Differentiating Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Responses Between Infection and Vaccination: Challenges for Epidemiological Research

Sunav N Nayagam; William Coote; Matthew T C Carroll; Zheng Quan Toh; Paul V Licciardi; Michael J Abramson; Karen Walker-Bone; Tyler J Lane

doi:10.1093/infdis/jiaf295

Differentiating Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Responses Between Infection and Vaccination: Challenges for Epidemiological Research

J Infect Dis. 2025 Jul 30;232(1):9-13. doi: 10.1093/infdis/jiaf295.

Authors

Sunav N Nayagam¹, William Coote^{2

3}, Matthew T C Carroll², Zheng Quan Toh^{4

5}, Paul V Licciardi^{4

5}, Michael J Abramson^{1

6}, Karen Walker-Bone¹, Tyler J Lane¹

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
² Monash Rural Health Churchill, Monash University, Churchill, Victoria, Australia.
³ Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁴ Infection, Immunity and Global Health Theme, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁵ Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
⁶ School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.

Abstract

Some common coronavirus disease 2019 (COVID-19) vaccines elicit antibody responses that most serological tests are unable to differentiate from an infection response. This presents a challenge for COVID-19 epidemiology and serosurveys. In this perspective, we examine the potential scale of this problem.

Keywords: COVID-19; antibodies; epidemiology; serology; vaccines.

MeSH terms

Antibodies, Viral* / blood
Antibodies, Viral* / immunology
Antibody Formation
COVID-19 Vaccines* / immunology
COVID-19* / epidemiology
COVID-19* / immunology
COVID-19* / prevention & control
Humans
SARS-CoV-2* / immunology
Vaccination

Substances

COVID-19 Vaccines
Antibodies, Viral