Testing for COVID-19 Antibodies

It was a lengthy debate.

After receiving a COVID-19 vaccine in April and reading all the mixed research saying that some people who are immunocompromised or have autoimmune conditions may not be as well protected, I pondered for months: Do I really want to know?

My COVID-19 diagnosis with RA

In late April 2020, I somehow caught the virus along with my husband Richard.

We did okay. He recovered from the major symptoms quickly but lost his sense of smell for several months. I took longer but didn’t have a severe case. It did take me a few weeks to recover from the major symptoms, and then a month or so more to recover from the extra fatigue.

Although my immune response to the virus was slow and plodding, I did have one. I fought off the virus and recovered without having a terrible case.

But did I develop antibodies that would protect me from future infection?

Testing negative for COVID-19 antibodies

A few months later, we were both tested for COVID-19 antibodies. We wanted to know if we now had some protection from future infection.

Richard came up positive and I came up negative. My doctor said it could be a multitude of causes. Perhaps we waited too long and my antibodies had already faded (although that seemed doubtful when Richard had them).

Or, maybe some combination of my rheumatoid arthritis and immunosuppressing drugs had somehow swept away the antibodies?

There was really no telling, but it meant that I had to continue to be very careful during the ongoing pandemic.

Continuing all precautions

With this information, I felt it prudent to continue all the precautions. I stayed mostly at home and, when I needed to go out, I always wore a mask (or even two) and made the excursion as brief as possible.

I kept my physical distance and waited patiently for the very first moment a vaccine was available to me. While my previous successful battle against the virus would hopefully mean I would prevail again, there was no guarantee - especially with the increasing number of viral variants circulating.

Vaccination brings some relief

After getting vaccinated and waiting the two-week period, I felt a huge relief. I had done what I could to protect myself during a dangerous global pandemic.

While I didn’t change my habits, it gave me a sense of calm that I had done everything possible. I still continued to practice all the safety precautions because I read the research about the uncertainty of the effect of the vaccine on people with immune issues.

How much was I protected by the vaccine?

My doctor advised that I continue to be as cautious as possible because he couldn’t say if the vaccine would provide full protection.

At first, the guidance was to stay patient and wait to see the research. It was advised that people not get antibodies testing because most people would be protected by the vaccine.

But increasingly the question nagged at me: Did the vaccine offer me full, partial, or zero detectable protection?

Protection in T cells

I spoke with my doctor about whether I should be tested for the antibodies. Was it better to know, even if the test came back negative?

My doctor explained that it was possible that I would test negative.

But, research had found that even people who test negative for antibodies can have protection in their T cells, which are the memory cells; that can only be tested by pulling bone marrow.^1,2

I wasn’t willing to go that far, so if I had a negative test I would still be in an uncertain zone.

However, if I came up with some or full protection, it would be a relief to know that my immune system reacted to the vaccine and I would have some safety in case of exposure. Sure, I could still get sick but all the research is showing vaccinated people with a good immune response have light cases.

Information is power

It came down to the matter of information. My doctor thought it was a good idea to get tested for antibodies because it would give me more information.

A negative result would guide me to stay in my careful zone. A positive result would give me some flexibility and assurances that, should I be exposed, I would likely be okay.

He didn’t have any predictions because the results of autoimmune patients have been all over the place. Only testing and time will hopefully give us more answers to reveal patterns.

A strong result

Living in the pandemic has been a balance between understanding what is known, gathering the available information, and weighing this against risks and comfort level.

I decided that information was power and so went forward with the antibodies test. I was elated to find I had a strong result.

While I’m not changing any habits, I am reassured that my crazy mixed-up immune system has built up some antibodies that should protect me against exposure to the virus.

I don’t know if I just lucked out or what happened, but am grateful in any case. For me, it was better to have more information on my personal situation and I am glad that I took the leap to find out.