Pre-vaccination testing could expand coverage of two-dose COVID vaccines

Carl AB Pearson ORCID logo; Sam Clifford ORCID logo; Juliet RC Pulliam ORCID logo; Rosalind M Eggo ORCID logo; (2021) Pre-vaccination testing could expand coverage of two-dose COVID vaccines. Wellcome Open Research, 6. p. 105. DOI: 10.12688/wellcomeopenres.16835.1
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<ns3:p>Recent evidence indicates that a single dose of mRNA-based vaccines produce similar immune responses in people with evidence of past infection compared with two doses in immunologically naive individuals. For COVID-19 vaccines with two dose regimens, point-of-care antibody testing for prior infection when administering the first dose could enable expanded vaccine access in a cost-effective manner. Generally, antibody tests with sensitivity and specificity well below that typically accepted for product licensure would still enable expanded vaccine coverage, though to be cost-beneficial total test cost (<ns3:italic>i.e.</ns3:italic> procurement and administration) needs to be less than roughly a third of total vaccine dose cost. For highly sensitive (90%) and specific (99%) tests, coverage could be expanded by more than 33%. Tests with the appropriate performance characteristics are plausible, though likely need setting specific tailoring.</ns3:p>



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