Frequently Asked Questions About the Report

• When will I receive my report after sending in my sample?

  It will take approximately 3 weeks to receive your report once your sample arrives at our laboratory. Once your report is generated, you will receive an email with instructions for viewing your report.

• The result for my total antibody score was in the range of pre-pandemic individuals, but I have been vaccinated/had COVID-19. What does this mean?

  A low antibody score does not mean that you do not have immunity to the virus. Antibodies are only one of several components that play a role in immunity. Even if your level of antibodies is not detectable by our tests, your antibody response is stored in your body and will be reactivated if you are exposed to the virus again. Additionally, although we use more than one test to measure SARS-CoV-2 antibodies, no test is 100% accurate.

• I had COVID-19, but my report says that my response looks like vaccination. What does this mean?

  The COVID vaccine targets an area of the SARS-CoV-2 virus called Spike glycoprotein. The natural infection score is determined by looking for antibodies to proteins that are not targeted by the vaccine (areas other than Spike glycoprotein). Some people do not make as many antibodies to these other proteins, so their response looks more like vaccination. Other people initially make antibodies to these other proteins, but they disappear more rapidly than antibodies to the Spike glycoprotein, so over time their response looks more like vaccination than natural infection.

• My acute score indicated N/A, but I recently had COVID. What does this mean?

  When our lab receives your sample, we run an IgG test first as it is the most informative test for our clinical study. The acute infection score is determined by running an IgM test. If there is not enough serum from your sample for the IgM test, our lab will report the score as N/A. Very few people in our clinical study are positive on the acute score, and rather than having you provide a second sample, we opted for an N/A result in the cases where there is insufficient sample volume to run both IgG and IgM.

• I have received a booster shot and would like to see how it has changed my antibody response. Can I submit another sample?

  Yes, we are very happy to collect another sample from you if you have received a booster shot. You can request another sample collection kit through your Serimmune portal. To allow enough time for changes to occur in your antibody response, we ask that you wait 2 weeks following your booster shot to collect another sample.

• How is my total antibody score determined?

  In order to calculate your total antibody score, our technology measures the amount of different antibodies you have to the virus based on the peptide motifs in our library to which the antibodies bind. These motifs mimic the natural binding sites of the antibodies in SARS-CoV-2 viral proteins. The amount of each motif is an approximation of the amount of each antibody present in your blood. We also use a conventional serology test, called an ELISA, which measures the amount of antibodies you have to the SARS-CoV-2 spike glycoprotein receptor binding domain (RBD). From these tests we calculate a composite score which indicates whether you have made antibodies to SARS-CoV-2 from either vaccination or natural infection.

  The value of the score may be influenced by many factors which may include: your age, how recently you were exposed or received the vaccine, whether you are taking any medicine that may compromise your immune system and, if you were naturally infected, the severity of your illness. We do not know how long a detectable immune response lasts. That is one of the primary aims of our study. If the antibodies in your blood decrease over time, or even if they become undetectable by our tests, this does not necessarily mean that you are no longer immune to the virus. Another goal of our study is to determine whether people become infected at some point after vaccination and whether that correlates with a decline in antibodies.

• How is the vaccination vs. natural infection score calculated?

  People that have been naturally infected with SARS-CoV-2 make antibodies to multiple different proteins contained in the virus. People who are vaccinated for SARS-CoV-2, however, will only make antibodies to the spike glycoprotein present in the vaccine. Our test can distinguish natural infection from vaccination by measuring an individuals’ antibodies to peptide motifs from SARS-CoV-2 proteins other than the spike glycoprotein. We have provided this score for people in case they wondered whether they had been naturally infected with COVID-19 during a previous illness, but had never been tested, or if people suspect that they might have COVID-19 whether or not they previously received a vaccine. Occasionally, people who are naturally infected may have a weak response to non-spike proteins and their immune response may look more like a vaccinated person’s response. Additionally, people who were exposed several months previously may have a declining antibody response to the full virus and a subsequent vaccination may selectively enhance the antibody response to spike proteins. In these individuals, the response may also look more like vaccination than natural infection. The majority of the time, we can distinguish these two states.

• How is my acute or recent COVID-19 infection score calculated?

  Our test measures two different antibody isotypes present in the blood, IgG and IgM. The acute infection score is calculated by specifically measuring IgM antibodies in the blood. These particular IgM antibodies were detected in people with natural infection and are not present in people who have been vaccinated and so they are specific to infection. IgM antibodies are generally the first type to appear after infection and they are also the first to decline. The IgM antibody response varies amongst individuals and with the type of infection. For some types of infections, the IgM response can be prolonged for many months or even longer. From our studies in people naturally infected with COVID-19, the IgM response lasts for several months, however we have limited long term data. In this study, we hope to gain a better understanding about the kinetics of the IgM response to COVID-19.

• How were the mild, moderate and severe COVID-19 antibody heat maps generated and how should I interpret them compared with my heat map?

  We have screened over 500 COVID-19 cases spanning all disease severities and mapped the detected antibody specificities within each group. These maps showed that people with mild disease have fewer distinct antibody specificities compared with moderate and severe disease. Each person’s antibody response is unique, and the number or relative abundance of an individual’s antibodies doesn’t indicate greater or lesser immunity to the virus. Because of this unique and heterogeneous response, it is not possible to show a heat map of an average antibody response for any severity category. Instead, for each column, we are depicting the range of antibodies that we have identified within each disease severity category, or within vaccinated individuals. There are some antibodies that are found at the same level across all groups, whereas other are present almost exclusively in moderate and/or severe COVID-19 cases. Within each of these columns, the darker the box, the more prevalent and/or more enriched that antibody species is in that severity group. We have provided these columns for reference and as the study progresses, we hope to understand whether the differences we have observed in our studies are representative of the larger population.

  The primary value of the heat map for an individual is to visualize how your personal antibody response changes over time. For example, do some antibodies decrease while others remain? Does your global antibody response remain high for months or years? Does revaccination result in a greater boost of pre-existing immunity than was observed in the initial vaccination? Do people who get COVID-19 after having been previously naturally exposed or vaccinated have less severe cases overall?