{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:02:09Z","timestamp":1760234529412,"version":"build-2065373602"},"reference-count":98,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>In the UK, population virus or antibody testing using virus swabs, serum samples, blood spots or oral fluids has been performed to a limited extent for several diseases including measles, mumps, rubella and hepatitis and HIV. The collection of population-based infection and immunity data is key to the monitoring of disease prevalence and assessing the effectiveness of interventions such as behavioural modifications and vaccination. In particular, the biological properties of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its interaction with the human host have presented several challenges towards the development of population-based immunity testing. Measuring SARS-CoV-2 immunity requires the development of antibody assays of acceptable sensitivity and specificity which are capable of accurately detecting seroprevalence and differentiating protection from non-protective responses. Now that anti-COVID-19 vaccines are becoming available there is a pressing need to measure vaccine efficacy and the development of herd immunity. The unprecedented impact of the SARS-CoV-2 pandemic in the UK in terms of morbidity, mortality, and economic and social disruption has mobilized a national scientific effort to learn more about this virus. In this article, the challenges of testing for SARS-CoV-2 infection, particularly in relation to population-based immunity testing, will be considered and examples given of relevant national level studies.<\/jats:p>","DOI":"10.3390\/vaccines9060550","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T23:35:05Z","timestamp":1621899305000},"page":"550","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Population (Antibody) Testing for COVID-19\u2014Technical Challenges, Application and Relevance, an English Perspective"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-5191","authenticated-orcid":false,"given":"Peter A. C.","family":"Maple","sequence":"first","affiliation":[{"name":"Clinical Neurology Research Group, Department of Neurology, Division of Clinical Neuroscience, University of Nottingham School of Medicine, Queen\u2019s Medical Centre, Nottingham NG7 2UH, UK"},{"name":"Molecular (COVID) Department, UK Lighthouse Laboratory, Cheshire SK10 4TG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1056\/NEJMoa2001316","article-title":"Early transmission dynamics in Wuhan, China, of Novel Coronavirus\u2014Infected pneumonia","volume":"382","author":"Li","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Coronaviridae Study Group of the International Committee on Taxonomy of Viruses (2020). The species Severe acute respiratory syndrome-related coronavirus: Classifying 2019-nCoV and naming it SARS-CoV-2. Nat. Microbiol., 5, 536\u2013544.","DOI":"10.1038\/s41564-020-0695-z"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1017\/dmp.2020.103","article-title":"Pandemic March: 2019 Coronavirus Disease\u2019s First Wave Circumnavigates the Globe","volume":"14","author":"Shultz","year":"2020","journal-title":"Disaster Med. Public Heal. Prep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"m1985","DOI":"10.1136\/bmj.m1985","article-title":"Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: Prospective observational cohort study","volume":"369","author":"Docherty","year":"2020","journal-title":"BMJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.jinf.2020.02.020","article-title":"Novel coronavirus disease (Covid-19): The first two patients in the UK with person to person transmission","volume":"80","author":"Lillie","year":"2020","journal-title":"J. Infect."},{"key":"ref_7","unstructured":"(2021, April 02). GOV.UK Coronavirus (COVID-19) in the UK. The official UK Government website for data and insights on Coronavirus (COVID-19), Available online: https:\/\/coronavirus.data.gov.uk\/details\/."},{"key":"ref_8","first-page":"760","article-title":"Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19","volume":"16","author":"Hanson","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Machado, B.A.S., Hodel, K.V.S., Barbosa-J\u00fanior, V.G., Soares, M.B.P., and Badar\u00f3, R. (2020). The Main Molecular and Serological Methods for Diagnosing COVID-19: An Overview Based on the Literature. Viruses, 13.","DOI":"10.3390\/v13010040"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Garneret, P., Coz, E., Martin, E., Manuguerra, J.C., Brient-Litzler, E., Enouf, V., Obando, D.F.G., Olivo-Marin, J.C., Monti, F., and van der Werf, S. (2021). Performing point-of-care molecular testing for SARS-CoV-2 with RNA extraction and isothermal amplification. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0243712"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"104712","DOI":"10.1016\/j.jcv.2020.104712","article-title":"Evaluation of rapid antigen detection kit from the WHO Emergency Use List for detecting SARS-CoV-2","volume":"134","author":"Mak","year":"2021","journal-title":"J. Clin. Virol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"104713","DOI":"10.1016\/j.jcv.2020.104713","article-title":"Evaluation of a SARS-CoV-2 rapid antigen test: Potential to help reduce community spread?","volume":"135","author":"Toptan","year":"2021","journal-title":"J. Clin. Virol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104684","DOI":"10.1016\/j.jcv.2020.104684","article-title":"Analytical sensitivity and clinical sensitivity of the three rapid antigen detection kits for detection of SARS-CoV-2 virus","volume":"133","author":"Mak","year":"2020","journal-title":"J. Clin. Virol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kohmer, N., Toptan, T., Pallas, C., Karaca, O., Pfeiffer, A., Westhaus, S., Widera, M., Berger, A., Hoehl, S., and Kammel, M. (2021). The Comparative Clinical Performance of Four SARS-CoV-2 Rapid Antigen Tests and Their Correlation to Infectivity In Vitro. J. Clin. Med., 10.","DOI":"10.3390\/jcm10020328"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"6252","DOI":"10.12998\/wjcc.v8.i24.6252","article-title":"Virus load and virus shedding of SARS-CoV-2 and their impact on patient outcomes","volume":"8","author":"Chen","year":"2020","journal-title":"World J. Clin. Cases"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.ijid.2020.05.030","article-title":"Viral dynamics in asymptomatic patients with COVID-19","volume":"96","author":"Zhou","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1007\/s12250-020-00329-9","article-title":"Viral and antibody kinetics of COVID-19 patients with different disease severities in acute and convalescent phases: A 6-month follow-up study","volume":"35","author":"Zhang","year":"2020","journal-title":"Virol. Sin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"m1222","DOI":"10.1136\/bmj.m1222","article-title":"Covid-19: What is the UK\u2019s testing strategy?","volume":"368","author":"Iacobucci","year":"2020","journal-title":"BMJ"},{"key":"ref_19","unstructured":"Department of Health and Social Care (2021, February 09). Coronavirus (COVID-19) Scaling up Our Testing Programmes. Policy Paper Published 4th April 2020, Available online: www.gov.uk\/government\/publications\/coronavirus-covid-19-scaling-up-testing-programmes."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1093\/jpids\/piaa037","article-title":"What\u2019s new with the old coronaviruses?","volume":"9","author":"Ogimi","year":"2020","journal-title":"J. Pediatric. Infect. Dis. Soc."},{"key":"ref_21","first-page":"163","article-title":"Hosts and Sources of Endemic Human Coronaviruses","volume":"100","author":"Corman","year":"2018","journal-title":"Adv. Applied Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/220650b0","article-title":"Coronaviruses","volume":"220","author":"Almeida","year":"1968","journal-title":"Nature"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.chom.2020.02.001","article-title":"Genome Composition and Divergence of the Novel Coronavirus (2019-nCoV) Originating in China","volume":"27","author":"Wu","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1073\/pnas.2003138117","article-title":"Cell entry mechanisms of SARS-CoV-2","volume":"117","author":"Shang","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.bbrc.2020.02.071","article-title":"Structure analysis of the receptor binding of 2019-nCoV","volume":"525","author":"Chen","year":"2020","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Xia, X. (2021). Domains and Functions of Spike Protein in Sars-Cov-2 in the Context of Vaccine Design. Viruses, 13.","DOI":"10.3390\/v13010109"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"563085","DOI":"10.3389\/fcimb.2021.563085","article-title":"COVID-19: Molecular and Cellular Response","volume":"11","author":"Alipoor","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2991","DOI":"10.3390\/v6082991","article-title":"The Coronavirus Nucleocapsid Is a Multifunctional Protein","volume":"6","author":"McBride","year":"2014","journal-title":"Viruses"},{"key":"ref_29","first-page":"1","article-title":"The SARS-CoV-2 nucleocapsid phosphoprotein forms mutually exclusive condensates with RNA and the membrane-associated M protein","volume":"12","author":"Lu","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1038\/s41586-020-2169-0","article-title":"Identifying SARS-CoV-2-related coronaviruses in Malayan pangolins","volume":"583","author":"Lam","year":"2020","journal-title":"Nature"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1038\/s41579-018-0118-9","article-title":"Origin and evolution of pathogenic coronaviruses","volume":"17","author":"Cui","year":"2019","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_32","first-page":"1","article-title":"Genome evolution of SARS-CoV-2 and its virological characteristics","volume":"40","author":"Nakagawa","year":"2020","journal-title":"Inflamm. Regen."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s10311-020-01151-1","article-title":"Tracing the origins of SARS-COV-2 in coronavirus phylogenies: A review","volume":"19","author":"Sallard","year":"2021","journal-title":"Environ. Chem. Lett."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"104351","DOI":"10.1016\/j.meegid.2020.104351","article-title":"Emergence of genomic diversity and recurrent mutations in SARS-CoV-2","volume":"83","author":"Acman","year":"2020","journal-title":"Infect. Genet. Evol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1001\/jama.2020.27124","article-title":"Genetic variants of SARS-CoV-2\u2014what do they mean?","volume":"325","author":"Lauring","year":"2021","journal-title":"JAMA"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/j.cell.2021.01.044","article-title":"Public health actions to control new SARS-CoV-2 variants","volume":"184","author":"Grubaugh","year":"2021","journal-title":"Cell"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.cmi.2020.03.024","article-title":"Follow-up of asymptomatic patients with SARS-CoV-2 infection","volume":"26","author":"Zhou","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S2213-2600(20)30079-5","article-title":"Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centred, retrospective, observational study","volume":"8","author":"Yang","year":"2020","journal-title":"Lancet Resp. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1515\/revneuro-2020-0070","article-title":"CNS implications of COVID-19: A comprehensive review","volume":"32","author":"Nagu","year":"2021","journal-title":"Rev. Neurosci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1038\/s41591-020-0965-6","article-title":"Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections","volume":"26","author":"Long","year":"2020","journal-title":"Nat. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.cell.2020.04.026","article-title":"Imbalanced host response to SARS-CoV-2 drives development of COVID-19","volume":"181","author":"Liu","year":"2020","journal-title":"Cell"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1002\/ped4.12228","article-title":"Cell-mediated immunity to SARS-CoV-2","volume":"4","author":"Wang","year":"2020","journal-title":"Pediatr. Investig."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/j.cell.2021.01.007","article-title":"Adaptive immunity to SARS-CoV-2 and COVID-19","volume":"184","author":"Sette","year":"2021","journal-title":"Cell"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"610688","DOI":"10.3389\/fimmu.2020.610688","article-title":"Humoral Responses and Serological Assays in SARS-CoV-2 Infections","volume":"11","author":"Galipeau","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1038\/s41591-020-0897-1","article-title":"Antibody responses to SARS-CoV-2 in patients with COVID-19","volume":"26","author":"Long","year":"2020","journal-title":"Nat. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1038\/s41590-020-0782-6","article-title":"Broad and strong memory CD4+ and CD8+ T cells induced by SARS-CoV-2 in UK convalescent individuals following COVID-19","volume":"21","author":"Peng","year":"2020","journal-title":"Nat. Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.medj.2021.02.001","article-title":"Persistence of SARS-CoV-2-specific B and T cell responses in convalescent COVID-19 patients 6\u20138 months after the infection","volume":"2","author":"Sherina","year":"2021","journal-title":"Med"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Sui, Y., Bekele, Y., and Berzofsky, J.A. (2021). Potential SARS-CoV-2 immune correlates of protection in infection and vaccine immunization. Pathogens, 10.","DOI":"10.3390\/pathogens10020138"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Dutta, N.K., Mazumdar, K., and Gordy, J.T. (2020). The Nucleocapsid Protein of SARS\u2013CoV-2: A Target for Vaccine Development. J. Virol., 94.","DOI":"10.1128\/JVI.00647-20"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/s41586-020-2380-z","article-title":"Human neutralizing antibodies elicited by SARS-CoV-2 infection","volume":"584","author":"Ju","year":"2020","journal-title":"Nature"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Theel, E.S., Couturier, M.R., Filkins, L., Palavecino, E., Mitchell, S., Campbell, S., Pentella, M., Butler-Wu, S., Jerke, K., and Dharmarha, V. (2020). Application, Verification, and Implementation of SARS-CoV-2 Serologic Assays with Emergency Use Authorization. J. Clin. Microbiol., 59.","DOI":"10.1128\/JCM.02148-20"},{"key":"ref_52","unstructured":"Public Health England (2021, March 10). COVID-19: Laboratory Evaluations of Serological Assays. Reports published 19th May 2020, Available online: www.gov.uk\/government\/publications\/covid-19-laboratory-evaluations-of-serological-assays#history."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"m4262","DOI":"10.1136\/bmj.m4262","article-title":"Accuracy of UK rapid test consortium (UK-RTC) \u201cAbC-19 rapid test\u201d for detection of previous SARS-CoV-2 infection in key workers: Test accuracy study","volume":"371","author":"Mulchandani","year":"2020","journal-title":"BMJ"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Almahboub, S.A., Algaissi, A., AlFaleh, M.A., ElAssouli, M.-Z., and Hashem, A.M. (2020). Evaluation of Neutralizing Antibodies Against Highly Pathogenic Coronaviruses: A Detailed Protocol for a Rapid Evaluation of Neutralizing Antibodies Using Vesicular Stomatitis Virus Pseudovirus-Based Assay. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.02020"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.trac.2016.06.006","article-title":"Lateral flow assays: Principles, designs and labels","volume":"82","author":"Bahadir","year":"2016","journal-title":"Trends Analyt. Chem."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e73","DOI":"10.1016\/j.clon.2020.10.008","article-title":"How Useful is COVID-19 Antibody Testing\u2014A Current Assessment for Oncologists","volume":"33","author":"Maple","year":"2021","journal-title":"Clin. Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e384","DOI":"10.1093\/cid\/ciaa1178","article-title":"Usability and Acceptability of Home-based Self-testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies for Population Surveillance","volume":"72","author":"Atchison","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Moshe, M., Daunt, A., Flower, B., Simmons, B., Brown, J.C., Frise, R., Penn, R., Kugathasan, R., Petersen, C., and Stockmann, H. (2021). SARS-CoV-2 lateral flow assays for possible use in national covid-19 seroprevalence surveys (React 2): Diagnostic accuracy study. BMJ, 372.","DOI":"10.1136\/bmj.n423"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1038\/s41587-020-0659-0","article-title":"Evaluation of SARS-CoV-2 serology assays reveals a range of test performance","volume":"38","author":"Whitman","year":"2020","journal-title":"Nat. Biotechnol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1136\/jclinpath-2020-206685","article-title":"Towards effective diagnostic assays for COVID-19: A review","volume":"73","author":"Venter","year":"2020","journal-title":"J. Clin. Pathol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2249","DOI":"10.1001\/jama.2020.8259","article-title":"Interpreting diagnostic tests for SARS-CoV-2","volume":"323","author":"Sethuraman","year":"2020","journal-title":"JAMA"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"103259","DOI":"10.1016\/j.ebiom.2021.103259","article-title":"Time series analysis and mechanistic modelling of heterogeneity and sero-reversion in antibody responses to mild SARS-CoV-2 infection","volume":"65","author":"Manisty","year":"2021","journal-title":"EBioMedicine"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1038\/s41564-020-00813-8","article-title":"Longitudinal observation and decline of neutralizing antibody responses in the three months following SARS-CoV-2 infection in humans","volume":"5","author":"Seow","year":"2020","journal-title":"Nat. Microbiol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Dan, J.M., Mateus, J., Kato, Y., Hastie, K.M., Yu, E.D., Faliti, C.E., Grifoni, A., Ramirez, S.I., Haupt, S., and Frazier, A. (2021). Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science, 371.","DOI":"10.1126\/science.abf4063"},{"key":"ref_65","unstructured":"Hartog, G.D., A Vos, E.R., Hoogen, L.L.V.D., van Boven, M., Schepp, R.M., Smits, G., van Vliet, J., Woudstra, L., Wijmenga-Monsuur, A.J., and E van Hagen, C.C. (2021). Persistence of antibodies to SARS-CoV-2 in relation to symptoms in a nationwide prospective study. Clin. Infect. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.medj.2021.01.005","article-title":"Stable neutralizing antibody levels 6 months after mild and severe COVID-19 episodes","volume":"2","author":"Pradenas","year":"2021","journal-title":"Med"},{"key":"ref_67","unstructured":"Department of Health and Social Care (2021, March 26). COVID-19 Surveillance and Immunity Studies, Available online: https:\/\/www.gov.uk\/government\/publications\/covid-19-surveillance."},{"key":"ref_68","unstructured":"Offices of the Nuffield Professor of Medicine, University of Oxford (2021, March 26). COVID-19 Infection Survey. Available online: https:\/\/www.ndm.ox.ac.uk\/covid-19\/covid-19-infection-survey."},{"key":"ref_69","unstructured":"National SARS-CoV-2 Serology Assay Evaluation Group (2020). Performance characteristics of five immunoassays for SARS-CoV-2: A head-to-head benchmark comparison. Lancet Infect. Dis., 20, 1390\u20131400."},{"key":"ref_70","unstructured":"Office for National Statistics (2021, March 26). Coronavirus (COVID-19) Infection Survey, Antibody Data for the UK: 16 March 2021, Available online: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/articles\/coronaviruscovid19infectionsurveyantibodydatafortheuk\/16march2021."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-021-21237-w","article-title":"SARS-CoV-2 antibody prevalence in England following the first peak of the pandemic","volume":"12","author":"Ward","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Ward, H., Cooke, G., Whitaker, M., Redd, R., Eales, O., Brown, J.C., Collet, K., Cooper, E., Daunt, A., and Jones, K. (2021). REACT-2 Round 5: Increasing prevalence of SARS-CoV-2 antibodies demonstrate impact of the second wave and of vaccine roll-out in England. MedRxiv.","DOI":"10.1101\/2021.02.26.21252512"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Wallace, S., Hall, V., Charlett, A., Kirwan, P.D., Cole, M.J., Shroti, M., Rokadiya, S., Oguti, B., Vusurikaia, A., and Zambon, M. (2021). SIREN protocol: Impact of detectable anti-SARS-CoV-2 on the subsequent incidence of COVID-19 in 100,000 healthcare workers: Do antibody positive healthcare workers have less reinfection than antibody negative healthcare workers?. MedRxiv.","DOI":"10.1101\/2020.12.15.20247981"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/S0140-6736(21)00675-9","article-title":"SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: A large, multicentre, prospective cohort study (SIREN)","volume":"397","author":"Hall","year":"2021","journal-title":"Lancet"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"232","DOI":"10.12688\/wellcomeopenres.16193.2","article-title":"Study Protocol: Understanding SARS-Cov-2 infection, immunity and its duration in care home residents and staff in England (VIVALDI)","volume":"5","author":"Krutikov","year":"2021","journal-title":"Wellcome Open Res."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Krutikov, M., Palmer, T., Tut, G., Fuller, C., Shroti, M., Williams, H., Davies, D., Irwin-Singer, A., Robson, J., and Hayward, A. (2021). Incidence of SARS-CoV-2 infection according to baseline antibody status in staff and residents of 100 long term care facilities (VIVALDI study). MedRxiv.","DOI":"10.1101\/2021.03.08.21253110"},{"key":"ref_77","unstructured":"Office for National Statistics (2021, April 01). COVID-19 Schools Infection Survey: Methods and Further Information, Available online: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/methodologies\/covid19schoolsinfectionsurveymethodsandfurtherinformation."},{"key":"ref_78","unstructured":"Office for National Statistics (2021, April 01). COVID-19 Schools Infection Survey Round 2, England: December 2020, Available online: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/bulletins\/covid19schoolsinfectionsurveyround2england\/december2020."},{"key":"ref_79","unstructured":"Department of Health and Social Care (2021, April 02). Protective Immunity from T Cells in Healthcare Workers. Available online: http:\/\/www.pitch-study.org\/index.html."},{"key":"ref_80","unstructured":"Angyal, A., Longet, S., Moore, S., Payne, R.P., Harding, A., Tipton, T., Rongkard, P., Ali, M., Hering, L.M., and Meardon, N. (2021, April 02). T-cell and antibody responses to first BNT 162b2 vaccine dose in previously SARS-CoV-2 infected and infection- na\u00efve UK healthcare workers: A multicentre, prospective, observational cohort study. Available online: https:\/\/ssrn.com\/abstract=3812375."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1093\/ije\/29.2.362","article-title":"Ten years of serological surveillance in England and Wales: Methods, results, implications and action","volume":"29","author":"Osborne","year":"2000","journal-title":"Int. J. Epidemiol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0264-410X(00)00184-5","article-title":"Immunity to diphtheria and tetanus in England and Wales","volume":"19","author":"Maple","year":"2000","journal-title":"Vaccine"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/j.vaccine.2003.08.039","article-title":"Sero-epidemiology of Bordetella pertussis in England and Wales","volume":"22","author":"Nardone","year":"2004","journal-title":"Vaccine"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1017\/S0950268806006340","article-title":"Interpreting serological surveys using mixture models: The seroepidemiology of measles, mumps and rubella in England and Wales at the beginning of the 21st century","volume":"134","author":"Vyse","year":"2006","journal-title":"Epidemiol. Infect."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1053\/jinf.2002.1059","article-title":"The Prevalence of Hepatitis C in England and Wales","volume":"45","author":"Balogun","year":"2002","journal-title":"J. Infect."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1800377","DOI":"10.2807\/1560-7917.ES.2019.24.27.1800377","article-title":"Seroprevalence and demographic factors associated with hepatitis B, hepatitis C and HIV infection from a hospital emergency department testing programme, London, United Kingdom, 2015 to 2016","volume":"24","author":"Bundle","year":"2019","journal-title":"Eurosurveillance"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.jinf.2021.03.015","article-title":"Serological surveillance of SARS-CoV-2: Six-month trends and antibody response in a cohort of public health workers","volume":"82","author":"Harris","year":"2021","journal-title":"J. Infect."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.bbrc.2020.10.109","article-title":"The D614G mutations in the SARS-CoV-2 spike protein: Implications for viral infectivity, disease severity and vaccine design","volume":"538","author":"Groves","year":"2021","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_89","first-page":"9","article-title":"Indian government should heed its scientists on COVID","volume":"593","author":"Padma","year":"2021","journal-title":"Nat. Cell Biol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.chom.2021.02.010","article-title":"The great escape? SARS-CoV-2 variants evading neutralizing responses","volume":"29","author":"Finzi","year":"2021","journal-title":"Cell Host Microbe"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1038\/s41586-021-03324-6","article-title":"mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants","volume":"592","author":"Wang","year":"2021","journal-title":"Nature"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1136\/archdischild-2020-319372","article-title":"National active surveillance to understand and inform neonatal care in COVID-19","volume":"105","author":"Gale","year":"2020","journal-title":"Arch. Dis. Child Fetal. Neonatal. Ed."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Ladhani, S.N., Baawuah, F., Beckmann, J., Okike, I.O., Ahmad, S., Garstang, J., Brent, A.J., Brent, B., Walker, J., and Andrews, N. (2021). SARS-CoV-2 infection and transmission in primary schools in England in June-December 2020 (sKIDs): An active, prospective surveillance study. Lancet Child Adolesc. Health.","DOI":"10.1016\/S2352-4642(21)00061-4"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/S1473-3099(20)30882-3","article-title":"SARS-CoV-2 infection and transmission in educational settings: A prospective, cross-sectional analysis of infection clusters and outbreaks in England","volume":"21","author":"Ismail","year":"2021","journal-title":"Lancet Infect Dis."},{"key":"ref_95","unstructured":"Public Health England (2021, May 10). COVID-19: Paediatric Surveillance, Available online: https:\/\/www.gov.uk\/guidance\/covid-19-paediatric-surveillance."},{"key":"ref_96","first-page":"1","article-title":"Effects of SARS-CoV-2 variants on vaccine efficacy and response strategies","volume":"14","author":"Bian","year":"2021","journal-title":"Expert Rev. Vaccines"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11908-021-00752-3","article-title":"Status Report on COVID-19 Vaccines Development","volume":"23","author":"Kumar","year":"2021","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"256","DOI":"10.3389\/fpubh.2020.00256","article-title":"COVID-19 UK Lockdown Forecasts and R0","volume":"8","author":"Dropkin","year":"2020","journal-title":"Front Public Health"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/9\/6\/550\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:07:01Z","timestamp":1760162821000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/9\/6\/550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,24]]},"references-count":98,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["vaccines9060550"],"URL":"https:\/\/doi.org\/10.3390\/vaccines9060550","relation":{},"ISSN":["2076-393X"],"issn-type":[{"type":"electronic","value":"2076-393X"}],"subject":[],"published":{"date-parts":[[2021,5,24]]}}}