Which COVID-19 Test Should You Take?

By The Vault Team

When the pandemic first began, there were limited ways to test for COVID-19. Initially, it required an in-person visit with a doctor and a long, often uncomfortable, swab into the nose. Public officials were on their own to figure out a more comprehensive solution for navigating competition, supply chain issues, lab capacity problems, and limited expertise on the subject.

Today, there’s still no official COVID-19 testing infrastructure in place. But there are many more products available for consumers, health officials, businesses, schools, and more. As the testing ecosystem becomes more diverse, we gain an increased level of resilience in meeting the needs of the country. Simply put, more COVID tests are a good thing for Americans. But with so many testing options to choose from, there is added confusion around which test is the most accurate and efficient.

So, what test should parents, employers, and consumers be using? The short answer: it depends. Unfortunately, there’s no one-size-fits-all answer. What consumers need to know is how to take the right test at the right time—and for the right reason.

Antigen (rapid) testing vs PCR testing

We’ve come a long way when it comes to COVID-19 testing. Since March 2020, the Food and Drug Administration (FDA) has issued emergency green lights to more than 200 types of coronavirus tests. But the two main groups of diagnostic testing - PCR and antigen - each have their unique benefits and challenges.

Polymerase chain reaction (PCR) tests remain the preferred tests for diagnosing acute COVID-19 infection. These molecular tests amplify and detect specific fragments of viral RNA. They’re considered “the gold standard” of COVID tests because they’re typically 98-99 percent accurate, making them more reliable than antigen testing.

Antigen testing (sometimes referred to as rapid testing) detects specific fragments of the SARS-CoV-2 viral protein, as opposed to viral RNA detected by PCR tests. The biggest advantages are convenience and turnaround time—many antigen tests are available to take at-home with results ready within 15 minutes. However, these tests sacrifice some accuracy for their speed. With lower sensitivity, antigen tests can produce more false negatives with generally around 80-85 percent accuracy. Also, they’re only approved by the FDA for use on symptomatic individuals, because without symptoms, it’s very difficult for an antigen test to pick up on COVID.

When should you take a PCR test?

Here are some of the events in which a PCR test might be most useful:

  • When a more accurate result is important

  • When you don’t need an immediate result

  • When you’ve been exposed to the COVID-19 virus

  • When you’re asymptomatic 

  • When you have time to plan ahead (including before a trip)

  • When it’s important that results are transmitted to the local health department for contact tracing

  • When going to see an immunocompromised loved one (also a great opportunity to combine with an antigen test)

  • When you want to help public health track variant spread 

  • When you need documentation (in some cases, antigen tests performed by a provider may have documentation as reliable as PCR)

When should you take an antigen “rapid” test?

Unlike PCR tests, there is one specific event in which an antigen test can be most useful:

  • If you or your child are symptomatic

Antigen tests have only been approved by the FDA for symptomatic individuals. Because these tests are less sensitive than PCR-based laboratory tests, they’re not as accurate at detecting COVID-19 when it’s present in low amounts (including some asymptomatic infections and before symptoms begin, but when you still may be contagious).

However, trials conducted by test makers show that when antigen tests are taken in the first few days after symptoms surface, their results can match up with those of PCR tests more than 80 percent of the time

What does this mean? The best application for an antigen test is when you or a family member, including your child, comes home with symptoms, like a fever or cough. In these cases, antigen tests can offer a reliable result and help you and your family know if and when you need to isolate and inform friends, colleagues, or school officials.

Keep in mind that even if you get a positive result with an antigen test, you should confirm the result with a followup PCR test. And if you’re a parent and your child has symptoms but tests negative, many schools will require a negative PCR result before allowing them to return to school. 

Still, an at-home antigen test can help to provide fast results when you or a loved one is showing symptoms. It can also save you the stress of seeking out urgent care, where you could be exposed to additional germs, where wait times are long, and where local healthcare solutions are already overburdened.

As enticing as it may be, rapid antigen tests are not an appropriate solution if you’re a parent and your unvaccinated child is exposed at school. Though you may want to know right away, antigen tests aren’t effective at detecting infection in asymptomatic people, including children. In these cases, a high-quality PCR test is the best option.

Screening testing strategies

Screening testing is intended to identify people with COVID-19 who are asymptomatic and do not have known, suspected, or reported exposure to the virus. Examples may include:

  • Employees in a workplace setting

  • Students, faculty, or staff in a school setting

  • A person before or after travel

  • Someone at home with no symptoms or known exposure

The best strategy for screening is PCR testing, because antigen isn’t as sensitive or accurate when used in asymptomatic individuals. 

PCR screening tests can be employed effectively in schools, the workplace, and other large settings. 

 How Vault can help

Understanding the difference between the many COVID tests available has never been more critical. Tests are required for us to participate in various activities—in our professional and personal lives. We need to know what test will provide us with the most accurate information, in order to keep us safe.

Vault Health is an established leader, having brought to market the first FDA-authorized at-home PCR test. We’ve sold more than 10 million COVID tests nationwide, working with more than 3,000 enterprise, government, public health, and education clients. Our experts have learned a lot about what works and what doesn’t. Though we can’t test our way out of this pandemic, we won’t get out without implementing the right testing strategy.

To learn more about our testing solutions, visit this page.

DISCLAIMER: This article is for general information purposes only, does not constitute medical advice and is not intended to be relied upon for medical diagnosis or treatment.  If you are experiencing an emergency, dial 911 or contact a medical provider immediately.  Consistent with Vault Health, Inc.’s website privacy policy, Vault Health, Inc. is not responsible for the privacy practices or the content found at links to other websites.  The content of this article represents the views and opinions of the individual author.

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