Thread by @michaelmina_lab

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

Thread
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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.

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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

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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

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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.

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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

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So how will this work??

Example:

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

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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.

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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.

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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

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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)

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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

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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.

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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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