Coronavirus (COVID-19) Infection Survey, antibody and vaccination data, UK: 23 November 2021

Antibody and vaccination data by UK country and regions in England from the Coronavirus (COVID-19) Infection Survey. This analysis has been produced in partnership with University of Oxford, University of Manchester, UK Health Security Agency and Wellcome Trust. This study is jointly led by the ONS and the Department for Health and Social Care (DHSC) working with the University of Oxford and Lighthouse Laboratories to collect and test samples.

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Cyswllt:
Email Kara Steel and Zoë Willis

Dyddiad y datganiad:
23 November 2021

Cyhoeddiad nesaf:
8 December 2021

1. Main points

The following statistics are the percentage of the adult population that would have tested positive on a blood test for antibodies against SARS-CoV-2, the specific virus that causes coronavirus (COVID-19). This suggests that they have had the infection in the past or have been vaccinated.

  • In England, it is estimated that 92.8% of the adult population (95% credible interval: 91.6% to 93.9%) would have tested positive for antibodies against SARS-CoV-2 in the week beginning 1 November 2021.

  • In Wales, it is estimated that 91.4% of the adult population (95% credible interval: 89.7% to 92.9%) would have tested positive for antibodies against SARS-CoV-2 in the week beginning 1 November 2021.

  • In Northern Ireland, it is estimated that 93.3% of the adult population (95% credible interval: 90.2% to 94.9%) would have tested positive for antibodies against SARS-CoV-2 in the week beginning 1 November 2021.

  • In Scotland, it is estimated that 92.5% of the adult population (95% credible interval: 91.1% to 93.7%) would have tested positive for antibodies against SARS-CoV-2 in the week beginning 1 November 2021.

The percentage of the adult population who would have tested positive for antibodies against SARS-CoV-2 has increased in those aged 70 years and over across the UK, likely as a result of the vaccination booster programme.

About this bulletin

This bulletin presents the latest estimates of the number of adults who would test positive for antibodies to SARS-CoV-2 for England, Wales, Northern Ireland and Scotland based on findings from the Coronavirus (COVID-19) Infection Survey in the UK. People who test positive for antibodies are those who have experienced previous infection and/or vaccination. For context, we include estimates from our survey on the percentage of adults who reported they have received one or more doses of a vaccine against SARS-CoV-2, as well as identifying which of those report having received two or more doses of a COVID-19 vaccine (including booster doses).

Data in this bulletin

The analysis on antibodies in this bulletin is based on blood test results taken from a randomly selected subsample of individuals aged 16 years and over who live in private households. The survey excludes those in hospitals, care homes and/or other communal establishments. The blood samples are used to test for antibodies against SARS-CoV-2.

We also present data on the percentage of people aged 16 years and over who report they have received one or more doses of a COVID-19 vaccine since 14 December 2020, and two or more doses of a COVID-19 vaccine since 15 February 2021.

Our antibodies and vaccination estimates are based on the data we collect from people visited in the Coronavirus (COVID-19) Infection Survey (CIS). We present weekly modelled antibody estimates and vaccine estimates for adults by country, and grouped age for England, Wales, Northern Ireland and Scotland, as well as antibody estimates by regions in England. Further information on our method to model antibodies and vaccinations can be found in our methods article.

There is a clear pattern between vaccination and testing positive for COVID-19 antibodies but the detection of antibodies alone is not a precise measure of the immunity protection given by vaccination. Further information is available on antibody levels post vaccination from research partners at the University of Oxford.

Modelled vaccine estimates are produced to provide context alongside our antibodies estimates and do not replace the official government figures on vaccinations, which are a more precise count of total vaccines issued. While we would expect the overall trend of our estimated number of people who have received vaccines to increase, it is possible that in some weeks, the estimate may remain the same or decrease as a result of sampling variability (for example, we may have a lower number of participants recording a vaccination in the latest week compared with an earlier week).

National Immunisation Management System (NIMS) administrative data are used to validate CIS self-reported records of vaccination for England. The equivalent of this is currently not included for other countries, meaning the estimates for Wales, Scotland and Northern Ireland are produced just from CIS self-reported records of vaccination.

Our vaccination estimates are explained in more detail in Section 10: Measuring the data.

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2. Understanding antibodies and immunity

Antibody positivity is defined by having a fixed concentration of antibodies in the blood. A negative test result occurs if there are no antibodies, or if antibody levels are too low to reach a threshold at the time of testing. The threshold we use is 42 nanograms per millilitre (ng/ml). This is the threshold that the test is CE marked against providing greater than 99% sensitivity and specificity. Following infection or vaccination, antibody levels can vary and sometimes increase but may still be below the level identified as positive in our test and other tests, and so give a negative result.

Most people who are vaccinated will retain a higher antibody level than before vaccination even after dropping below the standard threshold value. A negative result does not mean that the antibody level is at zero, nor that a person has no protection against COVID-19, as an immune response does not rely on the presence of antibodies alone.

There are other parts of the immune system that will offer protection, for example, a person's T-cell response. This will not be detected by blood tests for antibodies. A person's immune response is affected by a number of factors, including health conditions and age.

Equally, antibody levels are expected to decrease over time irrespective of vaccination or natural infection, especially when exposure to the virus is reduced. This is because our bodies stop making antibodies when they are not needed.

Our blog on antibodies and immunity gives further information on the link between antibodies and immunity and the vaccine programme. Our blog on vaccine effectiveness provides information on the effectiveness of vaccinations against Alpha and Delta variants, which is based upon the research conducted by partners from the University of Oxford.

Our methodology article provides further information around the survey design, how we process data, and how data are analysed. The study protocol specifies the research for the study. The Coronavirus (COVID-19) Infection Survey QMI details the strength and limitations of the data.

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3. Percentages of adults testing positive for COVID-19 antibodies and vaccinated against COVID-19 in England, Wales, Northern Ireland and Scotland

In the week beginning 1 November 2021, the percentage of adults testing positive for antibodies remained high across the UK.

In the week beginning 1 November 2021, our estimates suggest the percentage of adults who reported they had received at least one dose of a COVID-19 vaccine remained high, ranging from 93.1% to 95.8% of adults across the UK. The estimated percentage of adults in the UK who had received two or more doses of a COVID-19 vaccine also remained high or continued to increase, ranging from 83.5% to 89.8% of adults across the UK in the week beginning 1 November 2021. These vaccination estimates will differ from official figures as explained in Section 1.

Figure 1: The percentage of adults testing positive for COVID-19 antibodies remained high across the UK in the most recent weeks up to 1 November 2021

Modelled percentage of adults: who tested positive for antibodies to SARS-CoV-2, who have reported to have received one or more doses of a COVID-19 vaccine; and two or more doses of a COVID-19 vaccine, UK countries, 7 December 2020 to 7 November 2021

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Notes:

  1. All results are provisional and subject to revision.
  2. These statistics refer to antibody tests and reported vaccinations for individuals living in private households. These figures exclude individuals in hospitals, care homes and/or other communal establishments.
  3. All estimates are subject to uncertainty, given that a sample is only part of the wider population. A credible interval gives an indication of the uncertainty of an estimate from data analysis.
  4. The denominators used for both antibodies and vaccinations are the total people in the sample at that particular time point, then post-stratified by the mid-year population estimate.
  5. Vaccination data for Northern Ireland start later than the other countries, from 21 December 2020.
  6. Our estimates of vaccination are provided for context alongside our antibodies estimates but are likely to be different from the official figures. The daily official government figures provide the recorded actual numbers of vaccines against SARS-CoV-2 issued.
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4. Percentages of adults testing positive for COVID-19 antibodies and vaccinated against COVID-19 by regions in England

The percentage of adults testing positive for coronavirus (COVID-19) antibodies and the percentage of adults who have received at least one vaccine remained at high levels across all regions of England in the week beginning 1 November 2021. Regional data can be found in our Coronavirus (COVID-19) Infection Survey: antibody and vaccination dataset.

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5. Percentages of adults testing positive for COVID-19 antibodies and vaccinated against COVID-19 by grouped age in England, Wales, Northern Ireland and Scotland

In the week beginning 1 November 2021, the percentage of adults testing positive for coronavirus (COVID-19) antibodies remained high across all age groups and increased in those aged 70 years and over across the UK, likely as a result of the vaccination booster programme.

It is important to note that antibody positivity is defined by a fixed concentration of antibodies in the blood. Most people who are vaccinated will retain higher antibody levels than before vaccination but may have antibodies below the threshold used at the time of testing. This does not mean that these people have no protection against new infection. More information on antibodies and immunity can be found in our blog and in Section 2 of this bulletin.

The percentage of adults who reported they have received at least one dose of a COVID-19 vaccine is lowest in the younger age groups but is still high. Across the UK, the estimated percentage of adults aged 16 to 24 years who have received one or more doses of a COVID-19 vaccine ranged from 78.9% to 85.6%; this has increased sharply since the end of June 2021. These estimates of vaccination are based on reported vaccination status in our survey and are likely to be different from the official figures for the UK.

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In the data used to produce estimates for Wales, Northern Ireland and Scotland, the number of people sampled who tested positive for antibodies to SARS-CoV-2 or who have been vaccinated is low compared with England. This means there is a higher degree of uncertainty in estimates for these nations when our analysis splits the sample into smaller groups (for example, age groups) as indicated by larger credible intervals.

Modelled antibody estimates and modelled vaccine estimates relate to the adult population (aged 16 years and over) who live in private households. The true figure among the older age groups in the population may be different. In England, an estimated 90% of people aged 80 years and over live in private households and 10% live in other communal establishments such as care homes.

Figure 2: The percentage of adults testing positive for COVID-19 antibodies remained high across all age groups and increased in those aged over 70 years across the UK in the week beginning 1 November 2021

Modelled percentage of adults: who tested positive for antibodies to SARS-CoV-2, who have reported to have received one or more doses of a COVID-19 vaccine; and two or more doses of a COVID-19 vaccine, by grouped age, UK countries, 7 December 2020 to 7 November 2021

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Notes:

  1. All results are provisional and subject to revision.
  2. These statistics refer to antibody tests and reported vaccinations for individuals living in private households. These figures exclude individuals in hospitals, care homes and/or other communal establishments.
  3. In Northern Ireland, the number of people sampled is low compared with England, Wales and Scotland; therefore, people aged 50 to 69 years are included in the same age group, and those aged 70 years and over are included in the same age group.
  4. All estimates are subject to uncertainty, given that a sample is only part of the wider population. A credible interval gives an indication of the uncertainty of an estimate from data analysis.
  5. The denominators used for both antibodies and vaccinations are the total people in the sample at that particular time point, then post-stratified by the mid-year population estimate.
  6. Our estimates of vaccination are provided for context alongside our antibodies estimates but are likely to be different from the official figures. The daily official government figures provide the recorded actual numbers of vaccines against SARS-CoV-2 issued.
Download the data

.xlsx

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6. Percentage of adults testing positive for COVID-19 antibodies by single year of age in England, Wales, Northern Ireland and Scotland

The analysis in this section presents modelled daily estimates of antibody positivity by single year of age for England, Wales, Northern Ireland and Scotland separately, between 29 September and 9 November 2021. The modelled data in this section are produced using a different method to the weekly modelled estimates presented in Section 5 and so cannot be compared. Each data point represents a modelled estimate of antibody positivity for a particular day.

This more granular analysis shows a similar pattern to our grouped age analysis, with antibody positivity remaining high for most ages across the UK. In recent weeks, antibody positivity rates have increased for those aged 70 years and over in England, those aged 75 years and over in Wales, those aged 65 years and over in Scotland, and for most ages in Northern Ireland.

Figure 3: The percentages testing positive for COVID-19 antibodies by single year of age in England, Wales, Northern Ireland and Scotland

Modelled percentage of adults testing positive for antibodies to SARS-CoV-2, by single year of age, UK countries, 29 September to 9 November 2021

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Notes:

  1. All results are provisional and subject to revision.
  2. These statistics refer to antibody tests and reported vaccinations for individuals living in private households. These figures exclude individuals in hospitals, care homes and/or other communal establishments.
  3. The method used to generate the data differs from the modelled weekly estimates of antibody positivity by age and so is not comparable.
Download the data

.xlsx

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7. Coronavirus (COVID-19) Infection Survey data

Coronavirus (COVID-19) antibody and vaccination data, UK
Dataset | Released 23 November 2021
Antibody and vaccination data by UK country and regions in England from the Coronavirus (COVID-19) Infection Survey. This analysis has been produced in partnership with the University of Oxford, University of Manchester, UK Health Security Agency and Wellcome Trust. This study is jointly led by the Office for National Statistics (ONS) and the Department for Health and Social Care (DHSC) working with the University of Oxford and Lighthouse Laboratory to collect and test samples.

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8. Collaboration

Logos for University of Oxford, Wellcome Trust, UK HSA, University of Manchester

The Coronavirus (COVID-19) Infection Survey analysis was produced by the Office for National Statistics (ONS) in collaboration with our research partners at the University of Oxford, the University of Manchester, UK Health Security Agency and Wellcome Trust. Of particular note are:

  • Sarah Walker - University of Oxford, Nuffield Department for Medicine: Professor of Medical Statistics and Epidemiology and Study Chief Investigator

  • Koen Pouwels - University of Oxford, Health Economics Research Centre, Nuffield Department of Population Health: Senior Researcher in Biostatistics and Health Economics

  • Thomas House - University of Manchester, Department of Mathematics: Reader in Mathematical Statistics

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9. Glossary

Antibodies

We measure the presence of antibodies in people who live in private households to understand who has had coronavirus (COVID-19) in the past, and the impact of vaccinations. It takes between two and three weeks after infection or vaccination for the body to make enough antibodies to fight the infection. Antibodies can help prevent individuals from getting the same infection again. If they do get infected, people with antibodies are less likely to have severe symptoms. Once infected or vaccinated, antibodies remain in the blood at low levels and can decline over time. The length of time antibodies remain at detectable levels in the blood is not fully known.

SARS-CoV-2

This is the scientific name given to the specific virus that causes COVID-19.

Confidence interval

A confidence interval gives an indication of the degree of uncertainty of an estimate, showing the precision of a sample estimate. The 95% confidence intervals are calculated so that if we repeated the study many times, 95% of the time the true unknown value would lie between the lower and upper confidence limits. A wider interval indicates more uncertainty in the estimate. Overlapping confidence intervals indicate that there may not be a true difference between two estimates.

For more information, see our methodology page on statistical uncertainty.

Credible interval

A credible interval gives an indication of the uncertainty of an estimate from data analysis. A 95% credible interval is calculated so that there is a 95% probability of the true value lying in the interval.

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10. Measuring the data

Reference dates

We produce weekly modelled estimates using standard calendar weeks starting on Mondays. To provide the most timely and accurate estimates possible for antibody positivity, the model will include data for the first four to seven days of the most recent week available, depending on the availability of test results. The antibody and vaccination estimates for the most recent week in this publication includes data from 1 to 7 November 2021.

More information on measuring the data is available in the Coronavirus (COVID-19) Infection Survey statistical bulletin.

Our methodology article provides further information around the survey design, how we process data, and how data are analysed. The Quality and Methodology Information explains the strengths and limitations of the data, methods used, and data uses and users.

Vaccination estimates

While the daily official government figures provide the recorded actual numbers of vaccines against SARS-CoV-2 issued, our vaccination estimates are likely to be different from the official figures. This is because they are estimates based on a sample survey of reported vaccine status and are provided for context alongside our antibodies estimates. We control for the effect of ethnicity by post-stratifying our analysis by White and other ethnic groups, rather than individual ethnicities, because of our current sample size. This could result in differences between our survey estimates and the government figures in the numbers of vaccines received for some ethnic minority groups.

Importantly, our survey collects information from the population living in private households and does not include people living in communal establishments such as care homes, hospitals or prisons.

The value of showing our estimates of vaccines alongside our estimates of people testing positive for antibodies is to illustrate the relationship between the two.

Differences between official figures and the estimates from this survey differ in scale across each of the four UK nations (some survey estimates are closer to the official reported figures than others) because of differences in reporting dates and the inclusion of National Immunisation Management System (NIMS) data for England. In addition, our sampling method for Northern Ireland is different to the other nations, inviting only people who have previously participated in a Northern Ireland Statistics and Research Agency (NISRA) survey, which could result in a sample of individuals who are more likely to get vaccinated. This should be taken into consideration if comparing vaccine and antibody estimates across the four nations, as vaccine status and antibody positivity are related.

In addition, as our analysis develops, our survey-based estimates will enable possible future analysis of people who have received a vaccine with other characteristics collected in the survey.

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11. Strengths and limitations

More information on strengths and limitations of the data is available in Coronavirus (COVID-19) Infection Survey QMI and in the Coronavirus (COVID-19) Infection Survey statistical bulletin.

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Manylion cyswllt ar gyfer y Bwletin ystadegol

Kara Steel and Zoë Willis
infection.survey.analysis@ons.gov.uk
Ffôn: +44 1633 560499