In order to participate in the study, you must meet these criteria. Cannot have had a COVID vaccination yet (and will be receivng your vaccination at UCSF or elswhere, we do not provide vaccines) Not have serious health conditions that directly affect immune system (eg, autoimmune). Have a smartphone or computer Be 18 years or older Speak English and be able to fill out questionnaires in English Not currently pregnant

For your first visit for the study, you will come to our clinic at the Rutter Center at Mission Bay located at 1675 Owens St, San Francisco. For the following visits, you will visit the UCSF Clinical Research Center at Parnassus, located at 400 Parnassus Avenue, A101 in San Francisco.

You will fill out questionnaires at 4 time points and have 3 blood draws. The questionnaires involve one 15–20-minute packet, which mainly asks about health, mood and stress. Then you will fill out a daily questionnaire. See the timeline for more details.

No costs are associated with your participation in this study.

You can get paid up to $300 for completing all aspects of this study. You will receive your compensation via mail after completing each of the 7-day daily diaries. For You will receive $100 compensation after the second round of daily diaries, which occurs right after your second vaccination. (If you have J&J you will be paid after your first round of daily diaries). For visit 2: $100 after the 7- day daily diary (one month after vaccination #2). Lastly, for visit 3: $100 after the 7- day daily diary. (six months after vaccination #2). One-hour parking vouchers will also be provided for each of the 3 blood draws.

You will complete four rounds of 7 day daily diaries during your participation in the study. There are two diaries per day, one in the morning around 7 AM and one in the evening around 7 PM. Daily diaries are delivered to you via email or SMS, depending on if you opted into text messages while completing the baseline survey. First Vaccination: You will start recieving your daily diaries the day prior to your first vaccination and continue them for 7 continous days. Second Vaccination: You will start recieving your daily diaries the day prior to your second vaccination and continue them for 7 continous days (unless you have recieved the J&J vaccine). Follow Up Appointment 1: You will start recieving your daily diaries on the day of your first follow up visit. Follow Up Appointment 2: You will start receiving your daily diaries on the day of your second follow up visit. ENROLLED PARTICIPANTS: We often have techincal difficulties with our surveys and it is crucial that we know of your vaccination dates as soon as possible to know when your daily diaries should be sent out. Please email us at BOOSTstudy@ucsf.edu if you notice you are missing a daily diary or if you have not told us your vaccination dates.

We would ideally like you to answer all the questions because it helps us get the best data possible, allowing us to determine for whom the vaccine works best for and why. If certain questions make you very uncomfortable, we ask that you pause the survey and return back to it after a certain period away (you have one week to finish the survey after starting it). If upon returning, you still cannot answer the question(s), then you may omit it.

You can end at any time. There will be no penalty to you in any way for dropping out. However, it is essential that you carefully weigh your decision to join before enrolling in the study. In consenting to participate, you have made a commitment both to yourself and to the scientific quality of the research. In these studies, it is very important that we minimize the number of people who drop out of the study as we have limited enrollment slots. While we will honor your right to drop out of the study at any time, we appreciate you considering this decision and the scientific integrity of this study.

We suggest that you complete all surveys in one sitting, but if you happen to exit out, then you may return to your survey where you left off. As long as you return on the same device (your computer or smartphone), then your answers will be saved.

Fortunately, the COVID vaccinations offer strong protection from developing COVID-19 (94.1 to 95% protection from severe symptoms of COVID). However, there is still a lot to learn about how strong the vaccination is for different people. We know from studying other vaccines, as well as from initial studies of COVID-19 vaccinations, that when we look at blood to measure individual’s immune responses there is still a lot of differences in the level of antibodies that different people produce. We will measure the antibody response to understand what predicts a strong response one month later, and what predicts the ability of the body to maintain high levels of antibodies over time (6 months after that). The CDC estimates that the flu vaccination is 70% to 80% effective in preventing the flu (based on large review of randomized placebo-controlled trials of healthy adults). However, the effectiveness of that vaccine is not as strong in older adults. A quantitative review of 30 large studies on the antibody response to flu vaccination estimates that for people 65 years old the protection is only 17% to 53% (Goodwin et al, 2006). Therefore, it is important to examine the influence of age on response to the COVID-19 vaccine as well as other the factors that may play a role in how well we respond to the vaccine. Psychological stress has been shown to impact the immune responses (O’Connor et al, 2021). The global COVID-19 pandemic has led to many types of stressors, such as financial stability, psychological distress, anxiety, and depression, while the need for social distancing has resulted in social isolation and loneliness. Our BIPOC communities have been especially burdened both with stress as well as discrimination. In addition, the Bay Area is experiencing climate crises, from wildfires to heatwaves. Our communities are under tremendous stress. We will measure an array of challenges as well as factors that protect us from stress and if these predict COVID-19 vaccination responses. You can read more here from the UCSF News Center: New Study Will Examine How Robustly Individuals Respond to COVID-19 Vaccination Citations: Goodwin, K., Viboud, C., & Simonsen, L. (2006). Antibody response to influenza vaccination in the elderly: A quantitative review. Vaccine, 24(8), 1159–1169. https://doi.org/10.1016/j.vaccine.2005.08.105 O'Connor DB, Thayer JF, Vedhara K. Stress and Health: A Review of Psychobiological Processes. Annu Rev Psychol. 2021 Jan 4;72:663-688. doi: 10.1146/annurev-psych-062520-122331. Epub 2020 Sep 4. PMID: 32886587.

Our only blood draw site for the initial study visit is at UCSF Mission Bay Campus. We do not offer any other locations, unfortunately. For the follow up blood draws, they will be held at Parnassus campus in San Francisco. See exact addresses in the second question above.

Rescheduling appointments is very difficult due to the protocols Clinical Research Services has in place. We ask participants to adhere to their scheduled appointment as much as possible. We cannot accomodate any changes to the schedule without at least 48 hours notice. If you need to cancel or reschedule your appointment due to an emergency, please contact us as soon as you can by emailing BOOSTstudy@ucsf.edu and we will do our best to help accomodate you.

No, the BOOST Study does not provide COVID-19 vaccine doses. You can reach out to your primary care practitioner regarding vaccine eligibility.

You must join before your first vaccination. We are sorry that we cannot enroll people who have already had their first COVID-19 vaccination.

Yes. We will be able to accommodate whichever vaccine you receive, and still be part of the study. In the study timeline, the differences will be as follows: You can ignore the listed procedures for the second vaccination (which includes a daily diary). You will have your second blood draw one month after the initial vaccination (instead of after the second vaccination)

An antibody (also called immunoglobulin) is a protein the immune system creates when it is exposed to antigens (viruses or foreign substances). Antibodies (shown below) latch onto the COVID virus to remove it from the body. We are conducting a sophisticated assessment of how well your immune cells can fight the virus that causes COVID-19 (i.e., SARS-CoV-2 virus). The stronger the antibody response, the more likely the person will be able to fight off symptoms of illness.

Antibody maintenance is a critical clinical issue. If antibodies are not well maintained a year later, there may be a need for COVID-19 vaccine booster shots to restock the body with antibodies. Some experts think we will need annual booster shots for COVID-19 given the proliferation of variants of the SARS-CoV-2 virus. This is an open scientific question that the CDC has yet determined, and it will take time to answer. Therefore, understanding the predictors of a robust antibody response and maintenance are critical issues. Our study will provide data on the maintenance of the robust functional response of the immune system to clear the virus. We will measure factors that are known to affect antibody responses to other vaccines, including a range of psychological stress exposures, and markers of immune system aging (e.g., telomeres), and we may discover new factors that make a difference in long term response.

We anticipate to share results to participants in late spring of 2022 via email.

We are only giving out Oura ring to a few participants over the age of 50. If you qualify, then you will have access to the dashboard available on the mobile application, where you can view your data.

If you are having issues connecting your Oura ring, please follow instructions provided on their website which can be found here. If you are still having issues, you can contact the study staff at BOOSTstudy@ucsf.edu.

Unfortunatley, no. We are only enrolling current BOOST participants in this sub-study.

No, this is a completely optional part of the study and no one is required to continue. If you would like to continue, we will ask you to sign a new consent form.

Participation includes completing a questionnaire battery and a quick trip to UCSF Parnassus Campus for a blood draw 6-months after your booster shot. You may be asked to complete daily diaries the week of your booster vaccination.

The blood draw is at the same location as the last two visits, Clinical Research Services at the UCSF Parnassus Campus (400 Parnassus Ave). All proceedures will remain the same as the past visits, and free parking will be provided.

Participants that complete all parts of the follow up assessment will be compensated with a $100 Amazon E-gift card. Gift cards will be sent to participants via email.

Yes, all participants are welcome to continue their participation. Please make sure to report your booster vaccination date and type to a study staff member in order to schedule your follow up appointment in the correct time window 6 months later.