What does my antibody test mean?

We are answering your questions about the coronavirus vaccines and what we need to do next. Submit your question using this form or email Lois Solomon at AskLois@ sunsentinel.com.

Q. “I had an antibodies test (months after receiving two Pfizer shots), and the number was 7.6. However, I can’t find any explanation for what that means.” — Sharon Kersten, Wilton Manors

A. Unfortunately many of our local doctors are anti-antibody tests and would not answer this question.

“Test results from currently authorized SARS-CoV-2 antibody tests should not be used to evaluate a person’s level of immunity or protection from COVID-19,” said Dr. Geeta Nayyar, an associate professor at the University of Miami. “The U.S. Food and Drug Administration is reminding the public and health care providers that results from currently authorized antibody tests should not be used to evaluate a person’s level of immunity or protection from

COVID-19 at any time, and especially after the person received a

COVID-19 vaccination.”

Dr. Hila Beckerman of Delray Beach agreed.

“As of now, we don’t really recommend antibody testing as a way of directing your care because even if you have some antibodies after vaccination or disease, you should still get vaccinated or receive the booster,” she said. “This is because you don’t know when

the level will wane low enough to not really be protective anymore

for you as an individual. Most labs will give you a reference number, above which you are considered to be ‘protected’ but the number per se is not very indicative of what would happen should you become re-infected.”

Antibody levels are only one measure of how you will fight a

COVID-19 attack. Your immune cell levels are another important component, and they’re not measured in the antibody test.

I was disappointed about all this because I’ve been wanting to get an

antibody test, too, to see if I really need a booster. But this is one of

those situations where health officials are afraid people will become too dependent on the technology and ignore their warnings about

how to stay safe. According to the FDA: “If antibody test results are interpreted incorrectly, there is a potential risk that people may take fewer precautions against SARSCoV-2 exposure.”

Q. “I’m 73 years old, I live in Florida and was fully vaccinated (Moderna) eight months ago. When can I get the third vaccine and will it be at 50%?”

— Rey Curva

A. Federal health officials completed authorization of a Moderna half-dose third shot on Oct. 21. Publix, which has both Moderna and Pfizer in pharmacies, has been offering fullstrength Moderna booster doses since August to people who are

immune-compromised, and likely will be prepared to offer the half dose in the coming days. Call Publix or any pharmacy offering vaccines and see if they are ready for the new population of people who are now eligible for the halfdose, which includes you as a senior citizen.

Q. “My wife and I were both vaccinated with Pfizer in January and February but came

down with breakthrough infections in July. Our symptoms were fairly mild. We would like to get the booster shot but are getting conflicting and confusing information from the doctors we see.

One said wait three months, then get an antibody test to see if you need a booster. Another said we don’t need boosters because having had the virus is

more protective than a booster and we should wait until next year sometime. Yet another

said to get the booster now and to forget about antibody tests

because results tend to be inaccurate, hard to interpret and yield different results depending which test is used.

Can you offer any information or sources that will help us determine if a booster is appropriate at this time?” —

A. Isn’t it the worst when every doctor is giving you a different opinion? Well here’s another opinion, this one from Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.

“You should receive a booster one month after your infection if it’s been at least six months since your second vaccine,” Beckerman said. “Antibody testing is not recommended for a few reasons: There is no target amount of antibodies that will keep you ‘safe,’ each test is different with no good standard, and you also don’t know at which point your antibody level will wane as to leave you unprotected. You would have to test yourself weekly.”

She added that she doesn’t like the term “breakthrough infection.”

“The vaccine protects you from becoming seriously ill, not preventing you from acquiring the infection,” she said. “You were infected in July and had mild symptoms probably either because you still had some protection from the vaccines or you would have had a mild course naturally. There is no way to know, which is why we recommend that everyone receive their vaccines — we don’t gamble.”

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Q I’m 71 and in very good health. I received my second Pfizer vaccine in late February. In mid-September, I came down with a very mild breakthrough infection. I was tested again a week later and am still positive. According to my doctor, you can’t be positive for COVID-19 and get the booster. I was told I can get the booster once I’ve been negative for 30 days. I have another test scheduled soon. If it comes back positive for a third time in a month, can I get the booster?”

— Bill Bradley, Fort Lauderdale

A. You can get the booster if a month has passed since your infection and you no longer have symptoms, even if you’re still testing positive, said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.

“You can test positive for COVID for many weeks after your initial test because you may still have broken down viral particles that are still hanging out in your respiratory system,” she said. “This is why I don’t recommend getting retested after an infection. Ten days after an infection, as long as you don’t have symptoms, you are no longer considered contagious, even if your tests keep coming back positive.”

Q. “How long after receiving the booster does peak immunity occur?” — Richard, Safety Harbor

A. Everyone has their own rate of antibody development, but the range is mostly from one to three weeks for peak immunity, said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.

“Some people, mostly young and healthy, can develop peak antibody levels after seven days,” she said. “Older people, or those with compromised immune systems, can take much longer, up to three weeks to achieve peak immunity. “

Q. “The day after I was vaccinated I had mild tinnitus, pressure in my head, tingling and numbness in the left side of my face. Over the coming days I would also have twitching in my face, hands and feet. These effects lasted for three months. The worst part was having an episode of severe vertigo with nausea that lasted for nine days. Intervention with vestibular therapy helped to resolve that.

My doctor had suggested that I hold off on getting the second shot, and I still haven’t gotten it. I searched for answers to figure out what happened to me. I discovered a website, Vestibular.org, and looked at their forum on COVID-19 vaccine side effects, and found over 60 pages of comments from people who had similar issues.

I desperately want to get the second shot, but I am afraid to do so, fearing that I could have another reaction. Why doesn’t the media acknowledge these adverse effects, and why are we not hearing anything from the medical professionals?” — Diann Hasseman, Orlando

A. It’s been really hard for researchers to understand individuals’ adverse reactions after the COVID-19 vaccine. Tests on large populations have determined the vaccines are safe, but then there are people who have had experiences such as yours.

“With additional time and vaccine experience, what we know about your particular situation may change,” said Dr. Joanna Drowos, an associate professor of family medicine at Florida Atlantic University’s Charles E. Schmidt

College of Medicine. “The challenge becomes that just because something is reported, it doesn’t mean that it was caused by receiving the vaccine, and if it happens rarely it is even harder to determine whether there is a link to the vaccine.”

There have been case reports where individual physicians describe neurologic symptoms following the vaccine, and some of these same symptoms have also occurred in patients who are infected with COVID-19. But Drowos said researchers are not seeing unfavorable responses commonly enough to attribute them to the vaccine, or to even determine the best approach forward for an individual patient.

“This doesn’t take away from what you and others are experiencing,” she said. “There just isn’t enough data or experience with these types of events yet in order to identify whether there is an increased risk of them occurring over what would occur in the general population, and how to handle subsequent immunization.”