Will the COVID vaccine make me test positive for the coronavirus? 5 questions about vaccines and COVID testing answered

COVID-19 vaccination is rolling out across Australia. So health authorities are keen to dispel myths about the vaccines, including any impact on COVID testing.

Do the vaccines give you COVID, or make you test positive for COVID? Does the vaccine affect other tests? Do we still need to get COVID tested if we have symptoms, even after getting the shot? And will we still need COVID testing once more of the population gets vaccinated?

We look at the evidence to answer five common questions about the impact of COVID vaccines on testing.

Read more: Do I need to register for a COVID vaccine? How will I know when it's my turn? Vaccine rollout questions answered

1. Will the vaccine give me COVID?

The short answer is “no”. That’s because the vaccines approved for use so far in Australia and elsewhere don’t contain live COVID virus.

The Pfizer/BioNTech vaccine contains an artificially generated portion of viral mRNA (messenger ribonucleic acid). This carries the specific genetic instructions for your body to make the coronavirus’s “spike protein”, against which your body mounts a protective immune response.

The AstraZeneca vaccine uses a different technology. It packages viral DNA into a viral vector “carrier” based on a chimpanzee adenovirus. When this is delivered into your arm, the DNA prompts your body to produce the spike protein, again stimulating an immune response.

Any vaccine side-effects, such as fever or feeling fatigued, are usually mild and temporary. These are signs the vaccines are working to boost your immune system, rather than signs of COVID itself. These symptoms are also common after routine vaccines.

2. Will the COVID vaccine make me test positive?

No, a COVID vaccine will not affect the results of a diagnostic COVID test.

The current gold-standard diagnostic test is known as nucleic acid PCR testing. This looks for the mRNA (genetic material) of SARS-CoV-2, the virus that causes COVID-19. This is a marker of current infection.

This is the test the vast majority of people have when they line up at a drive-through testing clinic, or attend a COVID clinic at their local hospital.

Yes, the Pfizer vaccine contains mRNA. But the mRNA it uses is only a small part of the entire viral RNA. It also cannot make copies of itself, which would be needed for it to be in sufficient quantity to be detected. So it cannot be detected by a PCR test.

The AstraZeneca vaccine also only contains part of the DNA but is inserted in an adenovirus carrier that cannot replicate so cannot give you infection or a positive PCR test.

Read more: How mRNA vaccines from Pfizer and Moderna work, why they're a breakthrough and why they need to be kept so cold

3. How about antibody testing?

While PCR testing is used to look for current infection, antibody testing — also known as serology testing — picks up past infections.

Laboratories look to see if your immune system has raised antibodies against the coronavirus, a sign your body has been exposed to it. As it takes time for antibodies to develop, testing positive with an antibody test may indicate you were infected weeks or months ago.

But your body also produces antibodies as a response to vaccination. That’s the way it can recognise SARS-CoV-2, the next time it meets it, to protect you from severe COVID.

So as COVID vaccines are rolled out, and people develop a vaccine-induced antibody response, it may become difficult to differentiate between someone who has had COVID in the past and someone who was vaccinated a month ago. But this will depend on the serology test used.

Read more: Antibody tests: to get a grip on coronavirus, we need to know who's already had it

The good news is that antibody testing is not nearly as common as PCR testing. And it’s only ordered under limited and rare circumstances.

For instance, when someone tests positive with PCR, but they are a false positive due to the characteristics of the test, or have fragments of virus lingering in the respiratory tract from an old infection, public health experts might request an antibody test to see whether that person was infected in the past. They might also order an antibody test during contact tracing of cases with an unknown source of infection.

Read more: Why can't we use antibody tests for diagnosing COVID-19 yet?

4. If I get vaccinated, do I still need a COVID test if I have symptoms?

Yes, we will continue to test for COVID as long as the virus is circulating anywhere in the world.

Even though the COVID vaccines are looking promising in preventing people from getting seriously sick or dying, they won’t provide 100% protection.

Real-world data suggests some vaccinated people can still catch the virus, but they usually only get mild disease. We are unsure whether vaccinated people will be able to potentially pass it to others, even if they don’t have any symptoms. So it’s important people continue to get tested.

Furthermore, not everyone will be eligible to receive a COVID-19 vaccine. For instance, in Australia, current guidelines exclude people under 16 years of age, and those who are allergic to ingredients in the vaccine. And although pregnant women are not ruled out from receiving the vaccine, it is not routinely recommended. This means a proportion of the population will remain susceptible to catching the virus.

We also are unsure about how effective vaccines will be against emerging SARS-CoV-2 variants. So we will continue to test to ensure people are not infected with these strains.

Read more: UK, South African, Brazilian: a virologist explains each COVID variant and what they mean for the pandemic

We know testing, detecting new cases early and contact tracing are the core components of the public health response to COVID, and will continue to be a priority from a public health perspective.

Minimum numbers of daily COVID tests are also needed so we can be confident the virus is not circulating in the community. As an example, New South Wales aims for 8,000 or more tests a day to maintain this peace of mind.

Continued vigilance and high rates of testing for COVID will also be important as we enter the flu season. That’s because the only way to differentiate between COVID and influenza (or any other respiratory infection) is via testing.

5. Will testing for COVID stop as time goes on?

It is unlikely our approach to COVID testing will change in the immediate future. However, as COVID vaccines are rolled out and since COVID is likely to become endemic and stay with us for a long time, the acute response phase to the pandemic will end.

So COVID testing may become part of managing other infectious diseases and part of how we respond to other ongoing health priorities.

Read more: Coronavirus might become endemic – here's how

Meru Sheel, Epidemiologist | Senior Research Fellow, Australian National University; Charlee J Law, Epidemiologist | Research Associate, Australian National University, and Cyra Patel, PhD candidate, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Leaving the past behind: what became of the anal personality?

In theory, bad scientific ideas are abandoned and replaced by better ones. We no longer believe living things are animated by a vital force or that combustible matter contains phlogiston. We don’t believe the bumps on our skulls reveal our strengths and weaknesses or that disease is caused by foul air.

Sometimes, though, ideas are abandoned too soon. They may simply become unfashionable or contain a germ of truth that is wrapped in a husk of error. Arguably one of Sigmund Freud’s oddest ideas – the existence of an anal character type – is an example of the latter. In this case, the baby may have been thrown out with its soiled bathwater.

The anal character

Writing in 1908, Freud identified a cluster of personality traits that came to be known as the “anal triad”. Orderliness refers to excessive conscientiousness and a concern with neatness and cleanliness. Obstinacy involves being stubborn, wilful and rigid. Parsimony represents stinginess with money and time.

Freud found these traits clustered together in people who expressed, during psychoanalytic treatment, an emotionally charged fascination with defecation. They recalled taking pleasure in emptying their bowels and in “holding back”, a pleasure Freud described as erotic in his expansive understanding of the word. Their anal traits originated in this childhood obsession. Orderliness was a reaction against their fascination with filth, and obstinacy and miserliness were sublimated, socially acceptable expressions of faecal retention.

Later psychoanalytic theorists such as Ernest Jones and Karl Abraham filled in Freud’s sketch of the anal personality. This character type was perfectionistic, pedantic, detail oriented, prone to disgust, and excessively self-reliant. Anal characters had a passion for classifying, organising and statistics and they were drawn to collecting objects like coins and stamps which, to Freudians, symbolised excrement (filthy lucre).

Anal characters were often “notorious bores” afflicted by “Sunday neurosis”: the inability to relax on the weekend. Writers speculated they were fascinated by tunnels, tended not to change underwear “more than is absolutely necessary” and were exceedingly sparing in their use of toilet paper.

Research on the anal character

In the mid 20th century researchers began to subject these pungent ideas to empirical scrutiny. Some of their findings were encouraging: anal character traits did tend to cluster together among adults, although they formed a spectrum rather than a type. However the more basic question is whether these traits are rooted in early childhood and linked to defecation. If not, the anal character is in no meaningful sense anal.

One amusing study examined whether anal characters were indeed particularly troubled by faeces. People high or low in anal traits were asked to identify by touch objects submerged in different liquids. In one experimental condition that liquid was water and in the other a malodorous pseudo-faecal mixture of flour and used crankcase oil. As predicted, anal characters performed more poorly in the faecal condition, supposedly thrown off by their excremental anxieties.

Other research was less supportive, however. Studies repeatedly failed to find any correlation between aspects of childhood toilet training and anal traits in adulthood. Cross-cultural studies found no link between the severity of a culture’s toilet training regimes and its rigidity or other anal trends.

The end of the anal character?

As Freudian ideas about the anal character failed to receive empirical support, and psychoanalytic theory was increasingly eclipsed in psychology, they were progressively abandoned. In the Google books database the term “anal character” hit its peak popularity in 1956, tailing off sharply thereafter. “Anal personality” held on a little longer, cresting in 1987 but then dropping precipitously to the point where it is rarely used today.

So has the anal character been wiped from the field? Reports of its death are greatly exaggerated, as anal traits have reappeared in several new guises in more recent personality psychology. Active research programs explore the complexities of perfectionism, orderliness, disgust proneness and detail focus. However, the best preserved expression of this very undead idea is obsessive-compulsive personality disorder (OCPD).

OCPD is a psychiatric diagnosis that is alive and unwell. It refers to a pervasive pattern of inflexibility, compulsiveness, overwhelming need for mental and interpersonal control, and excessive attention to detail. Studies suggest it may be the most common of the ten recognised personality disorders, and thus the preeminent form of disturbed personality.

The diagnostic criteria for this condition align almost perfectly with Freud’s portrait of the anal character. Orderliness reappears as perfectionism and preoccupation with rules and lists. Obstinacy returns as rigidity and a reluctance to delegate tasks. Parsimony lives on in miserly spending habits and an inability to discard worn out objects.

Freud’s anal character type is neither anal nor a type. Even so, cleansed of its dirty connotations, it captures a common personality variant that remains with us to this day. Freud’s bad idea has been not so much abandoned as recycled into a few better ones.

Nick Haslam, Professor of Psychology, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.