Can you explain why fully vaccinated people shouldn't get tested? That makes no sense to me. You still have a gathering of people from multiple communities that are then going back into their respective areas. Asymptomatic spreaders seem to be an obvious concern here.
The rapid tests appear to be FSA eligible, so if your employer has a flexspend benefit, you're in luck. Of course this is ludicrously regressive (if your marginal tax rate is 25%, you're basically getting a 25% rebate on the test from the IRS).
I saw an opinion piece in, I think, NEJM, that intravascular introduction might be a factor in myopericarditis awhile ago. Mouse model data, however, aren't always transferable to the human.
"the amount of COVID-19 mRNA Spike-RBD gene copies in heart tissues was significantly higher in IV than IM group "
I find it disturbing that any were found at all in the IM group. Weren't were led to believe that the spike protein wouldn't be present anywhere in the body except localized near the injection site? Where are the spike protein/vaccine biodistribution studies?
Aside from small-vessel circulation within the muscle, you've also got lymphatic drainage. It's completely conceivable that not all the vaccine dose remains at the injection site. The deltoid is just a convenient place for an injection. A lot of the B- and T-cell impression occurs in the marrow. I'm much more interested in whether the issue is with the mRNA products or in the liposomal carriers used by, esp., Moderna. We're talking acute, usually sub-emergent, and short-lived. This doesn't sound like a protein issue, so much as a fat-soluble issue.
Agreed, not always transferable. The study did not identify which mice. Interesting that it did have one group of only male. I would repeat this experiment with mice expressing human ACE2.
Any further suggestions for those of us lucky enough to have at-home nucleic-acid amplification tests (NAAT) like Cue? My employer buys us Cue devices and lets us run up to 20 tests a month at their expense, on ourselves or those around us.
My understanding is that they're basically in between a true PCR test and a rapid antigen test for accuracy. But pragmatically, they run in half an hour like an antigen test.
I'm assuming the takeaway is just to treat it like you suggest an antigen test, though the Tuesday morning test is not as critical?
The stats Cue state are pretty close to PCR for sensitivity and specificity. Thanks for posting. I'd missed that test, and the Lucira noted below.
Regardless, home tests, especially antigen testing should be vanishingly inexpensive, allowing repeat testing when using the antigen systems (negative tests followed up 36-48 hours later to confirm) and/or allowing confirmation with the home PCRs.
I need to learn a lot more about the lab specifics surrounding the home "PCR" tests.
You don't mention the at-home rapid molecular test "Lucira Check-It". Results in 30 minutes. Yes it is very expensive ($75), but supposedly it gives more accurate results than the rapid antigen test? I think it is the same test that pharmacies give when you ask for a "rapid PCR" test? https://checkit.lucirahealth.com/
"More accurate" covers a lot of ground. Nucleic acid amplification tests (PCR) are more sensitive but may give false positives in the post-infection period. Antigen tests, performed serially, are likely to be sufficiently sensitive if "serially" is done right: at least 24 and preferably 30-36 hours between successive tests. Antigen tests are more sensitive when symptoms exist, OR if the viral load is sufficient for contagious condition. A positive antigen test is considered definitive; a negative is considered presumptive and needs to be repeated or augmented by a NAAT/PCR test to confirm or deny. Specificty of 97+% is sufficient to be comfortable with the outcome of a positive test, especially if the result occurs rapidly, in less than the nominal interval.
This is timely. And I'm already going off-label! We've someone we're working with who's younger than the recommended age for the test (Abbott BINAX-Now) who was exposed in school last Monday. I'm serially testing them today and tomorrow, days 6 and 7. If both are negative I've sufficient confidence to assume she is not going to convert to positive. Currently asymptomatic.
There are several reasons to use testing instead of simply quarantine that explaining my cause to jeopardize confidentiality, but I've sufficient confidence that this approach was selected. I am, of course, depending on Abbott's stated statistics to be accurate. It does help to have a background that allows for a critical assessment of their stats.
Can you explain why fully vaccinated people shouldn't get tested? That makes no sense to me. You still have a gathering of people from multiple communities that are then going back into their respective areas. Asymptomatic spreaders seem to be an obvious concern here.
The rapid tests appear to be FSA eligible, so if your employer has a flexspend benefit, you're in luck. Of course this is ludicrously regressive (if your marginal tax rate is 25%, you're basically getting a 25% rebate on the test from the IRS).
BNT162b2 Vaccine: possible codons misreading, errors in protein synthesis and alternative splicing's anomalies
https://www.authorea.com/users/348455/articles/503889-bnt162b2-vaccine-possible-codons-misreading-errors-in-protein-synthesis-and-alternative-splicing-s-anomalies
Please update this for the current upcoming holiday season, now that we have Omicron to contend with. Thank you
Intravenous Injection of Coronavirus Disease 2019 (COVID-19) mRNA Vaccine Can Induce Acute Myopericarditis in Mouse Model
Denmark has already changed the recommended injection procedure to include brief withdrawal of syringe plunger to exclude blood aspiration. https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab707/6353927
I saw an opinion piece in, I think, NEJM, that intravascular introduction might be a factor in myopericarditis awhile ago. Mouse model data, however, aren't always transferable to the human.
"the amount of COVID-19 mRNA Spike-RBD gene copies in heart tissues was significantly higher in IV than IM group "
I find it disturbing that any were found at all in the IM group. Weren't were led to believe that the spike protein wouldn't be present anywhere in the body except localized near the injection site? Where are the spike protein/vaccine biodistribution studies?
Aside from small-vessel circulation within the muscle, you've also got lymphatic drainage. It's completely conceivable that not all the vaccine dose remains at the injection site. The deltoid is just a convenient place for an injection. A lot of the B- and T-cell impression occurs in the marrow. I'm much more interested in whether the issue is with the mRNA products or in the liposomal carriers used by, esp., Moderna. We're talking acute, usually sub-emergent, and short-lived. This doesn't sound like a protein issue, so much as a fat-soluble issue.
Agreed, not always transferable. The study did not identify which mice. Interesting that it did have one group of only male. I would repeat this experiment with mice expressing human ACE2.
Any further suggestions for those of us lucky enough to have at-home nucleic-acid amplification tests (NAAT) like Cue? My employer buys us Cue devices and lets us run up to 20 tests a month at their expense, on ourselves or those around us.
My understanding is that they're basically in between a true PCR test and a rapid antigen test for accuracy. But pragmatically, they run in half an hour like an antigen test.
I'm assuming the takeaway is just to treat it like you suggest an antigen test, though the Tuesday morning test is not as critical?
The stats Cue state are pretty close to PCR for sensitivity and specificity. Thanks for posting. I'd missed that test, and the Lucira noted below.
Regardless, home tests, especially antigen testing should be vanishingly inexpensive, allowing repeat testing when using the antigen systems (negative tests followed up 36-48 hours later to confirm) and/or allowing confirmation with the home PCRs.
I need to learn a lot more about the lab specifics surrounding the home "PCR" tests.
You don't mention the at-home rapid molecular test "Lucira Check-It". Results in 30 minutes. Yes it is very expensive ($75), but supposedly it gives more accurate results than the rapid antigen test? I think it is the same test that pharmacies give when you ask for a "rapid PCR" test? https://checkit.lucirahealth.com/
"More accurate" covers a lot of ground. Nucleic acid amplification tests (PCR) are more sensitive but may give false positives in the post-infection period. Antigen tests, performed serially, are likely to be sufficiently sensitive if "serially" is done right: at least 24 and preferably 30-36 hours between successive tests. Antigen tests are more sensitive when symptoms exist, OR if the viral load is sufficient for contagious condition. A positive antigen test is considered definitive; a negative is considered presumptive and needs to be repeated or augmented by a NAAT/PCR test to confirm or deny. Specificty of 97+% is sufficient to be comfortable with the outcome of a positive test, especially if the result occurs rapidly, in less than the nominal interval.
This is timely. And I'm already going off-label! We've someone we're working with who's younger than the recommended age for the test (Abbott BINAX-Now) who was exposed in school last Monday. I'm serially testing them today and tomorrow, days 6 and 7. If both are negative I've sufficient confidence to assume she is not going to convert to positive. Currently asymptomatic.
There are several reasons to use testing instead of simply quarantine that explaining my cause to jeopardize confidentiality, but I've sufficient confidence that this approach was selected. I am, of course, depending on Abbott's stated statistics to be accurate. It does help to have a background that allows for a critical assessment of their stats.