COVID-19 Antibody Testing

Overview

COVID-19 antibody tests, often called serology tests, use a blood sample to look for antibodies made by the immune system after exposure to the SARS-CoV-2 virus or COVID-19 vaccination. These antibodies can help determine if someone had a past infection or vaccine-triggered immune response.

These tests do not detect active infections and should not be used to confirm immunity or protection from future illness. After exposure or vaccination, the body typically takes two to three weeks to produce enough antibodies to be detectable. Testing too early may lead to a false-negative result. There are two main types of COVID-19 antibody tests:

Test TypePurpose
Binding AntibodiesShows if someone has made any antibodies to the virus.
Neutralizing AntibodiesIdentifies a type of antibody that blocks the virus, mostly used in research.

Binding antibody tests are the most commonly used and indicate that the immune system has responded to the virus. However, they do not measure how protective that response is. Neutralizing antibody tests are more specialized and often used in research to assess whether antibodies can stop the virus from entering cells.

Antibodies can remain in the blood for months, but scientists are still studying how long and how strongly they protect against reinfection. These tests also help public health experts understand the spread of the virus in a community, though they are not recommended for individual immunity decisions.

Reasons for Using Antibody Tests

COVID-19 antibody tests are useful in several situations. Common uses for antibody testing include:

  • Confirming past infection in people who were never tested with a diagnostic test.
  • Assessing immune response in those who had a strong reaction to their first vaccine dose.
  • Identifying if someone has antibodies to donate plasma, which may help treat patients with severe COVID-19.
  • Helping diagnose children with multisystem inflammatory syndrome (MIS-C) possibly linked to COVID-19.

Tests usually detect antibodies against the virus’s spike or nucleocapsid protein. Availability may vary based on local resources and guidelines. Contact your local health department or healthcare provider for more information.

Possible Issues

Timing and test quality affect reliability. Testing too early or using a poorly validated test can result in errors. There are two main types of inaccuracies:

Error TypeWhat It Means
False-PositiveThe test says there are antibodies, but the person actually does not have them.
False-NegativeThe person has antibodies, but the test fails to detect them, or it is taken too early.

A false-positive result may give a false sense of protection. Even a true positive doesn’t confirm how much or how long someone is protected. Test performance may also vary with different virus strains and manufacturers. Only use tests approved by health authorities like the U.S. Food and Drug Administration.

How to Get Ready for Testing

Before arriving at the testing site, patients should follow any instructions provided by their healthcare provider. They should bring a list of current vaccines and ask whether masks are required for everyone attending the appointment.

What You Can Expect

A healthcare provider collects a blood sample, either by finger prick (for rapid testing) or from a vein (for lab testing). The sample is then analyzed for antibodies using immunoassay techniques.

Quick Facts Table

StepWhat Happens
Sample CollectionBlood taken by finger prick or vein.
Testing ProcessSample analyzed for antibodies (signs of past infection).
Results TimeSame day or within a few days, depending on the location.

Findings

If the result is positive, it means the test detected COVID-19 antibodies in the person’s blood, suggesting past exposure to the virus. However, a positive result does not guarantee immunity. Reinfections have occurred, and experts are still studying how long antibody-based protection lasts and how strong it is.

A negative result means no COVID-19 antibodies were found in the blood sample, often indicating the individual has not had the virus. However, false-negative results are possible—especially if the test was done too early, before the body has produced enough detectable antibodies. The accuracy of antibody tests depends on two key measures:

Test CharacteristicDescription
SensitivityHow well the test finds people who really have the antibodies.
SpecificityHow well the test avoids saying there are antibodies when there are not.

False-positive results can occur if antibodies from other coronaviruses are detected. False-negatives are more likely if the test is done too early. Even after a positive test, precautions like vaccination, hand washing, and avoiding close contact remain important.

Summary: Understanding COVID-19 Antibody Testing

COVID-19 antibody testing checks for an immune response following infection or vaccination. While useful for understanding exposure history, these tests do not diagnose current illness or confirm immunity. There are two main types of results:

Test TypeWhat it DetectsUsed For
Antibody TestImmune response after infection or vaccinationChecking for past infection or response to vaccine
Diagnostic TestActive virusConfirming current infection