Allison writes:

Dear most highly esteemed TWiV team!

Like your other avid fans, I have been listening with great interest for months. I first found you after I tested positive with SARS-CoV-2 on Halloween 2020. Re-immersing myself in immunology and virology helped me understand what was happening within my own body, and helped me visualize my T cells carrying spike to the germinal centers where the antibodies would train following somatic hypermutation (did I get that right?!).

When I got my rapid results, I put a cardboard note out on our front porch and didn’t even toss candy to kids. I slept in our closet, propped windows, wore a mask constantly, ate in a separate room, and thankfully no one else got it. I wanted a medal for keeping household transmission to zero, but we moved on and just focused on trying to keep exposures low. My husband is now fully vaccinated, and teen boys have remained PCR-negative. Although they are low risk, I feel like vaccination is the “cleaner” way to develop immunity. I really did not like hearing about immunomodulation in the germinal centers in episode 685 – fascinating as that was! I’m hoping vaccinations for kids will be available before they pick it up naturally. The down side of knowledge is now I’m a terrible hovering hypochondriac tuned in to subtle symptoms in my kids, and even myself. The risk of reinfection prompted me to turn once again to immunology – the under-appreciated T cells, and a new test…the subject of this email at long last!

I have exciting and very nerdy news you will appreciate.

Quest Diagnostics JUST approved test code 34499 which is a semi-quantitative anti-spike Ab test available by direct purchase for $119. The “index” value I got (attached) was 11.21 with ref >= 1.0 being positive. There is no ref range yet other than an interval of 0-20 on the documentation related to the EUA. Not satisfied, I wanted to know the distribution of values and where my index fell so I chased documentation and references for the specific test they use at Quest.

From the list of references in this FAQ, #7 led me to the FDA documentation. Looks like a quant of 11.21 is midway to the interval range of 0-20, and higher than most of the test panels they ran.

Very interesting! What do you make of it? I’m 4.5 months post positive test, and I plan to give my husband a test when he is 4.5 months post full vaccination. I know this is only an n of 2, but it’s still super cool. If I really want, I can go get tested monthly for the next 6 months and plot my own curve. I’m merely a freelance epidemiologist and medical/technical writer filling most of my time on volunteer work in the community supporting the youth ice hockey program through a challenging season. It  has been such a privilege to work with the hockey director, the coaches, and the parents to implement intensive protocols and the kind of collaborative relationships needed to foster good communication. I could go on, but just visualize me filling up a white board calendar with quarantine and isolation timelines during a phone consult with a family following community exposure. Our goal was to keep the transmission within our teams to zero if possible by keeping covid outside the rink. I took a picture of the whiteboard and sent it to the family, then briefed the director. What an amazing boots-on-the-ground experience and great way to immerse in a new community having just moved from Yokosuka, Japan in Sept 2020. One pandemic, two countries, two cultures, two radically different experiences. I count myself fortunate in many ways.

In any case, thank you for keeping me informed and sane! I tell EVERYONE about you. Really need to get some TWiV swag now to go with this index value 😉

Take care!
Alli Krug, MPH
Principal and Owner, Artemis Biomedical Communications LLC

~ I’m not lost if I know where I am.
~ “He went to the cities, I went to the forests.” (Chateaubriand of de Tocqueville)

Brian writes:

Hi. Long time listener, especially of TWIV, way prior to the pandemic. Love all your shows. 

One question I hope you can help me with theorizing about that has been bothering me for months, since hearing about the mRNA covid vaccines, currently the ones  by Pfizer and Moderna, and the DNA vaccine by Janssen.  Since these vaccines harness the vaccinated individual’s cells to create the antigen, in the form of a spike protein, that other cells in the person then recognize as “not self”, isn’t there at least a hint of a possibility, if not a giant chance, of the body learning who the real culprit is and attacking them, meaning attacking your own cells that are making the antigen  – and then going on to attack all other cells in the body that are the same cell type. Is this not the perfect recipe for an autoimmune disease?  

I have scoured articles, interviews, and podcasts and only found one brief discussion of this.  I find this truly fascinating and to be honest also a little scary, especially when considering cost/benefit in using these vaccines to vaccinate children, when there is no long term data on the safety of these vaccines and as the potential harm to children from Covid-19 is important, but of a smaller magnitude than in the elderly or other high risk groups. 

Thanks for considering discussing this. I am not a vaccine denier by any means, and actually as a Pediatric Nurse Practitioner spend time with lots of parents discussing the benefits of getting their kids vaccinated as per CDC guidelines….But this one is new and different. 

From sunny Sacramento, California

Brenda writes:

Don’t know if you have heard.

 New French coronavirus variant appears to bypass standard tests. “While harder to detect, the “initial analyses of this new variant doesn’t suggest either increased severity or increased transmissibility,”

WHO Presser is tomorrow (Friday) so we may get info before your next recording.

May I suggest that you cover WHO and its work (as it relates to virology) in some future podcast?  Would be interesting, I’m sure.


Keith writes:

I don’t usually do poetry, but this idea came to me after my second shot of Pfizer’s vaccine today. To the tune of Mister Sandman.

Oh Mister Virus
Oh SARS coe-vee two

Here comes a vaccine
Made especially for you

It’s got the blueprint
Of your spike protein

It’ll teach my B cells
How to wipe you clean

Say Mister Virus
Say Covid-nineteen

You’re gonna get a kick
Like you’ve never seen

When those antibodies
They grab on your spikes

And those big old T cells
Come and make you say “Yikes”

Hey Mister Virus
Hey SARS coe-vee two

What will you do when there are
No hosts for you

You caused a pandemic
Of that there’s no doubt

But human ingenuity
Will wipe you out

— Keith from Minnesota