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Understanding the presence of adaptive immune responses that are associated with protection from disease (potential protective immunity) caused by SARS-CoV-2 at the population level is critical for public policy. Potential protective immunity can be acquired either through vaccination or past infection.1- 3 We used history of vaccination or presence of antibodies specific to the receptor binding domain (RBD antibodies) of the spike protein of the SARS-CoV-2 virus as potential markers for potential protective immunity as both are strongly associated with presence of neutralizing antibodies.4,5 We conducted surveys and serologic tests in a representative community sample to estimate the fraction of the Los Angeles County (LAC) adult population that had potential protective immunity in April 2021. We tested for differences in potential protective immunity by demographics and whether presence of RBD antibodies waned with time since infection.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Accepted for Publication: November 23, 2021.
Published: January 20, 2022. doi:10.1001/jamanetworkopen.2021.44258
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Sood N et al. JAMA Network Open.
Corresponding Author: Neeraj Sood, PhD, Sol Price School of Public Policy, University of Southern California, University Park Campus, 635 Downey Way, Verna and Peter Dauterive Hall, Los Angeles, CA 90089 (firstname.lastname@example.org).
Author Contributions: Dr Sood had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Sood, Klipp, Kotha, Kovacs, Hu.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Sood, Lam, Kotha, Kovacs, Hu.
Critical revision of the manuscript for important intellectual content: Sood, Pernet, Lam, Klipp, Kovacs, Hu.
Statistical analysis: Sood, Pernet, Lam, Kotha, Hu.
Obtained funding: Sood, Kotha, Hu.
Administrative, technical, or material support: Sood, Pernet, Klipp, Kotha, Hu.
Supervision: Sood, Klipp, Hu.
Conflict of Interest Disclosures: Dr Pernet reported being CEO of EnViro International Laboratories, a nonprofit organization working on emerging diseases and outbreak preparedness. No other disclosures were reported.
Funding/Support: We acknowledge funding from the Conrad N. Hilton Foundation, Office of the President University of Southern California, Los Angeles County Department of Public Health, the U.S. Centers for Disease Control and Prevention, the Keck School of Medicine at USC, and the Keck Family Foundation.
Role of the Funder/Sponsor: Funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: We are grateful to Paul Simon and William Nicholas from Los Angeles County Department of Public Health for help with research design; Jennifer Holland, Julie McClammy, Elinor Gaida, and Jacqueline Rosales from LRW, a Material Company, for help with data collection; Anna Rodriguez-Vasquez from University of Southern California, for supervising testing sites; Kevin Ramos from University of Southern California, for help with data analysis. George Celis, Siddharth Saharan, Patricia Anthony from University of Southern California for help with antibody testing. They were not compensated for these contributions.
Additional Information: LA County adult population estimates from IPUMS USA are available at https://usa.ipums.org/usa/. LA County confirmed cases of COVID-19 as of April 25, 2021, from Los Angeles County Department of Public Health are available at http://dashboard.publichealth.lacounty.gov/covid19_surveillance_dashboard/. LA County number of adults vaccinated as of April 25, 2021, from Los Angeles County Department of Public Health are available at http://publichealth.lacounty.gov/media/coronavirus/vaccine/vaccine-dashboard.htm.
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