Prospective investigation of SARS-CoV-2 seroprevalence in relation to natural infection and vaccination between October 2020 and September 2021 in the Czech Republic

PurposeMonitoring the seroprevalence of COVID-19 antibodies is an important tool to design and adjust preventive strategies. We used prospective data on a large population sample with repeated IgG antibody measurement to examine changes in seropositivity before and during the national vaccination campaign in the Czech Republic. Methods22,130 persons provided blood samples for COVID-19 IgG antibody measurement at two time points approximately 5-7 months apart, between October 2020 and March 2021 (Phase 1, before vaccination), and between April and September 2021 (during vaccination campaign). ResultsBefore vaccination (Phase 1), seroprevalence increased from 15% in October 2020 to 56% in March 2021. By the end of Phase 2, in September 2021, prevalence increased to 91%; the highest seroprevalence was seen among vaccinated persons with and without previous SARS-CoV-2 infection (99.7% and 97.2%, respectively), while the lowest seroprevalence was found among unvaccinated persons with no signs of disease (26%). Vaccination rates were lower in persons who were seropositive in phase 1 but increased with age and body mass index. Only 9% of unvaccinated subjects who were seropositive in phase 1 became seronegative by phase 2. ConclusionThe rapid increase in seropositivity during the 2nd wave of the COVID-19 epidemic (covered by phase 1 of this study) was followed by a similarly steep rise in seroprevalence during the national vaccination campaign, reaching seropositivity rates of over 97% among vaccinated persons.