Do High Antibody Levels Mean I’m Protected Against COVID-19?

Ed Tobias avatar

by Ed Tobias |

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Is 2,500 my magical COVID-19 number?

At my annual MS checkup a week ago, my neurologist included a blood test for SARS-CoV-2 antibodies. Antibodies are proteins in the blood that protect the body from being attacked by viruses, bacteria, and the like. In this case, the blood test was searching for antibodies that would protect me against the SARS-CoV-2 virus, the virus that causes COVID-19.

With two shots of the Moderna vaccine in my bloodstream since early March, I should have a bunch of antibodies, and I do. According to my test report from LabCorp, a result of 0.8 units per milliliter (U/mL) or higher indicates the presence of SARS-CoV-2 antibodies. My test result was greater than 2,500 U/mL. An article written by the manufacturer of one antibody test reports that this number indicates a very robust vaccination response. So, should I consider myself protected against SARS-CoV-2?

Reading the fine print

Probably, but not certainly. My test results caution that “it is yet undetermined what level of antibody to SARS-CoV-2 spike protection correlates to immunity against developing symptomatic SARS-CoV-2 disease.” And the U.S. Food and Drug Administration has issued a strong statement that “antibody tests should not be used at this time to determine immunity or protection against COVID-19 at any time, and especially after a person has received a COVID-19 vaccination.”

Darn!

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Antibodies may not be the only protection

Does it really matter how high an antibody level I have? Immunologist Dan Barouch of Harvard Medical School says probably not and points to a study being done at the school.

“In this study, we define the role of antibodies versus T cells in protection against COVID-19 in monkeys,” Barouch said. “We report that a relatively low antibody titer [the concentration of antibodies in the blood] is needed for protection.”

Another article, this one on the Children’s Hospital of Philadelphia website, agrees with Barouch’s assessment. It points to the fact that scientists have not yet identified a “correlate of protection” for the COVID-19 vaccines. This is “a quantity of specific antibodies above which a person is protected against an infection and below which protection is uncertain.” It also points to evidence that some types of T-cells can affect a person’s course of a SARS-CoV-2 infection. And it agrees that “getting an antibody test to see if the vaccine worked is not as helpful as it would appear.”

I’m confident, but I’m still careful

So much for that 2,500 score on my antibody test. I guess I’ll just feel confident in the efficacy of my Moderna vaccine, which the Centers for Disease Control and Prevention reports is more than 94% effective. But I’ll also keep washing, distancing, and masking where it’s appropriate, just to be safe.

You’re invited to visit my personal blog at www.themswire.com.

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.

Comments

Philip Siddons avatar

Philip Siddons

I receive Ocrevus infusions twice a year which target my B-cells. Although I am fully vaccinated with 2 doses of the Pfizer vaccine, I wonder if there is any data yet for efficacy for those of us who are on Ocrevus.

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Ed Tobias avatar

Ed Tobias

Hi Philip,

Unfortunately, recent research shows a poor antibody response in people vaccinated with Pfizer and who are being treated with Ocrevus. https://multiplesclerosisnewstoday.com/columns/2021/05/11/the-covid-19-vaccine-reported-to-be-more-effective-with-some-dmts-than-others/

Ed

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Claudia Chamberlain avatar

Claudia Chamberlain

Sure hope T calls are helping! My antibody test after 2 doses of Pfizer, the second with nasty MS side effects, was ZERO antigens. So disappointed!

Reply
Ed Tobias avatar

Ed Tobias

Hi Claudia,

I'm sorry about your low antigen level but, as I wrote, it's not the only game in town. Also, I wonder if your level will increase with time. If you wind up getting tested again please let us know the results.

Ed

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GUILLERMO MENDOZA avatar

GUILLERMO MENDOZA

So in the spirit of understanding the importance of T-cell activation after vaccination has there been any public health interest in using the existing Adapt-T test which is readily available and comparatively inexpensive to better identify patients with suboptimal vaccine response?

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Ed Tobias avatar

Ed Tobias

Hi Guillermo,

I don't know. I'm not familiar with the Adapt-T test and haven't seen it mentioned in what I've read about SARS-CoV-2 and the various vaccines.

Ed

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Jackie Lupario avatar

Jackie Lupario

Specifically why is it not good to get an antibody test? Would you lose some of the antibodies protecting you?

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Ed Tobias avatar

Ed Tobias

Hi Jackie,

I think the reason the health organizations are recommending against getting an antibody test is that researchers haven't yet determined the level of antibodies at which someone becomes protected against the SARS-CoV-2 virus.

Ed

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Tom Anderson avatar

Tom Anderson

So when the CDC says to wear a mask if you are unvaxxed, and implies that those who are immunocompromised are considered unvaxxed if they do not have a typical vaccine response, where are people on anti-CD20 therapies to be? Should we still wear a mask, especially if as you say, antibody tests don't mean anything anyway?

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Ed Tobias avatar

Ed Tobias

Hi Tom,

All that I can say as a patient, not a healthcare professional, is that the most recent studies indicate that the vaccines appear to be less effective with people who are on anti-CD20 therapies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938733/. So, wear a mask, wash and distance.

I didn't intend to suggest that the antibody tests don't mean anything. Rather, there's not yet good knowledge about how much protection a specific antibody level provides.

Regards,

Ed

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Seth avatar

Seth

Nice to read. With ppms i know my antibody level isn't that good, what with the b b cell suppressants?

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Barbara Cordts avatar

Barbara Cordts

You don't indicate whether you take any immunosuppressive medications and I would be very interested in knowing that.
thanks in advance for your response

Reply
Ed Tobias avatar

Ed Tobias

Hi Barbara,

I was treated with Lemtrada and my first infusions were in December, 2016. I'm now more than 3 years post Round 2 and have not been treated with any DMT since then.

Ed

Reply
Maria Recio avatar

Maria Recio

I received the one-dose Jenssen vaccine about 2and a half months ago. I was tested yesterday with the quantitative antibodies test against SARS Covid 19 and my numbers are 16 for the Spike antibodies. My sons' results, we were vaccinated on the same date, are over 250. Does this mean he has a better inmune response after the vaccine? We've heard about some people who have had similar results as mine and they have received one dose of the Pfizer vaccine and then they are tested again and get in the range of over 250. Should we try to make our antibodies against the virus grow? Thanks.

Reply
Ed Tobias avatar

Ed Tobias

Hi Maria,

The problem with these tests, as I tried to make clear in my column, is that there is uncertainty in the scientific community about what these antibody test results show...i.e. at what test number are you protected. I wouldn't obsess over the numbers and I certainly wouldn't try any do-it-yourself methods of increasing antibodies.

Ed

Reply
Nancy Wise avatar

Nancy Wise

I read a recent NYT article about having an ELISA antibody test instead of the standard antibody test after COVID-19 vaccines for people who are immune compromised. My husband has his next Ocrevus infusion 5 weeks after his last Moderna vaccine and I want him to have this test. I’m wondering if you have heard of the ELISA blood test to determine if antibodies were present after the vaccine.

Reply
Ed Tobias avatar

Ed Tobias

Hi Nancy,

I've heard of the ELISA test but I only know that it's one of a number of antibody tests being used. The problem is, there appears to be no scientific consensus about what these test results actually mean in reference to COVID-19 protection. The best thing for you to do, I think, is to ask your husband's neurologist about the test. BTW, the test require a prescription so you'll need to speak with the neuro anyway.

Ed

Reply
Rafat avatar

Rafat

Is it recommended for a person over 70 years old who got COVID-19 and recovered to get vaccine?. The anti-bodies test results after the recovery was 1664.

Reply
Ed Tobias avatar

Ed Tobias

Hi Rafat,

That's a good question and I don't know the answer. It's really best to ask your neurologist about that. I'm very glad that you recovered and I hope you'll remain healthy.

Ed

Reply
Mary J Gregg avatar

Mary J Gregg

I had Covid diagnosed on March 4th this year, I got really bad and was given the infusion called Bamlanivimab 700mg , after than I began to recover, slowly but surely. I was told not to do anything for at least 3 months as far as vaccinations, and get tested before my decision as to vacs or not. It has been 4 months and got an antibody test, and it showed a positive 150.1 out of the scale of .7 above positive. So is there any ideas on what to do next, should I take the vaccination Maderna, or should I just wait! I am scared of the shot, but i definitely do not want Covid again, I am a 75 year old almost 76 year old woman, with a thyroid half removed and on blood pressure meds, so I just do not want to do the wrong thing. Do you have any recommendations? We live in the panhandle of Florida, and their is just so many pros and cons. Do you feel the 150.1 is a good positive number? My husband same age had the Moderna 2 vac, and did fine after first shot, than experienced a couple weeks of heart flutters but now better, but he has no health issues at all, so I am just concerned about the heart inflammation issues I have heard about from the shot. Please email me with any help you may offer. Thanks you so much for your time. M.Gregg

Reply
Ed Tobias avatar

Ed Tobias

Hello Mary,

I understand your concerns but, as a lay person, I'm not in a position to recommend what you should do. From what I've read, side effects vaccines occur very infrequently but they do occur. It's very much a risk/benefit decision. For me, personally, the potential benefits of the vaccine far outweighed the possible risks. But, this is really a decision that should only be made with guidance from your physician.

Ed

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