Cleveland Clinic journal of medicine
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An effective vaccine is considered the best method to achieve herd immunity. As of February 2021, 12 vaccines were in late-stage clinical trials worldwide, with many more in development. ⋯ These vaccines use various platforms to deliver the vaccines, each with pros and cons. Published data show these vaccines are effective in preventing the severe symptoms associated with COVID-19 in adults with few side effects, but challenges remain with storage and delivery and treating virus variants.
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The authors review the rationale behind and approaches to testing for COVID-19, the quality of currently available tests, the role of data analytics in strategizing testing, and using the electronic medical record and other programs designed to steward COVID-19 testing and follow-up of patients.
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The home test kits for detecting SARS-CoV-2 infection with Food and Drug Administration emergency use authorization primarily use either isothermal nucleic acid amplification or antigen detection, and each test has advantages and limitations in terms of sensitivity and specificity, cost, results reporting, and results turnaround time. In clinical studies, these tests provide accurate positive results in symptomatic individuals, although negative results are less accurate. There are also accuracy concerns for positive results in asymptomatic individuals. These factors have implications for their clinical interpretation and use.
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Recent reports of allergic reactions to the Pfizer-BioNTech and the Moderna COVID-19 vaccines have resulted in questions about how and to whom they can be safely administered. Although anaphylaxis was not observed in clinical trials for either vaccine, there have been 21 reported possible cases of anaphylaxis associated with the Pfizer vaccine (11.1 cases per million doses administered) and 10 possible cases associated with the Moderna vaccine (2.5 anaphylaxis cases per million doses administered). ⋯ The overall incidence of anaphylaxis to COVID-19 mRNA vaccines is very low. By following recommendations from the US Centers for Disease Control and Prevention, an overwhelming majority of the US population can be safely immunized.