#MSCOVID19 don’t forget about the Blood Spot Test.


The Blood Spot test is a way to see if people are making a vaccine response. If you are, that is great news, but if you are not, its not the end of the world, as a T cell response may do the job.

We have the first news from Israel, which was in part expected and not the best news for anti-CD20 and fingolimod users. But this is based on the Pfizer vaccine. We still need to know about Astrazeneca and the effects with other DMT (MS drugs)

The Astrazeneca trials as you know, were in my opinion a dogs-breakfast and they did this and they did that. They did trials where they hadn’t worked out the dose and so gave some people lower-doses because they worked out the concentration in a different way and then they ran out of supply and so people didn;t get a dose when it was planned. This meant that some people got dosed at 4 weeks and others at 24 weeks. But in all of this I am sure people’s safety was never, ever, compromised. They were racing to get something useful. They have done an amazing job to make something that has crossed the line. Look at GSK (UK pharma) and Sanofi (French Pharma) they had great promise but they did not get right enough. However, they lucked-out with the dosing interval because the longer you wait the bigger the vaccine response is. Look at doses two for the antibody levels


The Mousers tried to model this and gave a low dose of adenovirus vaccine and then gave the stanadard dose and there was a higher response than standard and standard dosing. I hate to say this but why bother?. We know what happened in humans. Who cares what happens in animals! If this is going to be useful they have to do a trial in humans. I suspect it isn’t that different.

Limiting the priming dose of a SARS CoV-2 vaccine improves virus-specific immunitySarah Sanchez, Nicole Palacio, Tanushree Dangi, Thomas Ciucci, Pablo Penaloza-MacMasterbioRxiv 2021.03.31.437931; doi: https://doi.org/10.1101/2021.03.31.437931

However, I hope that a poor first response to first dose, bodes well for second dose. Why? For personal reasons.

As you know we have been developing assays for COVID-19 infection and started with response to nucleocapsid, but to measure vaccine response we need reagents to Spike and notably receptor binding domain.

Today we had a lab meeting and Dr Angry presented some data to our Team to say that we are ready to crank up the vaccine Spike response testing…He showed his responses and then said “I don’t know who that DB person is, but they gave a shitty response to the first dose“. So I am sure ProfB (DB) hopes that having a shitty response is a good indicator of a good response to a second round. You may be on a DMT and get a poor vaccine response but some people not on DMT will give a poor response too, and will suffer the same dilemas.

However, the reason for this post is to say that if you have sent in a Blood spot we haven’t forgotten you.

The nucleocapsid antigen is inside the cell and we can make this in bacteria. We made enough for 2 million tests in a couple of days and scaled it up to make tests for most of the UK. However because Spike has sugars on the protein we made the test using mammalian cells that makes sugars but it took alot longer to make a few thousand tests. We have found that we can make the Spike test in bacteria too.

But we have been waiting for people get their second doses and then waiting for a few weeks to allow the antibody response to form.

It is better to do most of the samples in the same run. We have intially focussed on ocrelizumab as this is percieved to be the biggest risk to not producing a vsaccine response. We had a lot of before and after vaccine tests and we know what a background response is, so if you have responded well we will see it, even if you have not had a pre-dose sample. But you can still volunteer if you want to. I am doing it my self and have been donating blood to the cause since the summer of 2020. So if you want to contribute to the BartsMS COVID effort you still can

Send an Email to mscovid19ab@qmul.ac.uk

The gang will contact you and send you a testing kit. No cost to you, ProfG, Pom and Kit sponsorship effort’s have taken care of the postage costs. All you have to do is shout “Scratch Scrath (it masks the pain of the needle prick) put plastic against finger skin (the lancet). With more hands and time maybe we could have developed the spit tests of a bit of Spit and a Q-tip/Cotton Bud, because they have more uses than make-up removall and ear wax

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  • Excellent news!! However, it is still April 1st across the pond, so I sincerely hope this post is not a joke MD.

  • The mechanism of the better boost after the lower dose is very likely determined by the immune response to the adenovirus vector, and not any magic about the COVID antigen. The lower first dose provokes less immunity to the adenovirus, so that the second dose has a higher probability of “take”. So low response after one dose in Ocrevus patients like me probably won’t predict good response on the second, since we’re probably just not really responding. I hope I’m wrong though!

    • Thanks for the explanation. The differnce in dose in Oxford (Low dose) was 22 trillion verses 30-50 trillion (standard dose) viral particles, but thanks you have exposed my bullshit and tenuous use of the post to say: (1) Why are we doing this in animals. The human experiment is whats needed. It is probably too late to start a trial if it has not already been started…Maybe next pandemic we can do this, but is adenovirus the way to go as most of UK will now have adenoviral response (2) Some people like me, even those not on DMT can make a shitty response to the first dose and may share a bond with some people on anti-CD20. I could have selected others such as paper looking at dialyis patietnts and health care workers and most importantly (3) It is not too late to get a blood spot test. We are keen to get a range of people taking various disease modifying agents. Many people will have contacted by their GPs to get their vaccine as opposed to contact via 11D. Those contacted by their GP won’t get reminded about the antibody response. We are keen to get a range of responses back from people on other DMT

    • Not sure where the ethics is but certainly I think if you have been here you would be covered, even if Barts isn’t your site. Dr Ruth can correct me on this one

  • Got my 2nd vaccine yesterday at 8 weeks; brilliant. Had been slow turning round my second blood spot test because of a cataract op. Who knows what I would have punctured? My left ear? Turned it round just before leaving for the vaccine centre. Next cataract and next blood spot test will probably coincide too, to say nothing of not being supposedly being able to swim for 3 months after (a pain, as Dr Ruth will attest).

    So pwMS get a blood test kit if you haven’t already. Do as MD suggests and email QMUL for one.

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