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How do you test for antibodies?

I'm very glad you asked. I'll answer with a copy of my current correspondence with Labcorp, who is one provider of these tests.

My email to Labcorp:

I have a long history of adverse reactions to influenza vaccines, which in three different years left me very ill within a week of the vaccination. The most recent (5 years ago) left me bedridden with severe influenza symptoms for 5 weeks. I haven’t had a flu vaccine (nor the flu) since then.

I fully understand the mRNA Covid-19 vaccines are much different, but in spite of that (and maybe because of that as well) I am extremely reluctant to accept that vaccine.

The current fact is that in the past 15 months on 2 occasions I have experienced symptoms that might have been Covid-19, (but different and less serious than my previous bouts with the flu) and would really desire a reliable test to see if I have natural antibodies to Covid-19.

https://www.labcorp.com/coronavirus-disease-covid-19/individuals/antibody-test

(from that link)

Go Through Labcorp.com to Request a Test

GET STARTED: Request through Labcorp.com

Learn About the Test
• This test checks for antibodies to COVID-19. If you’ve been exposed to COVID-19 or vaccinated, your body produces antibodies as part of your immune response. The test provides a numerical value that indicates whether or not you may have antibodies to COVID-19.

• If you have been exposed to the virus that causes COVID-19, your body typically produces antibodies as part of the immune response to the virus.

• It can take at least two weeks after exposure to develop antibodies.

• This COVID-19 semi-quantitative test is for individuals who think they may have had COVID-19 and do not currently have symptoms.

• You can get the antibody test through your doctor or healthcare provider.

• You have the option to request the antibody test through Labcorp.com. While the test itself has no upfront costs, there is a $10 non-refundable service fee for the physician order through PWNHealth. The $10 service fee is not submitted to insurance for reimbursement. Labcorp will bill the cost of the COVID-19 antibody test directly to your health plan if you are insured, or if you are uninsured, Labcorp will bill the appropriate government program.

• To receive your test results, you will need to sign in or create a Labcorp Patient™ account.

So I ordered it, and got a test note: the test that was delivered was NOT what I expected or needed, covered later below)

• I understand from a Consumer Labs review that labcorp offers the Abbot SARS-CoV-2 IgG nucleocapsid 100% sensitive 99.6% specific
or the Roche Elecsys Anti-SARS-CoV-2 IgG nucleocapsid 100% sensitive 99.8% specific.

I assume either one of these may be the labcorp SARS-CoV-2 Antibodies, Nucleocapsid 164068, which is really the test I expected to receive in accordance with the description shown above.

Specifically, that “If you have been exposed to the virus that causes COVID-19, your body typically produces antibodies as part of the immune response to the virus.”

It turns out that the test I got was labcorp test number 164090, which specifically test for antibodies to the spike protein produced by the vaccine, which I do not have, as I have not been (nor plan to be) vaccinated. It also comes with a specific disclaimer, as follows:
o “Values generated with this assay cannot be used to determine whether or not an individual has developed protective immunity against infection and cannot be directly compared to other assays until a universal standard is established for assay calibration.”

It is therefore clear that this test (164090) is not appropriate for the purposes stated above

The intended use of 164090 is: “Semi-quantitative detection of high affinity antibodies to the receptor binding domain (RBD) of the spike (S) protein of SARS-CoV-2. Intended for use as an aid in identifying individuals with an adaptive immune response to SARS-CoV-2 indicating recent or prior infection. This assay also can be used to detect antibody responses induced by currently available SARS-CoV-2 vaccines.”

Additional limitations of 164090 is:

“Values generated with this assay cannot be used to determine whether or not an individual has developed protective immunity against infection and cannot be directly compared to other assays until a universal standard is established for assay calibration. Results from this test should not be used as the sole basis to diagnose or exclude active SARS-CoV-2 infection”

I actually need labcorp test 164068, which should properly answer the above stated purpose for getting this test.

The intended use of 164068 is: “Qualitative detection of high affinity antibodies to the nucleocapsid (N) protein of SARS-CoV-2. Intended for use as an aid in identifying individuals with an adaptive immune response to SARS-CoV-2 indicating recent or prior infection. This assay can be used to differentiate between antibodies elicited due to natural infection versus vaccination.”

Additional limitations of 164068 is:

“This assay will not detect antibodies elicited by currently available SARS-CoV-2 vaccines.”

I request labcorp provide this more appropriate test (164068) for my needs.

https://www.labcorp.com/coronavirus-disease-covid-19/providers/antibody-test

(from that link)

What does Labcorp offer for COVID-19 antibody testing?

Labcorp offers testing for antibodies against either the spike (S) or nucleocapsid (N) proteins of the SARS-CoV-2 virus.

What is the difference in the spike and nucleocapsid proteins?

Antibodies against the SARS-CoV-2 viral spike protein have been shown to have neutralizing effects.1-3 Current vaccines have been developed to elicit antibodies to the spike protein.

Labcorp offers both semi-quantitative and qualitative options for testing for spike protein antibodies.

Use our test selection guide for physicians to understand which test to order for your patient.

Who can be tested?

Those who have previously been actively infected by the SARS-CoV-2 virus and do not currently have symptoms or have received a vaccine for COVID-19

Sample: Serum collected by venipuncture

Labcorp Test Number

• Physicians can order SARS-CoV-2 Semi-Quantitative Total Antibody 164090

o Values generated with this assay cannot be used to determine whether or not an individual has developed protective immunity against infection and cannot be directly compared to other assays until a universal standard is established for assay calibration.

• Physicians can order SARS-CoV-2 Antibodies, Nucleocapsid 164068

o This assay will not detect antibodies elicited by currently available SARS-CoV-2 vaccines.

• Physicians can order SARS-CoV-2 Antibody, IgG, Spike 164055

• Physicians can order SARS-CoV-2 Antibody, IgM, Spike 164034

describes 4 different Labcorp tests

SARS-CoV-2 Semi-Quantitative Total Antibody* 164090

SARS-CoV-2 Antibodies, Nucleocapsid* 164068

SARS-CoV-2 Antibodies, IgG, Spike* 164055

SARS-CoV-2 Antibody, IgM, Spike 164034

Three of these tests focus on antibodies to the spike protein. (164090, 164055, and 164034)

Only one focuses on the nucleocapsid protein of the actual Covid-19 virus vs those generated by the vaccine. It is also the most accurate and reliable of all the tests. (164068)
It’s also the only test (of the 4) designed to detect to the antibodies produced in response to an actual covid-19 infection.

Also, since I do NOT expect to ever get the presently available vaccines (I really don’t trust them) I prefer the most reliable test that will not be colored with results expected from the current vaccines.

In summary, I request labcorp provide this more appropriate test (164068) for my needs.

Note, you can not order this one directly from Labcorp for the $10 deal, your doctor must order it for you.