Should You Swab Your Throat When Taking an At-home Rapid COVID Test?

As COVID-19 cases continue to rise due to the current surge of the Omicron variant, people are testing more frequently to avoid inadvertently transmitting the virus to others. However, many say that at-home rapid tests are not detecting the Omicron variant well enough, leading to false-negative test results.

On social media, anecdotal reports of individuals testing negative with a nasal swab—but positive with a combined throat and nasal swab—are garnering a lot of attention. The hashtag #SwabYourThroat became popular on Twitter while some shared their experiences on TikTok, encouraging more people to give throat swabs a try. People claim that the method helped make the Omicron variant more detectable. 

Throat and nose test kits have been in use in the United Kingdom, but the rapid antigen test kits authorized in the U.S. by the Food and Drug Administration (FDA) do not call for throat swabs.

Still, many are left wondering whether swabbing the throat should become part of our normal at-home testing routine. Verywell asked experts to weigh in.

Are Throat Swabs Better?

Although a few anecdotal reports encourage swabbing your throat, more research is needed to determine whether it does actually improve the accuracy of your test.

“It's really hard to say why this ‘might’ be true, and considerable reason to question whether it is,” Sheldon Campbell, MD, laboratory medicine physician at Yale Medicine and professor at the Yale School of Medicine, told Verywell. “There’s a ton of bias in this sort of anecdote since people who had a positive [result] on the nose wouldn’t bother to do the throat, and people who were negative on the nose then negative on the throat don’t tweet about it.” 

Preliminary studies suggest that antigen tests can detect the Omicron variant, but they may have a reduced sensitivity to it. Additionally, a recent study that is currently under peer review for publication found that Omicron replicates 70 times much faster in the bronchi than Delta.

“There’s some very-preliminary cell-culture type data to suggest that Omicron is better at replicating in the upper respiratory tract than the lower,” Campbell said. “That doesn’t necessarily mean the throat would be better than the nose.”

Should You Try Swabbing Your Throat Anyway?

“It is not recommended practice,” Campbell said. “I have to emphasize that nobody’s actually done a scientific study of nose versus throat [swabs]. If you absolutely feel compelled by the lack-of-evidence to swab your throat, swab it and your nose. Use the same swab and test. Don’t waste terribly scarce tests on this nonsense.”

Two weeks ago, a cell biologist from the University College London shared on Twitter that they tested positive after collecting a sample from both their nose and throat. They used a Flowflex COVID-19 Antigen Home Test, which required nose swabs only.

“Do not substitute throat for nose,” Campbell said. “It’s one thing to say ‘maybe the throat helps’ and add it, it’s quite another to decide that three Twitter anecdotes mean ignoring that we know the nose is a good specimen type.”

Swabbing both the throat and the nose might help collect more viral load, improving the chances of detecting the Omicron variant.

“Swabbing the throat and nose for a rapid self-test could potentially increase test sensitivity,” Preeti Pancholi, PhD, director of clinical microbiology at The Ohio State University College of Medicine, told Verywell. “Most viruses replicate in both the nasopharynx—the nose—and the oropharynx—the part of the throat at the back of the mouth—especially in people who have a sore throat. But if the test instructions don’t say to swab the throat, that means the test manufacturer and the FDA haven’t studied the test’s accuracy or efficacy in that way.”

With the increase of people calling for throat swabs on social media, the FDA took to Twitter to reiterate that the available rapid antigen tests are only authorized for nasal swabs.

“The FDA has ‘noted safety concerns regarding self-collection of throat swabs,’ which can harm a patient if done incorrectly. Furthermore, doing this could contaminate the specimen,” Pancholi said. “Self-collection of throat swabs is more complicated and should be collected by a trained professional when needed.”

So, What Should You Do?

The FDA advises following instructions and collecting the test specimens as indicated. If a rapid antigen test requires a nasal swab, it may be best to refrain from swabbing the back of your throat as well—at least until more data is available. Collecting an inadequate sample may lead to false negatives.

“If I were testing myself or a family member, I’d do a good, thorough nose swab, only,” Campbell said. “I think thoroughly swabbing up in the nose where the juice is, is more important than maybe-doing-the-throat.”

If you want to avoid possible errors, opting for the Reverse Transcription Polymerase Chain Reaction (RT-PCR) diagnostic test, which is generally more sensitive than rapid antigen tests, can be a safer bet.

“In any case, regardless of antigen test results, you should isolate for 5 days from the onset of symptoms,” Campbell said. “Right now, don’t go out and be with people if you’re symptomatic. This should be the rule going forward regardless of COVID—don’t infect your friends.”

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