The Covid19 vaccination rollout continues in earnest around the world. Research studies have been popping up to suggest the success of different vaccines, but there’s ongoing concern for particular populations whose immune systems may not respond so effectively. This is where an antibody test comes into play.
Individuals with autoimmune diseases, older individuals, and those on immunosuppressant therapies may not be as well protected by a vaccine, with antibody and T cell testing suggesting more breakthrough infections and deaths are likely in such immunosuppressed people.
So how good is an antibody test to assess the success of a vaccine and should you get one if you’re vulnerable?
Is There A Need For Antibody Testing & Who Should Get It?
In an article published by the New York Times, the need for appropriate timing and an appropriate antibody test is highlighted. Akiko Iwasaki, an immunologist at the prestigious Yale University, noted that “most people shouldn’t even be worrying about this”.
However, the article goes on to say that “antibody tests can be crucial for people with weak immune systems or those who take certain medications”. There will be a proportion of the population who, for such reasons, are less likely to develop the same immune response to a vaccination. For instance, someone with an autoimmune disease, someone who’s had an organ transplant, or someone taking immunosuppressant medication, like Methotrexate for rheumatoid arthritis.
Curiosity can be quenched with an antibody test and for those who are immunocompromised in any way, the results might provide some peace of mind. Scientists don’t know whether a certain level of antibodies can confidently protect against serious illness and death, but data suggests antibodies can give a general indication of protection.
On the other hand, finding you have a low or non-existent level of antibodies may be disconcerting; that also doesn’t necessarily mean you’re not protected at all, but it could serve important to know so that distancing, masks, hand washing and other hygiene measures can be maintained. It may also be important for future ‘booster’ jabs or for employment purposes, for instance in requesting the continuance of remote working.
Those With Weaker Immune Responses To Vaccines
While figures suggest older individuals are most at risk from being ill or dying from Covid, partly because the immune system may not mount as robust a response compared to a younger individual, it’s not just the elderly who can be immunocompromised in some way.
In the case of immunosuppressants, there will be a significant number of people of varying ages worldwide that take these. These can include the likes of prednisone, methotrexate and rituximab, which essentially deplete the body’s B cells that are required for antibody production. Blood cancer patients, organ transplant recipients and cancer patients undergoing chemotherapy may also be at risk of a lower immune response, as are those with autoimmune disease, from lupus and inflammatory bowel disease, to multiple sclerosis and rheumatoid arthritis.
There is very little research involving individuals with underlying conditions and immunosuppression when it comes to Covid19 vaccinations. There is, however, growing evidence to suggest those with a compromised immune system may not mount a particularly strong response to a vaccine, if any at all.
Breakthrough Hospitalisations & Deaths Data
While very little has been said until more recently by the UK media or government, some US-based news outlets have covered the so-called “breakthrough” infections and deaths, where individuals have died despite being fully vaccinated well before they were infected.
- In recently published data from the CDC pertaining to cases in the US, 4,115 people have either been hospitalised or have sadly died with Covid19 despite having been fully inoculated. Of those hospitalisations and deaths, 76% have been in those over the age of 65. Not all cases have been symptomatic. The CDC has stopped reporting all breakthrough infections but continues to record those that have resulted in hospitalisation or death.
- In the UK, PHE (Public Health England) reported that of 117 deaths resulting from the Delta variant recently, 50 were fully vaccinated (42%) and all the fully vaccinated that died were over 50.
- In US media, a few stories have reported individuals who’ve died after contracting Covid despite being fully vaccinated had low/non-existent antibody levels. For instance, 75 year old Alan Sporn died two months after receiving his second dose. He’d met up with family to celebrate being vaccinated and getting through such a tough year, but tested positive for Covid19 days later. His family revealed that after his death it was found he had very low or no antibodies in his blood. One of his children went on to say “I wish more people knew about the antibody test… It’s just one more test, and it’s a safety procedure that would have definitely saved my father’s life.”
Antibodies Aren’t The Whole Story
While antibody testing seems the simple answer to understanding how effectively we might be protected from the virus, it’s not the fully story. The body maintains a system of “cellular immunity” with other defenders that respond to foreign invaders like a virus. This would include the work of T cells. Someone with a low level of antibodies may not necessarily be poorly protected from coronavirus because other aspects of the immune system, like those T cells, may be prepped to respond. These other immune system elements aren’t assessed in the current commercially available tests.
What Antibody Level Provides Immunity?
Aside from antibodies not being the whole story, scientists don’t know how great the level of antibodies needs to be to confer protective properties. There’s no ‘normal’ level and no idea of how any level relates to protection from serious illness and death.
That said, there are some general guidance figures and research continues to illuminate post-vaccination findings.
Researchers at the University of Oxford published findings on 24th June 2021 regarding their antibody research and the findings of certain “correlates of protection” against symptomatic coronavirus infection.
Medichecks, providing information on their antibody test, note that the NHS Blood and Transplant scheme targeted individuals with antibody levels that were greater than 62U/ml for plasma donation in the hopes of treating coronavirus patients. A result above 0.8 U/ml means antibodies have been detected.
It has also been suggested that a result of levels >2500 U/ml indicates the most effective response to the vaccines.
What You Need To Know Before Getting An Antibody Test
There are different types of antibody testing. One type would just tell you ‘yes’ or ‘no’ as to whether you have any detectable antibodies. This is used for seeing whether you’ve previously been infected with Covid, though it’s not known how long antibodies will last for. Another type tells you the level of Covid antibodies in the blood, if indeed antibodies are found. This is better for if you’ve had a vaccination, so you can see the strength of the antibody response and track it over time if you wish.
Testing is only to give general indications of whether your body has responded to the vaccination because at present the full picture is still unknown. Scientists just say that antibodies should indicate a degree of protection from serious illness and death.
What Covid Antibody Test Should I Get?
- Commercial antibody testing early on in the pandemic to check prior infection would look at antibodies in the blood in response to the N protein (nucleocapsid). However, Covid vaccines trigger antibodies to the spike, a protein on the surface of the Covid virus, and not to the N protein (nucleocapsid). Antibody testing post-vaccination therefore needs to be looking at antibodies to the spike rather than to the N protein. This may be written as “anti-spike IgG antibody” testing.
- An antibody test should also provide the antibody level rather than giving a simple yes/no result, which may not pick up lower levels of antibodies.
When Should I Get An Antibody Test?
Anyone looking to get an antibody test post-vaccination should wait at least two weeks after getting the second vaccination to give the immune system time to respond fully.
Where Can You Get An Antibody Test?
This will vary between countries. A Google search might pick up some options for you specific to your country.
Where Can You Get An Antibody Test In The UK?
In the UK, the general public can’t get an antibody test via the government or on the NHS, unless you’re involved in a research study (such as the REACT study). However, private antibody testing is available. Most testing, such as via private hospitals like Nuffield, will be of the basic kind to tell you yes/no as to whether antibodies are detected.
If you want to test for the antibody level post-vaccination, you can do this privately via Medichecks, who now offer the qualitative test on their website. This Roche test checks for antibodies to the spike protein of SARS-CoV-2.
You can do this safely from the comfort of your home with a finger prick test kit. The full instructions are in the box and their customer service are on hand should you have any queries or issues with collecting the sample. Pop the sample in the pre-paid bag and take it to the post box. You’ll get an email as soon as it’s arrived and then you’ll get the results sent back to you with details of the level of antibodies detected (turnaround time is estimated at two days).
To give an idea, I sent the two tests back on Monday morning. I had an email Tuesday morning so say they’d been received. On Wednesday morning I had two emails to say the results were available on the accounts. I downloaded these as PDFs to keep for future reference.
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Vaccine & Antibody Test Awareness
The arrival of vaccines seemed to be the light at the end of the tunnel for ending the pandemic. But vaccines aren’t a guarantee and the concern of their limited effectiveness in the more vulnerable is disconcerting for many people when lockdowns are starting to lift.
I’ve not written this post to encourage people to rush out & try an antibody test. The aim is to – hopefully – help make some sense of the mass of confusing information out there so that you can make a more informed decision for yourself as to whether it’s something you’d want to consider.
Hopefully this also makes more people aware of the fact that vaccinations don’t come with immunity guarantees, and that antibody testing is available in some countries if you pay privately. This hasn’t been highlighted by the government or NHS in the UK so there are likely going to be people wanting such a test but are totally unaware that they’re even available.
Is Covid19 antibody testing after vaccination something that you, or someone you know, would be interested in, perhaps because of being immunocompromised in some way? Or have you already tried it?