Vaccines will not eliminate the need for COVID-19 testing

Bruce Carlson

Bruce Carlson from Kalorama Information.

It may be logical to suspect that if a vaccine is available there will be fewer cases and therefore less reason to test. But this is not normally the interplay between vaccines and disease.

In the COVID-19 update report, Kalorama Information estimated that test volume in laboratories and among IVD providers is increasing, and that new technologies are becoming available. The company, a sister company of, projects a $ 10.5 billion market for tests related to COVID-19. This is an increase of more than $ 1 billion dollars from the company’s August update, with much of the increase based on production and use of antigen testing.

It is possible that a vaccine solution will be developed, which will be widely funded and distributed. Many major pharmaceutical candidates are at an advanced stage. Unless the disease ‘clears’ or appears to be getting better, the need for testing remains. Patients will show symptoms and they should be tested. We also note the following:

  • Despite the presence of one of the most widely used adult vaccines, hundreds of millions are made by IVD companies selling flu tests. Kalorama describes this market every year in its global IVD market report.
  • This issue of vaccines eliminating testing has been raised with cervical cancer vaccines related to histological staining and HPV testing, which has only grown since the launch of Gardasil and other vaccines.
  • The use of vaccines will not be universal. A recent online survey of adults living in the US found that nearly 70% of those surveyed would accept a COVID-19 vaccine if it were widely available. The results of the study have been published in the journal Vaccine on August 20. German daily Süddeutsche Zeitung reported on Sunday, citing a copy of the survey, that just over 60% of people in Germany would be willing to get vaccinated against COVID-19, a new survey found.
  • As Kalorama analyst Justin Saeks said, “It is also possible, as is the case with many new viruses, that the virus is passing through the population on a very large scale or there are mutations. So far, the journal literature is leading the other way. that mutations are not as likely due to error correction systems in the viral DNA. ”Still, the point remains – for market modelers and diagnostic industry viewers, it is still possible that COVID-19 forms or co-infects strains and variants with RSV and influenza.
  • Antibody tests have been developed and are, in a sense, ready to use. Labs will likely see a greater demand for antibody testing after a vaccine is available to test its effectiveness after vaccination and to test how long immunity lasts.
  • Patients with symptoms have yet to be tested. COVID-19 will remain at least an important test application for 2021 and probably in 2022.
  • Combination tests such as those offered by Quidel, Quest, LabCorp, Cepheid, and other makers group COVID-19 with other tests. This will be useful to rule out COVID-19 even after a period of extensive vaccine use. The ability to run COVID-19 as a panel instead of a single test will facilitate more testing.

It is fair to say that a COVID-19 vaccine can reduce the widespread expansion of SARS-CoV-2 testing, especially tests that extend to asymptomatic populations. Reopening plans in the US and other developed countries will stimulate the markets, creating additional unknowns beyond the medical concerns.

However, at the moment all indications are in the opposite direction, that wide tests are gaining popularity. This is made possible by rapid antigen tests, most of which are performed at the point of care, that detect viral particles rather than antibodies in the patient. They see usage, although perhaps not at the level recommended by some advocates. In some models, everyone would be tested, or every student or employee.

An entrepreneurial plan was recently detailed in the Atlantic Monthly, based on the plan of Harvard epidemiology professor Michael Mina. The plan includes extensive use of low-cost / high-volume rapid tests in schools and workplaces. Testing in this scenario would be done in large numbers and performed daily.

More moderate practice is likely to continue – some schools, some workplaces are doing these kinds of tests, with industry and regional differences.

The attractiveness of this is seen in the example of South Korea. The nation is a different governmental system from the US, but also a model for a testing protocol where testing volume would increase. A new study indicates that point-of-care testing played an important role in reducing the spread of SARS-CoV-2 there compared to the US, which has 47 times the number of cases and nearly 80 times the number of deaths experienced. South Korea’s response to the COVID-19 pandemic is critically acclaimed – and is currently under extensive study.

If COVID-19 vaccines reduce the overwhelming demand for testing to some extent, perhaps the lab industry could use it. Even in the fall of 2020, there are capacity limitations, questions about test accuracy, and challenges with sample collection. But creative solutions have emerged in laboratories to ease the burden in troubled times.

Bruce Carlson is the publisher of Kalorama Information, part of the Science and Medicine Group.

Disclosure: is a sister company of Kalorama Information.

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