Kids will now get vaccinated

Millions have unfortunately already been infected - we can’t undo that

Let’s not ignore it but use it to our benefit

Data shows Infxn + 1 dose Is as good as 2 dose in uninfected

Here’s a simple strategy to conserve vax and reduce burden

When kids show up to get their first dose of a vaccine, they are simultaneously offered an antibody test. The sample for the antibody test can be a simple mouth swab of the gums (or a blood draw - but I prefer a swab of gums personally since it’s painless and easy.

Now that the kid has their first vaccine AND a sample for antibody test, there will be 3-4 weeks to confirm if the child has antibodies to COVID.

This long period of time offers tons of flexibility to ensure a highly accurate result is obtained - I’ll give examples below

If a child is confirmed positive for pre-existing antibodies to SARS-CoV-2, this implies that they have already been infected.

At this point, parent can receive a text message/email etc stating the Ab test is positive and the child is considered fully vaccinated from 1 dose

This could ultimately save perhaps millions of doses of vaccine that can be offered to others, AND will save tens if not hundreds of millions of hours of lost work bringing kids to get the vaccine across the US.

Many people will say that this will be too complex and difficult and don’t fix something that isn’t broke.

I disagree. The hundreds of millions of hrs of work lost is not something to ignore. Nor are effects of a 2nd dose in many.

It’s worthwhile to think critically here

So how will this work??


We can use a fast antibody test that takes ten minutes to complete at the time of first Vax. Indeed one is EUAd for use with an oral gum swab

If the test is negative, then the child is told they’ll need a second dose. Doesn’t matter if it’s false negative - it’s taking the standard dosing approach.

But on other hand if sample is positive for antibody, we label it tentative.

The specimen is sent to a lab for a different confirmatory antibody test. Time isn’t critical here. Just needs to be done in 3-4 (or more if spacing more) weeks.

This is 100% doable w current resources.

If we do this it will greatly reduce resources required for vaccinating our kids, it will use science as it should be used in a pandemic, and it will demonstrate an ability to think clearly and critically and plow a path for future efficiency gains. Including for boosters

Importantly, it also offers an appropriate recognition of both how the immune system works and many parents concern about getting their children vaccinated (correct or not, it’s real and we can’t ignore it so we may as well demonstrate a willingness to meet halfway)

Everything we know suggests this will be safe, effective and efficient Public Health

We haven’t done well on the latter… not too late to start

Millions of doses would save many many older individual’s lives in poorer nations w out high vax coverage

Let’s make this effort

Also, let’s say that the rapid antibody test isn’t available. That’s Ok!

We can take a simple fingerprick blood draw on filter paper at the time of vaccination. This can be sent to a lab for testing for antibody. Again - time isn’t critical here. Have 3-4 weeks at least.

And to be very very crystal clear - this would be OPTIONAL for the millions of people who may want an option of a single dose IF they are confirmed to have prior infection.


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More from @michaelmina_lab

1 Nov
I truly dislike the term "Natural Immunity"

There is no such thing as artificial immunity

A vaccine drives a NATURAL immune response

The question is simply "how do you want to start building that immunity?" Through a risky infection or via a safe vaccine

Me? I choose vaccine.
Vaccines are one of the most holistic interventions we have in medicine and public health.

Vaccines utilize our natural evolved processes to provide our immune system with an Education.

They aren't a pill that kills pathogens by distributing to all our tissues...

Vaccines are perhaps the most natural thing we do in medicine to protect ppl from infections

Vaccines are small proteins that get taken up naturally by our immune cells.

The immune cells do exactly what they evolved to do naturally. Vaccines don't force anything.

Read 7 tweets
1 Nov
“I will plan to return to work in person at the conclusion of the ten day quarantine following a negative rapid test..."

Great use of a rapid test!

Importantly she’s not using a PCR test bc she’d still remain PCR pos, potentially for weeks.

Why is this important?

Bc imagine that she did not test early and isolate and got a PCR positive AFTER the day her isolation would have ended.

SHE would have to START an isolation that day, for ten days, even though she was NO LONGER INFECTIOUS


Let’s say in this scenario that @PressSec was not in contact w @POTUS when she was actually infectious bc Biden was in Europe.

But then they were in contact AFTER the infectious period, and just before she got the 1st (in this scenario) positive PCR test

Read 7 tweets
30 Oct
Recognizing a need for boosters in vulnerable when it comes to Delta & recognizing their benefit - which thus far seems high (even if turns out to be temporary)…

Why are we still vaccinating w mRNA sequence of the now obsolete Wuhan strain when we know the sequence for Delta.
This is only half sarcastic as a question.

Is it purely bc full trials haven’t been completed? Is it bc we don’t agree w an added benefit of using a sequence matching the most common and destructive variant?

My opinion is there would be benefit (or at least equivalency)
If we continue to Reenforce a response to the 1st virus, we may find ourselves stuck in that version of a response when we do want to make an update to the vaccine later on. Better to stay current.

Also, we know Delta has evasive mutations vs original immune response
Read 4 tweets
30 Oct
A common question today:

Q: “Can I get a flu vaccine at same time as a Covid vaccine?”


The immune system evolved to be able to respond to MANY targets simultaneously. Similar to parallel processes on a computer, the immune system has enormous parallel capability.
For example, in my research largely pre-COVID, we profile immune responses to pathogens and vaccines.

In a single vaccine or infection, the immune system responds to an enormous array of different “epitopes” on even one pathogen or vaccine.

When we add additional vaccines to the mix, it simply adds an extra set of epitopes (the parts of the vaccine or pathogen that the immune system recognizes) and our amazing immune systems don’t miss a beat

Read 4 tweets
29 Oct
Another EUA for a molecular home test!

At the start of the pandemic,
was one of the first to understand that we needed to get widespread access to rapid accurate and inexpensive Covid tests…

He came up with a prototype, put together a team of microbiologists & engineers and set out to develop a molecular (PCR like) test that could be used in the home, quickly…

Fast forward 18 months and
@DetectTest is an FDA authorized rapid molecular home test.

It’s an incredible feat going from 0 to EUA in 18 months. (Most molecular test companies existed for years preCOVID)…

Read 5 tweets
29 Oct

It’s OK to talk about the biological limitations of vaccines without being anti-vax


Just bc we wish vaccines stop transmission, doesn’t make it so. Vax limit spread a bit, but we’ve known for months that breakthroughs are not rare and spread among vax is common

Does this mean that COVID vaccines don’t work? Absolutely not. They work great… for what they were measured and authorized to do - stop disease.

They weren’t authorized for their ability to stop spread. Vaccines work! Let’s be open both about what they do and don’t do well

The more we try to toe the line and not quite be open w the limitations of vaccines - often suppressing messaging about their limitations - the more those limitations come back to haunt us in the form of loss in confidence across the population in the whole vaccine program.

Read 9 tweets

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