COVID-19 : Antibody & Vaccination - Alternative Strategy

THE QUESTION

In the mid of 2021, we have arrived at the phase where we have started getting accustomed to the situations related to the Corona virus related infections (I am not using the word “pandemic” intentionally).

And whenever we start getting used to, we generally stop asking questions. Therefore, we are hurrying now, to be vaccinated.

We will touch upon the point who these “we” are, but at a later stage.

Now, the question which should have been asked at this stage, where a shortage of vaccine is one of the challenges of the vaccination drive, is this -

If corona vaccines make our bodies to create antibody, specific to Corona virus (SARS-CoV-2), then why aren’t we first doing antibody tests, and skipping vaccinations for those who already have developed the Corona specific antibodies due to past infections?

If we do that, the count of people requiring vaccinations, should ideally reduce, and the degree of shortage of availability of vaccines should decrease as well.

THE BACKGROUND

The question, that we asked in the previous section, arises if we try to arrange the logic around the viral infection and the related immunity processes.

So, to gather more knowledge around these logical paths, I did some studies. I found that this is what CDC is saying on this topic.

Antibody testing is not currently recommended to assess for immunity to COVID-19 following COVID-19 vaccination or to assess the need for vaccination in an unvaccinated person. Since vaccines induce antibodies to specific viral protein targets, post-vaccination serologic test results will be negative in persons without history of previous natural infection i f the test used does not detect antibodies induced by the vaccine.

Therefore, according to CDC, presence of Corona virus specific antibodies in our bodies are not to be considered for not being vaccinated.

Sounds contradictory, doesn’t it?

So, I thought, let’s recheck what the vaccines are doing. Aren’t they triggering the antibody creation process in our bodies, which is same as what our bodies do when we are exposed to and infected by the virus?

The answer was here.

In those with a normal immune system, sufficient IgG is produced to prevent re-infection. Vaccinations use this process to prevent initial infections and add to the catalog of IgG antibodies, by exposing a person to a weakened, live microorganism or to an antigen that stimulates recognition of the microorganism.

So, to confirm the logic, yes, vaccination does the same thing that our immune system does when exposed to the virus (antigen).

At this point, after realising that there is clear contradiction between what CDC is saying in this respect, and what science is doing, according to FDA, it was time for me to dig deeper. Means, more reading!

IS ANTIBODY TEST THE SOLUTION?

It seemed so. If you know that covid antibody present in your body, you should ideally be skipping the vaccination process.

However, why CDC is saying that presence of antibody should not be considered to decide not to get vaccinated?

Well, for that, here is a simple description of how antibody tests work, and determines the presence of the specific antibody.

The test centres check the Immunoglobulins’ (Ig) levels in our blood to determine the presence of various antibodies. Three classes of Ig are tested together generally - IgM, IgG and IgA, and the results are evaluated together. A spike in all those three Ig levels generally means a past occurrence of infection.

So, the next question that arose was, is these tests accurate enough to decide that it’s SARS-CoV-2, not the other viruses in the same family?

And according to FDA, the answer is no, it’s not. At least, yet. This is what they are saying.

Because antibody tests may detect coronaviruses other than SARS-CoV-2, such as those that cause the common cold.

Well, that sucks!

However, CDC is saying something a little different.

Before vaccine introduction, a SARS-CoV-2 serologic test that detects any of the N, S or RBD antibodies could be considered to indicate previous exposure to SARS-CoV-2.

Well, that really sucks!

THERE IS A PROBLEM

Yes, antibody tests can’t probably tell you very accurately, at least until now, and without more specific tests (checking subclasses of IgM, IgG and IgA), whether you have already developed covid specific antibodies.

At the time of writing this article, I do not have enough information about those specific tests - how costly those are, or what type of infrastructures they need and availability of that - to decide whether these tests can be done to determine presence of covid antibody faster than the vaccines can be administered.

SO, VACCINATION?

Yes, and No.

As we do not see any planning from the Govt to conduct covid antibody tests at a mass level, and deciding on the need of vaccination based on the results, that line of action is a moot point.

Thus, yes, vaccination is a way to develop the required antibodies.

Then why “No”?

Because, all that we discussed before about naturally developed antibodies, are also applicable for the vaccine induced antibodies. Including this -

How long anti-SARS-CoV-2 antibodies persist after infection remains unknown

That’s why, a No as well.

WHAT'S THE POINT, THEN?

That the naturally developed antibodies and the vaccine induced antibodies are same, based on what we know (or don’t know) till now.

Therefore, a covid antibody positive test result should have the same value of a vaccination certificate.

And, addressing the primary objective of this article, Govt should consider mixing antibody test strategy with vaccination strategy, to decrease unnecessary vaccinations, and thus targeting the right people for vaccinations, and optimising the pace to achieve herd immunity.

LAST, BUT NOT THE LEAST

I told that I will talk about “we” when I said this - “Therefore, we are hurrying now, to be vaccinated.”

Please remember that this “we” are a very handful of people among the entire 136 crore (136.64 crores as of 2019) population of India. According to my experience, a huge (I can’t use the word "majority" as I do not have the data ready) portion of the entire population doesn’t even know what a virus is.

All they know is that they have to work to get some food, which is mostly not sufficient, and that work is not available, mostly.

Therefore, I request you to think from others’ perspective too while you will re-read this article.

NOTE

All the referred sections are hyperlinked to the appropriate webpages.

I urge you to read those webpages too, they have interesting information.

And I urge you not to confuse the Govt with the Govt employees (who have updated those information), if you catch my drift.