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

Ed Tobias avatar

by Ed Tobias |

Share this article:

Share article via email
antibody, The MS Wire

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?

Recommended Reading
patients on anti-CD20 therapies should get COVID-19 vaccine/Multiple Sclerosis News Today/cells illustration

COVID-19 Vaccine Trial Testing Extra Dose in MS, Other Diseases

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!

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.

***

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.

Reply
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

Reply
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

Reply
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?

Reply
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

Reply
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?

Reply
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

Reply
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?

Reply
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

Reply
Seth avatar

Seth

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

Reply
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

Reply
Johanna kolipano avatar

Johanna kolipano

I had a blood test to tell me if I had antibodies in my system from having been exposed to COVID 19 in the past. The numbers came back as 12.80, no negative or positive designation, can anyone tell me what those numbers mean?

Reply
James levy avatar

James levy

i had transverse myelitis years ago but im 75% better i had covid a year ago the lab corp test came back at 1100.00 s protien does this correlate with anything. i hope a have some protection still. i really dont want to reactivate the TM again.

Reply
Ed Tobias avatar

Ed Tobias

Hi James,

I'm sorry that I can't help you with this question. I don't know what your protein level indicates and I've not heard of a connection between COVID-19 and TM. These are better questions for your neurologist.

Ed

Reply
matt avatar

matt

I had my second Pfizer shot 10 days ago , and did SARS-CoV-2 S antibody (Roche) test today . My results are :
6162.00 BAU/mL
Only thing I'm not sure : is U/mL the same as BAU/mL

Reply
Jani avatar

Jani

I had my last Pfizer vaccine on March 2nd. Just had the semi quantitative antibody test and my number was 568. I think being older I just wanted to know what that I had at least some antibodies formed to covid.

Reply
Ed Tobias avatar

Ed Tobias

Hi Jani,

I haven't seen any guidance about how those antibody numbers range in terms of protection. I only know that my neuro has told me that, with mine over 2,500, I don't need a third shot. Have you asked your neuro, or primary care doc, what your results indicate?

Ed

Reply
J Mc Isaac avatar

J Mc Isaac

I was vaccinated with my Moderna second shot back in February. I am immune compromised and get an infusion of IGG monthly. I had my antibodies tested last week and my number was only 31. That means I am very low, correct? I plan on getting a booster shot, my question is; should I get my booster before or after my IGG infusion?

Reply
Ed Tobias avatar

Ed Tobias

Hi J Mc,

I'm not a health care professional so I can't answer that one. I'd suggest you ask your doctor.

Ed

Reply
Talha Jahangir Vohra avatar

Talha Jahangir Vohra

Hi! My post vaccination antibody result is result 250 range 0.40 - 250 u/ml. Is it positive or negative?

Reply
Ed Tobias avatar

Ed Tobias

Hi Talha,

It's indicating you have some antibodies but, not being a health care professional, I can't assess what that level really means. It would be better to ask your doctor.

Ed

Reply
Jean Seitz avatar

Jean Seitz

I had Covid almost 8 months ago and did not get a
vaccination because I figured I had some natural immunity. I had the LabCorp antibody test on Monday 8/16/21 and my score is 233. I have no idea if that’s a good number or not? I’m obese
with no other known health issues I was fearful to get the vaccine because I thought it would ruin my natural immunity or increase the chance of side effects from getting the vaccine. I read that in China people only had to have a 50 in order to not have to quarantine when RE-entering their country. All the information and misinformation makes it hard for me to make a decision on whether to vaccinate or not. Thank you

Reply
Kareem avatar

Kareem

My take sharing info.
Nicely explained. Few confusion raised:
(1) Too little 🐜 body is a problem well known fact
(2)Too much antibody is a problem as this third/booster increase antibody which may PRE dispose patients to Wldenstrom’s, non Higgins type of cancer. Too much may not always fetch good outcome.
(3) third vac to immunocom: opening the Pandora’s jar.
(4) why? FDA said not to find if vaccinated has enough mature
antibody.It’s done for HepB. Fact not a fallacy though
You are voice herald the facts. Thanks

Reply
Lesley avatar

Lesley

Hey there! Thanks for the post! I just had my labs drawn yesterday and back today. After having the Moderna shots in Jan and Feb of this year with a possible mild covid infection in July (a positive rapid on Sunday after being very ill but then a negative pcr on Tuesday and Wednesday- dr says shes not convinced it was a false positive but rather the shot working) and my numbers today on the antibody test came back 840 u/ml positive on antibodies. I was pleased with it being that high this far out from my shots, especially since I have been on corticosteroids for the last month and they are an immune suppressor. Without those, I am sure it would have been a little higher. It just made me feel better to know that I had a good and detectable amount of them working. Next month, I will get in line to get the booster.
I am not a medical professional but from what I am reading, levels of positive antibodies are what help you keep from getting serious covid if you do get it. So everybody get those shots and make sure you have them in you! Stay safe all!!

Reply
Ed Tobias avatar

Ed Tobias

Thanks for the comments, Lesley. I think your view of all of this is correct and I'm glad you're doing ok.

Ed

Reply
Janice Zeoli avatar

Janice Zeoli

Hi, Claudia - Please check WHICH Covid antibody test you got. It should show TWO results: (1) the spike antibodies to the virus (which should be negative if you've never had Covid) and (2) the antibodies to the vaccine (which should be positive if you've been vaccinated and negative if you haven't). It wasn't until May or so that an actual vaccine antibody test was even developed. Before that, docs were just using the only test available, the one that determines if you had become infected. They couldn't figure out why all these vaccinated people or showing no antibodies until they figured out the font was with the diagnostic test itself.

Reply
Ed Tobias avatar

Ed Tobias

Janice,

Thanks for sharing this. It's good info, clearly stated.

Ed

Reply
Bobby avatar

Bobby

I can't believe they are making all these vaccines and not know what number antibody levels should be at for full protection. It's the 21st Century come on already.

Reply
Robert L. avatar

Robert L.

I had a liver transplant 8 years ago and also without a spleen… with the new liver comes my Prograf medication.
I had taken the Full course of the Pfizer Covid vaccines. A few weeks later….I had a blood test.
And my antibody results from Labcorp were negative.
A couple of months later I received another full treatment of the two Pfizer Covid vaccines… A few weeks later I again went and had another antibody test done by Labcorp.
This time, I’m happy to say that my results were positive >2500… I believe that individuals that are have a immunodeficiency and are in an older age bracket such as myself., should take responsibility and consider a booster shot as has been done in Israel and other countries. We must be proactive in our attention to this Covid plague and consider the consequences if not.

Reply
Ed Tobias avatar

Ed Tobias

Hi Robert,

Thanks for the info, which is very interesting. I think a lot of us who have had the first round of shots are planning on getting a booster, whether or not they have a medical condition or might be immunocrompromised. I know I'm planning on it, even with my >2,500 reading of a couple of months ago.

Ed

Reply
Edwina avatar

Edwina

Thank you! My results just came out as 2500 U/mL, after one sinovac jab and two moderna jabs. Did you receive cross-vaccinations as well?

Reply
Ed Tobias avatar

Ed Tobias

Hi Edwina,

No...just the standard two Moderna shots.

Ed

Reply
Liesl Nederhood avatar

Liesl Nederhood

I have RA/Lupus so take daily immune compromising drugs and have Rituxan normally 2x a year but now once a year due to Covid. I had the Pfizer vaccine with no response so decided to try the J&J figuring I had nothing to lose. Went from .5 to 15 which my doctor says is still low but can't get any more explanation than that. So will continue to act like I am not vaccinated which is harder to do as the rest of the county is opening up. Glad I live in CT where people have taken this very seriously.

Reply
Ed Tobias avatar

Ed Tobias

Hi Liesl,

Thanks for sharing your experience. I wish more vaccinated people would act as you are, as if they're unvaccinated. We'd all be better off.

Ed

Reply
rebecca jarman avatar

rebecca jarman

I have a naturally high igm, am on a blood thinner, my igg is a little low and iga is even lower I gtr moderna in jan-feb had a mild case of covid 9 days after second shot, does the high igm I have protect me from covid?

Reply
Mirian alvarez avatar

Mirian alvarez

I did a antigen test and my results were 2.45 no vaccine yet only had covid in January 2021

Reply
Tammy avatar

Tammy

Hi Jean, my husband and I both had covid last October. Went to Lab Corp and had the antibodies test. My antibodies number is 549! I do not plan on having the vaccine since obviously my natural immune response to covid was able to fight it just fine and I continue to show response to be able to fight it if need be again. I will continue to do what I can to remain healthy, workout, eat right, manage stress as best as possible. My husband elected to get the J&J shot after pressure from our doctor and has had nothing but problems since! Lots of joint pains! All this to say, if you have had covid, be cautious about running out to get the vaccine. If your body fought off the virus, you are part of the 99.8% who have survived because your immune system could handle it.

Reply
Ed Tobias avatar

Ed Tobias

Hi Tammy,

When making a COVID vaccine decision, please keep in mind that a person who survived a bout with COVID-19 early in the pandemic might not fare as well if exposed to the Delta variant. Your immune system might have fought off the earlier strain but might not be able to handle the current one, or the one after that.

Ed

Reply
Hightech Redneck avatar

Hightech Redneck

I've been immunocompromised for the last 30 years due to kidney transplants (3 of them). Other than that, I've been very healthy and not susceptible to sicknesses, and as a result, I don't bother with flu shots, nor did I get the Covid shot. I had a very, VERY mild case in January (4 days with no smell/taste, horrible if you're a coffee drinker). My antibody test came back today at 133. Given Labcorp's focus on the spike proteins only, I personally feel comfortable to assume that the myriad other identifiers within the coronavirus that my immune system recognizes gives an overall better identification of the virus' fingerprint than the vaccine alone. Obviously, each person has to make their own risk assessments and do what the feel is best. Just adding my anecdotal story since more open and transparent information is always good.

Reply
Ed Tobias avatar

Ed Tobias

Thanks for sharing H.R.,

I agree about individual risk assessments, taking into consideration the risk involves both that individual and others to whom that person might, unknowingly transmit a virus. There's also the possibility that your (thankfully) mild COVID case might not protect you from the more contagious Delta variant. I don't know that as a fact...just putting it out as a consideration. As you say, open and transparent is good for us all.

Ed

Reply
Sandy Robinson avatar

Sandy Robinson

After the antibodies test my level is 3500 is that good?

Reply
Ed Tobias avatar

Ed Tobias

Hi Sandy,

As I understand it, a level of 3,500 is quite high. Remember, however, that the antibody level is likely to drop over time.

Ed

Reply
Jurij Milatović avatar

Jurij Milatović

Hi, I am 74 and healthy, no medications at all, 185 cm /80 kg. I got my second Pfizer shot 8,5 months before my testing and result was 557 AU/ml. My collegue is 55 and 3,5 months after second shot his test result was 8300 AU/ml. I gues mine antybodies faded in 8,5 nonths so I took 3rd shot. I found an article on Pfizer testin cca 3000 people with their vaccine and the results were: Antibody responses >21 days post second Pfizer vaccination in those not previously infected, 10 058 (6408-15 582) AU/mL, were similar to those after prior infection followed by one vaccine dose.
Pfizer and the lab where i was tested use the same test: Abbott SARS-CoV-2 IgG II Quant test

Reply
Jaime Ruiz-Garcia avatar

Jaime Ruiz-Garcia

Dear Claudia Chamberlain
I work in physical virology. If your test was for antigens and it came back zero, that's normal and you should be happy because it means you haven't been infected. If you were vaccinated a few months before the antigen test, the antigens that the vaccine produces will disappear because the immune system will begin to produce antibodies. You should perform an antibody test instead of an antigen test to check the effectiveness of the vaccine.
Best wishes,
Jaime

Reply
RJ avatar

RJ

Wouldn't it be better to have people get tested to get a baseline of Antibody numbers and then monitor whether patients get covid? How will we ever know if the vaccine/natural immunity is working without quantitative numbers?

Reply
Elizabeth Dwyer avatar

Elizabeth Dwyer

I am not an MS patient. But came across this researching vaccine side effects. I will only tell you about my experience. Please contact your doctor to assess your risk vs benefit. I am not a doctor or employed in the medical community - just a person. This is only my experience and my opinion of my experience. You are a different person, so you are different. I am 59. I had a very nasty case of covid in Jan 2021. I had recovered in about 5-6 weeks. My symptoms were severe breathing issues, cough, headaches, muscle aches. My doctor at the time recommended that I get the shots saying - I didn't want to get it again. Failing to recognize that I had natural immunity at the time. I had my first vaccine in March of 2021 with a 3 day recovery - fever headache muscle aches, cough. I received the second vaccine in April with few side effects. By May I had started to develop an asthmatic cough. It is now October and I have severe asthma. This is new to me. Before I had allergies and very mild asthma rarely needed treatment. Meaning not even every year, but some more than others. I have also have acid reflux. I'm receiving medical care from a different doctor who understands this well. He is an immunologist. So there you go. This has been my experience and it has not been resolved. I am still suffering with severe asthma, and I would so love to go back to 2020 (does anyone actually say that?). Who knows what this all means. Do lots of research and talk to your doctor. I know that real scientific information exists - it will be hard to find though. I am of the belief that this shot is not good for everyone, however, some people can definitely benefit, and your being a little older and suffering from MS may be a big factor. I wish you peace and good luck.

Reply
Ed Tobias avatar

Ed Tobias

Hi Elizabeth,

I'm very sorry for all of the problems that you've had but I've very glad that you shared them here. As you say, it's only by researching facts, and understanding the difference between facts and opinions, that we can make informed decisions.

Ed

Ed

Reply
samantha avatar

samantha

i dont understand my test it says
roche anti-sars-cov-2-s Results >2500.0
0.8u/ml positive
i dont understand what this means

Reply
Ed Tobias avatar

Ed Tobias

Hi Samantha,

The ">2500.0" refers to your antibody level. My neurologist considers this a very robust level of protection against the SARS-Cov-2 virus that causes COVID-19. I don't, however, know what "0.8u/ml positive" indicates.

Ed

Reply
Lucia avatar

Lucia

What I don't understand is that the vaccine was developed on the earlier strain not the delta. So isn't it the same thing whether you had covid earlier and it may not protect you from delta variant or you get the vaccine which wasn't developed to fight delta, isn't it?? I think you would still have protection either way.

Reply
Ed Tobias avatar

Ed Tobias

Hi Lucia,

As I understand it, the Delta strain is just stronger and more contagious than the initial SARS-CoV-2 strain. It's still the same virus and the vaccines developed for it are effective against all of the various strains that may develop.

Ed

Reply

Leave a comment

Fill in the required fields to post. Your email address will not be published.

Dancing Doodle

Did you know some of the news and columns on Multiple Sclerosis News Today are recorded and available for listening on SoundCloud? These flash briefings give our readers an alternative option for accessing information important for them.

Listen Here

Video