Jennifer\u00a0Abbasi<\/h3>\n\n\n\nJAMA.\u00a0<\/em>Published online October 21, 2021. doi:10.1001\/jama.2021.18919<\/h3>\n\n\n\nEarly in the COVID-19 pandemic, developers designed\u00a0SARS-CoV-2 antibody tests<\/a>\u00a0to detect whether people had been infected. Some experts thought the blood tests eventually would help to ease lockdowns. One idea was that those with antibodies likely would be immune to reinfection at least temporarily, allowing them to reenter society without putting themselves or others at risk.<\/p>\n\n\n\n![\"\"\/](\"https:\/\/cdn.jamanetwork.com\/ama\/content_public\/journal\/jama\/0\/m_jmn210058fa_1634764026.50618.png?Expires=1637921156&Signature=RYkIZ2BR9vIISeBfV6vDFcXW4aGMiWM5KeI63WtmhDQv~Wkm1naW7sOFtb1ZlTcJtsg54yOuio2pVmV4ugJh4534brLkkf8llyhQAAFeamLxgjQ0TOgNYZN6JVwGV3bUXroiG4Tsy4ZY1vokQmRrtcLZszpD600SEjMAjjUSAqR0Q1YIC6KZ5wPJJjLuf7bgEGkcp06uBeAHQpaWX-D6F8aSShZOU~n45lfrTmas~N5mUDZeZQEhbsfwWAlgtI4yuJrOYoG61jKSG64Y0GJIVksXV8LKljXF1437K11whQMUjKx4jFPMA6brOjhFWt94UtTM-snm16DNhiWQ-JIXMw__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA\")
<\/figure>\n\n\n\nBut as the pandemic unfolded, the concept of an immunity passport<\/a> based on having antibodies didn\u2019t pan out. The early consumer tests\u2019 accuracy was unproven, making the results somewhat dubious. More fundamentally, the so-called correlates of protection were unknown. Which specific antibodies guarded against SARS-CoV-2 reinfection? How high did their levels need to be? And how long would they provide a reliable defense?<\/a><\/p>\n\n\n\nAs the assays\u2019 usefulness for individual patients became less clear and testing for active infections expanded, the public\u2019s clamor for antibody testing waned. But for some, the arrival of COVID-19 vaccines revived their interest in serology. Could a simple blood test reveal whether the vaccine was working or, later, if it was time for a booster shot?<\/a><\/p>\n\n\n\nNo, says the US Food and Drug Administration (FDA), which discouraged antibody testing as a do-it-yourself immunity check in a communication<\/a> to the public and clinicians this past spring. A spokesperson for the agency reiterated the position in an email to JAMA<\/em> in September.<\/a><\/p>\n\n\n\nYet many aren\u2019t heeding the advice. A recent New York Times<\/em>\ufeff article<\/a> described concierge clinicians who regularly test their clients for SARS-CoV-2 antibodies. And Florida-based Epitome Risk Solutions promises<\/a> that the direct-to-consumer SARS-CoV-2 serology assay it sells for $170 \u201ccorrectly identifies the number of neutralizing antibodies you have with 100% specificity\u201d so that in \u201c24-48 hours you\u2019ll know if your immune system is still protecting you from COVID\u201d after vaccination or infection.<\/a><\/p>\n\n\n\nElitza Theel, PhD, director of the Mayo Clinic\u2019s Infectious Diseases Serology Laboratory, confirmed the worrisome trend. \u201cI am aware of individuals getting tested just to see if they\u2019ve \u2018reacted\u2019 to the vaccine or if they have \u2018immunity,\u2019 despite our best efforts to educate,\u201d she wrote in an email.<\/a><\/p>\n\n\n\nSerology Oversimplified<\/a><\/p>\n\n\n\nThe SARS-CoV-2 serology tests that eventually received FDA Emergency Use Authorization (EUA) have demonstrated high sensitivity and specificity<\/a>, but that accuracy is for detecting antibodies. Their ability to predict protection against the virus based on those antibodies hasn\u2019t been proven. Plus, the FDA cautioned that some tests detect antibodies the immune system likely produces only after natural infection with the virus. Depending on the assay, people who weren\u2019t previously infected could test negative for antibodies despite having vaccine\u2013induced immunity.<\/a><\/p>\n\n\n\nTherefore, the agency in its May 19 communication stated that \u201cresults from currently authorized SARS-CoV-2 antibody tests should not be used to evaluate a person\u2019s level of immunity or protection from COVID-19 at any time, and especially after the person received a COVID-19 vaccination.\u201d<\/a><\/p>\n\n\n\nThe problem isn\u2019t simply that the tests weren\u2019t designed to assess immunity, experts told JAMA<\/em>. It\u2019s also that the protective antibodies and their thresholds still haven\u2019t been fully worked out.<\/a><\/p>\n\n\n\nIn an email, Nicole Doria-Rose, PhD, a staff scientist and chief of the Humoral Immunology Core at the National Institutes of Health\u2019s Vaccine Research Center, noted that antibodies that bind to the SARS-CoV-2 spike protein\u2014particularly neutralizing antibodies\u2014\u201cdo correlate with protection.\u201d For example, higher titers were associated with increased protection in 2 phase 3 studies: one not yet peer-reviewed of the mRNA-1273 (Moderna<\/a>) vaccine and another of the ChAdOx1 nCoV-19 (Oxford\/AstraZeneca<\/a>) vaccine. Still, she wrote, \u201cit\u2019s not a simple relationship\u2014there is no clear titer at which you can say whether a particular person is protected.\u201d What\u2019s more, different neutralizing antibody thresholds, or even different immune responses altogether, may correlate with protection against asymptomatic, symptomatic, or severe disease.<\/a><\/p>\n\n\n\nTheel pointed to a recent study of breakthrough infections<\/a> among 1497 fully vaccinated health care workers in Israel. The 39 workers who became infected after receiving their second dose of the BNT162b2 (Pfizer-BioNTech) vaccine had lower neutralizing antibody levels than their uninfected colleagues. Although antibody levels were associated with protection, the researchers were unable to pinpoint a threshold. None of the cases was severe, but antibodies obviously weren\u2019t foolproof against the virus.<\/a><\/p>\n\n\n\n\u201cIndividuals can have neutralizing antibodies and still get infected,\u201d Theel said in an interview. \u201cWe know that higher antibody levels, specifically higher neutralizing antibody levels, are better. But we don\u2019t know how high is high enough.\u201d<\/a><\/p>\n\n\n\nMeanwhile, the laboratory tests haven\u2019t been standardized. \u201cThat\u2019s a problem when people say, \u2018Okay, I want to go see if I should get a booster or not,\u2019\u201d Theel said. Some SARS-CoV-2 serology assays simply give a positive or negative result, without antibody values. Those that are quantitative use varying methods, detect different antibody classes, and report values using different units of measurement.<\/a><\/p>\n\n\n\nAccording to Theel, if and when correlates and thresholds of protection are determined, the tests will need to be standardized and calibrated, as has been done with antibody tests for other vaccine-preventable diseases, including tetanus, diphtheria, and measles. So far, only one commercially available SARS-CoV-2 antibody test, from Ortho-Clinical Diagnostics, has been calibrated to the World Health Organization\u2019s reference standard, she said.<\/a><\/p>\n\n\n\nWhat\u2019s more, all antibodies bind but only some neutralize, and almost none of the authorized clinical tests distinguish between them. Although some studies have shown a correlation between levels of binding and neutralizing antibodies, they\u2019re still an imperfect match.<\/a><\/p>\n\n\n\nDoria-Rose noted that measuring neutralizing antibodies requires a complex test that is run in only a few laboratories and hasn\u2019t been scaled up for diagnostic use. The test sold through Epitome Risk Solutions\u2019 subsidiary, FourthWall Testing, appeared to be an at-home version<\/a> of the FDA-authorized GenScript cPass SARS-CoV-2 Neutralization Antibody Detection Kit, a surrogate assay that indirectly measures neutralizing antibodies. According to an FDA spokesperson, the cPass test does not have authorization for sample collection at home. And despite Epitome\u2019s marketing hype, GenScript states<\/a> that customers \u201cshould not interpret the results of this test as an indication or degree of immunity or protection from reinfection.\u201d<\/a><\/p>\n\n\n\nManaging Expectations<\/a><\/p>\n\n\n\nFor Paul Offit, MD, director of the Vaccine Education Center at Children\u2019s Hospital of Philadelphia, there\u2019s another strong argument against using blood tests to assess whether individual patients are protected: circulating antibodies don\u2019t give a complete picture of SARS-CoV-2 immunity.<\/a><\/p>\n\n\n\n\u201cThe immunological component that is associated with protection against severe disease is immunological memory B cells,\u201d Offit said in an interview. \u201cThese cells aren't making antibodies, but they remember that they have seen this SARS-CoV-2 spike protein before.\u201d<\/a><\/p>\n\n\n\nTheel noted that circulating antibodies against the virus peak 2 or 3 months after natural infection or vaccination and then begin to decrease. But the immune system\u2019s ability to mount a defense lasts longer. \u201cJust because we\u2019re seeing a decrease in antibody levels doesn\u2019t necessarily mean that your immunity is gone,\u201d she said. \u201cWe know from a lot of studies now that your memory T cells and memory B cells persist for at least 6 to 8 months and continue to evolve and mature, and none of that information is relayed by an antibody test.\u201d<\/a><\/p>\n\n\n\nOffit explained that reinfection with the virus activates memory B cells to differentiate into antibody-secreting cells. Because this process can take 3 to 5 days, it doesn\u2019t stop SARS-CoV-2 infections from occurring, but it does help tamp down severe COVID-19. And that\u2019s a success story, in his view: \u201cThe goal of the vaccine is to protect you against serious illness.\u201d<\/a><\/p>\n\n\n\nSo far, it has. Although data suggest that mRNA vaccine\u2013induced protection against infection and symptomatic illness is decreasing<\/a> in the US, the shots continue to prevent<\/a> serious disease, hospitalization, and death.<\/a><\/p>\n\n\n\nThe data seem to contradict a widely reported rise in hospitalizations<\/a> among vaccinated individuals in Israel. But according to Offit, Israel\u2019s COVID-19 hospitalization trends can\u2019t be applied directly to the US. \u201cThey do have a different definition to some extent for what they consider severe,\u201d he said. \u201cIt\u2019s less rigid than ours.\u201d<\/a><\/p>\n\n\n\nOffit served on the FDA vaccine advisory committee that recommended against a booster dose for most adults who received the BNT162b2 vaccine. For now, a booster is only authorized for people with the greatest risk of severe illness: adults aged 65 years or older and adults who have certain underlying medical conditions, live or work in high-risk settings, or live in long-term care facilities. (People who are moderately to severely immunocompromised<\/a> and received the BNT162b2 or mRNA-1273 vaccine should get an additional dose, according to the CDC.)<\/a><\/p>\n\n\n\nOffit said that as antibodies wane, susceptibility to asymptomatic or milder infections increases. In a recent US study<\/a>, the BNT162b2 vaccine was 93% effective against hospitalizations with the Delta (B.1.617.2) variant after 6 months, but its effectiveness against Delta variant infections overall fell from 93% in the first month after full vaccination to 53% after 4 months. The authors attributed the reduction mainly to waning immunity rather than the variant\u2019s escape from vaccine protection.<\/a><\/p>\n\n\n\nOffit acknowledged that any infection can be disruptive but pointed out the impracticality of using periodic boosters to keep neutralizing antibodies high. He said that\u2019s akin to \u201crolling the stone up the hill only to have it come back again.\u201d<\/a><\/p>\n\n\n\nAnd like Theel, he knows that some infections will still break through. \u201cYou can have a robust or high level of virus neutralizing antibodies in your circulation,\u201d he said. \u201cThat\u2019s not going to prevent the virus from attaching to your nose and beginning to reproduce itself. That\u2019s an asymptomatic infection.\u201d<\/a><\/p>\n\n\n\nManaging expectations for COVID-19 vaccines may be in order. \u201cI think there was maybe an initial misunderstanding amongst the public that this would just halt all infections, and that\u2019s just not the case,\u201d Theel said. Ultimately, her advice for avoiding a SARS-CoV-2 infection in the first place comes down to a now-familiar combination of measures: \u201cgetting vaccinated, frequently washing your hands, wearing a mask, and avoiding high congregate in-door settings, particularly in areas that have high case rates.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
Medical News & Perspectives October 21,&n […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20637"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20637"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20637\/revisions"}],"predecessor-version":[{"id":20638,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20637\/revisions\/20638"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20637"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20637"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20637"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Early in the COVID-19 pandemic, developers designed\u00a0SARS-CoV-2 antibody tests<\/a>\u00a0to detect whether people had been infected. Some experts thought the blood tests eventually would help to ease lockdowns. One idea was that those with antibodies likely would be immune to reinfection at least temporarily, allowing them to reenter society without putting themselves or others at risk.<\/p>\n\n\n\n But as the pandemic unfolded, the concept of an immunity passport<\/a> based on having antibodies didn\u2019t pan out. The early consumer tests\u2019 accuracy was unproven, making the results somewhat dubious. More fundamentally, the so-called correlates of protection were unknown. Which specific antibodies guarded against SARS-CoV-2 reinfection? How high did their levels need to be? And how long would they provide a reliable defense?<\/a><\/p>\n\n\n\n As the assays\u2019 usefulness for individual patients became less clear and testing for active infections expanded, the public\u2019s clamor for antibody testing waned. But for some, the arrival of COVID-19 vaccines revived their interest in serology. Could a simple blood test reveal whether the vaccine was working or, later, if it was time for a booster shot?<\/a><\/p>\n\n\n\n No, says the US Food and Drug Administration (FDA), which discouraged antibody testing as a do-it-yourself immunity check in a communication<\/a> to the public and clinicians this past spring. A spokesperson for the agency reiterated the position in an email to JAMA<\/em> in September.<\/a><\/p>\n\n\n\n Yet many aren\u2019t heeding the advice. A recent New York Times<\/em>\ufeff article<\/a> described concierge clinicians who regularly test their clients for SARS-CoV-2 antibodies. And Florida-based Epitome Risk Solutions promises<\/a> that the direct-to-consumer SARS-CoV-2 serology assay it sells for $170 \u201ccorrectly identifies the number of neutralizing antibodies you have with 100% specificity\u201d so that in \u201c24-48 hours you\u2019ll know if your immune system is still protecting you from COVID\u201d after vaccination or infection.<\/a><\/p>\n\n\n\n Elitza Theel, PhD, director of the Mayo Clinic\u2019s Infectious Diseases Serology Laboratory, confirmed the worrisome trend. \u201cI am aware of individuals getting tested just to see if they\u2019ve \u2018reacted\u2019 to the vaccine or if they have \u2018immunity,\u2019 despite our best efforts to educate,\u201d she wrote in an email.<\/a><\/p>\n\n\n\n Serology Oversimplified<\/a><\/p>\n\n\n\n The SARS-CoV-2 serology tests that eventually received FDA Emergency Use Authorization (EUA) have demonstrated high sensitivity and specificity<\/a>, but that accuracy is for detecting antibodies. Their ability to predict protection against the virus based on those antibodies hasn\u2019t been proven. Plus, the FDA cautioned that some tests detect antibodies the immune system likely produces only after natural infection with the virus. Depending on the assay, people who weren\u2019t previously infected could test negative for antibodies despite having vaccine\u2013induced immunity.<\/a><\/p>\n\n\n\n Therefore, the agency in its May 19 communication stated that \u201cresults from currently authorized SARS-CoV-2 antibody tests should not be used to evaluate a person\u2019s level of immunity or protection from COVID-19 at any time, and especially after the person received a COVID-19 vaccination.\u201d<\/a><\/p>\n\n\n\n The problem isn\u2019t simply that the tests weren\u2019t designed to assess immunity, experts told JAMA<\/em>. It\u2019s also that the protective antibodies and their thresholds still haven\u2019t been fully worked out.<\/a><\/p>\n\n\n\n In an email, Nicole Doria-Rose, PhD, a staff scientist and chief of the Humoral Immunology Core at the National Institutes of Health\u2019s Vaccine Research Center, noted that antibodies that bind to the SARS-CoV-2 spike protein\u2014particularly neutralizing antibodies\u2014\u201cdo correlate with protection.\u201d For example, higher titers were associated with increased protection in 2 phase 3 studies: one not yet peer-reviewed of the mRNA-1273 (Moderna<\/a>) vaccine and another of the ChAdOx1 nCoV-19 (Oxford\/AstraZeneca<\/a>) vaccine. Still, she wrote, \u201cit\u2019s not a simple relationship\u2014there is no clear titer at which you can say whether a particular person is protected.\u201d What\u2019s more, different neutralizing antibody thresholds, or even different immune responses altogether, may correlate with protection against asymptomatic, symptomatic, or severe disease.<\/a><\/p>\n\n\n\n Theel pointed to a recent study of breakthrough infections<\/a> among 1497 fully vaccinated health care workers in Israel. The 39 workers who became infected after receiving their second dose of the BNT162b2 (Pfizer-BioNTech) vaccine had lower neutralizing antibody levels than their uninfected colleagues. Although antibody levels were associated with protection, the researchers were unable to pinpoint a threshold. None of the cases was severe, but antibodies obviously weren\u2019t foolproof against the virus.<\/a><\/p>\n\n\n\n \u201cIndividuals can have neutralizing antibodies and still get infected,\u201d Theel said in an interview. \u201cWe know that higher antibody levels, specifically higher neutralizing antibody levels, are better. But we don\u2019t know how high is high enough.\u201d<\/a><\/p>\n\n\n\n Meanwhile, the laboratory tests haven\u2019t been standardized. \u201cThat\u2019s a problem when people say, \u2018Okay, I want to go see if I should get a booster or not,\u2019\u201d Theel said. Some SARS-CoV-2 serology assays simply give a positive or negative result, without antibody values. Those that are quantitative use varying methods, detect different antibody classes, and report values using different units of measurement.<\/a><\/p>\n\n\n\n According to Theel, if and when correlates and thresholds of protection are determined, the tests will need to be standardized and calibrated, as has been done with antibody tests for other vaccine-preventable diseases, including tetanus, diphtheria, and measles. So far, only one commercially available SARS-CoV-2 antibody test, from Ortho-Clinical Diagnostics, has been calibrated to the World Health Organization\u2019s reference standard, she said.<\/a><\/p>\n\n\n\n What\u2019s more, all antibodies bind but only some neutralize, and almost none of the authorized clinical tests distinguish between them. Although some studies have shown a correlation between levels of binding and neutralizing antibodies, they\u2019re still an imperfect match.<\/a><\/p>\n\n\n\n Doria-Rose noted that measuring neutralizing antibodies requires a complex test that is run in only a few laboratories and hasn\u2019t been scaled up for diagnostic use. The test sold through Epitome Risk Solutions\u2019 subsidiary, FourthWall Testing, appeared to be an at-home version<\/a> of the FDA-authorized GenScript cPass SARS-CoV-2 Neutralization Antibody Detection Kit, a surrogate assay that indirectly measures neutralizing antibodies. According to an FDA spokesperson, the cPass test does not have authorization for sample collection at home. And despite Epitome\u2019s marketing hype, GenScript states<\/a> that customers \u201cshould not interpret the results of this test as an indication or degree of immunity or protection from reinfection.\u201d<\/a><\/p>\n\n\n\n Managing Expectations<\/a><\/p>\n\n\n\n For Paul Offit, MD, director of the Vaccine Education Center at Children\u2019s Hospital of Philadelphia, there\u2019s another strong argument against using blood tests to assess whether individual patients are protected: circulating antibodies don\u2019t give a complete picture of SARS-CoV-2 immunity.<\/a><\/p>\n\n\n\n \u201cThe immunological component that is associated with protection against severe disease is immunological memory B cells,\u201d Offit said in an interview. \u201cThese cells aren't making antibodies, but they remember that they have seen this SARS-CoV-2 spike protein before.\u201d<\/a><\/p>\n\n\n\n Theel noted that circulating antibodies against the virus peak 2 or 3 months after natural infection or vaccination and then begin to decrease. But the immune system\u2019s ability to mount a defense lasts longer. \u201cJust because we\u2019re seeing a decrease in antibody levels doesn\u2019t necessarily mean that your immunity is gone,\u201d she said. \u201cWe know from a lot of studies now that your memory T cells and memory B cells persist for at least 6 to 8 months and continue to evolve and mature, and none of that information is relayed by an antibody test.\u201d<\/a><\/p>\n\n\n\n Offit explained that reinfection with the virus activates memory B cells to differentiate into antibody-secreting cells. Because this process can take 3 to 5 days, it doesn\u2019t stop SARS-CoV-2 infections from occurring, but it does help tamp down severe COVID-19. And that\u2019s a success story, in his view: \u201cThe goal of the vaccine is to protect you against serious illness.\u201d<\/a><\/p>\n\n\n\n So far, it has. Although data suggest that mRNA vaccine\u2013induced protection against infection and symptomatic illness is decreasing<\/a> in the US, the shots continue to prevent<\/a> serious disease, hospitalization, and death.<\/a><\/p>\n\n\n\n The data seem to contradict a widely reported rise in hospitalizations<\/a> among vaccinated individuals in Israel. But according to Offit, Israel\u2019s COVID-19 hospitalization trends can\u2019t be applied directly to the US. \u201cThey do have a different definition to some extent for what they consider severe,\u201d he said. \u201cIt\u2019s less rigid than ours.\u201d<\/a><\/p>\n\n\n\n Offit served on the FDA vaccine advisory committee that recommended against a booster dose for most adults who received the BNT162b2 vaccine. For now, a booster is only authorized for people with the greatest risk of severe illness: adults aged 65 years or older and adults who have certain underlying medical conditions, live or work in high-risk settings, or live in long-term care facilities. (People who are moderately to severely immunocompromised<\/a> and received the BNT162b2 or mRNA-1273 vaccine should get an additional dose, according to the CDC.)<\/a><\/p>\n\n\n\n Offit said that as antibodies wane, susceptibility to asymptomatic or milder infections increases. In a recent US study<\/a>, the BNT162b2 vaccine was 93% effective against hospitalizations with the Delta (B.1.617.2) variant after 6 months, but its effectiveness against Delta variant infections overall fell from 93% in the first month after full vaccination to 53% after 4 months. The authors attributed the reduction mainly to waning immunity rather than the variant\u2019s escape from vaccine protection.<\/a><\/p>\n\n\n\n Offit acknowledged that any infection can be disruptive but pointed out the impracticality of using periodic boosters to keep neutralizing antibodies high. He said that\u2019s akin to \u201crolling the stone up the hill only to have it come back again.\u201d<\/a><\/p>\n\n\n\n And like Theel, he knows that some infections will still break through. \u201cYou can have a robust or high level of virus neutralizing antibodies in your circulation,\u201d he said. \u201cThat\u2019s not going to prevent the virus from attaching to your nose and beginning to reproduce itself. That\u2019s an asymptomatic infection.\u201d<\/a><\/p>\n\n\n\n Managing expectations for COVID-19 vaccines may be in order. \u201cI think there was maybe an initial misunderstanding amongst the public that this would just halt all infections, and that\u2019s just not the case,\u201d Theel said. Ultimately, her advice for avoiding a SARS-CoV-2 infection in the first place comes down to a now-familiar combination of measures: \u201cgetting vaccinated, frequently washing your hands, wearing a mask, and avoiding high congregate in-door settings, particularly in areas that have high case rates.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" Medical News & Perspectives October 21,&n […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20637"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20637"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20637\/revisions"}],"predecessor-version":[{"id":20638,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20637\/revisions\/20638"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20637"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20637"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20637"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}<\/figure>\n\n\n\n