You can be infected and still show negative on home tests — especially early in the disease. (CDC image)

The US Food and Drug Administration on Tuesday (5-17-22) authorized a third COVID shot for children ages 5-11 who’ve already gotten their first two. The US Centers for Disease Control is expected to update its recommendations later this week.

The availability of the booster for children is welcome news for Alaska’s public health officials who are trying to stem the tide of new cases in the state, which are rising at about 6-percent per week. About 41 Alaskans remain hospitalized with COVID-19, four of them on ventilators.

During a statewide teleconference last week (5-11-22), officials in the state Department of Health answered questions about the ongoing effort to vaccinate residents, and the role of home testing, now that rapid antigen tests are widely available over-the-counter.

Note: The US government is distributing a third round of free home test kits for COVID-19, beginning immediately. Eight kits will be mailed in this round. Sign up for delivery with the US Postal Service.

Healthcare providers hear this all the time: I feel sick, but my rapid test is negative. That’s because rapid tests sometimes don’t show a positive result in the early stages of the illness. State pharmacist Dr. Coleman Cutchins says to err on the side of caution, when interpreting the results of over-the-counter, or OTC, tests.

“If you have symptoms and think you have COVID, and you test negative, reach out to your health care provider, or consider getting a molecular test (aka PCR test or lab test) or repeating one of those at-home OTC tests every couple of days, as long as you have symptoms,” Cutchins said.

Data from the Journal of the American Medical Associations shows that PCR tests (or lab tests) are more reliable than home tests at detecting the virus early in the course of COVID-19 disease, and can detect more of the virus over the course of the illness. (Alaska DHSS image)

Cutchins said that recent data published by the Journal of the American Medical Association showed that rapid home tests were most reliable well after the onset of symptoms, and that molecular tests – or PCR tests done by health providers – could detect the virus even before patients developed symptoms.

Prompt confirmation can be important in the treatment of patients who are most at-risk of developing severe illness, says the state’s chief medical officer, Dr. Anne Zink.

“Particularly if you’re at-risk, and treatment would be something you would consider and you have an at-home antigen test that is negative, but you’re not feeling well,” said Zink, “getting that PCR, that molecular test, earlier can help to identify it earlier, so we can get you started on treatment earlier.”

Zink was pleased to report that 600 people a week were stepping up for their first vaccines in Alaska, as vaccination remains the number one weapon against the virus. But does the adaptability of the current Omicron variant suggest that boosters might be part of the fight indefinitely? Dr. Jeffrey Demain, an immunologist at Providence Hospital, doesn’t think so.

“I think in the fall we’re going to see a vaccine that is going to be somewhat different than what we’ve seen thus far,” said Demain. “It’ll be probably looking at more multiple aspects of attacking the virus, or stimulating the immune system response to the virus, rather than a single response. So I think as we go, we’re going to have new iterations. And I anticipate that we’re going to eventually get to a point where it’s going to be like our annual flu shot.”

Demain said that “we’re sort of playing catch-up a bit,” but regardless of your age, there’s no point in over-boosting. “You only want to get the shots that are recommended for you and your age group and your certain circumstances.”