration area at a time
• Document the lot and manufacturing date prior to administration and administration of the vaccine after it is given.
• Report all vaccine errors in VAERS. ISMP also request errors be reported to the ISMP VERP system

 
Medicago and GSK announced that in a 24,000 patient, Phase II/III trial (NCT04636697), where use of their COVID-19 vaccine had an overall vaccine efficacy 71% and 75.3% against the Delta variant.
 
A retrospective study of patients 21 years or younger who experienced myocarditis within 30 days of COVID-19 vaccination found most cases had a mild clinical course with rapid resolution of symptoms.
 
The 2,878 patient, Phase II, British COV-BOOST trial found that any COVID-19 vaccine can be used as a booster, regardless of the initial vaccine given. Patients received the Pfizer-BioNTech or AstraZeneca COVID-19 vaccines. After the Pfizer-BioNTech vaccine a good immunity boost was achieved with vaccines from Pfizer-BioNTech, Moderna, Johnson & Johnson, Novavax, AstraZeneca and CureVac. There was also a good boost in immunity after the AstraZeneca vaccine with the same set of vaccines, plus an investigational vaccine from Valneva
 
In the 1,072 patient, Phase III, Com-COV2 trial, patients received their first COVID-19 immunization with either the AstraZeneca or Pfizer-BioNTech vaccines. The second dose was given with the same vaccine, a vaccine from Moderna or Novovax. Both the Moderna and Novovax vaccines elicited higher antibody titers following the AZ vaccine than AZ’s own vaccine. Compared to a second dose of the Pfizer-BioNTech vaccine, Moderna elicited higher antibody titers, but Novovax did not.
 
COVID-19 Anti-Inflammatory
 
In the 28-day, 479 patient, Phase III, LIVE-AIR trial (NCT04351152), 84% of patients treated with lenzilumab were alive and did not require invasive mechanical ventilation compared to 78% with placebo in hospitalized patients with COVID-19, not requiring ventilation. 94% of patients received a corticosteroid, 72% received remdesivir and 69% received both.