COVID-19 vaccines available in the US target the spike protein, so post-vaccination antibodies are directed against spike. Antibodies to nucleocapsid develop only after natural infection. Testing for nucleocapsid antibodies can identify past COVID-19 infection in patients regardless of vaccination status.
This test is used to identify past infection for epidemiologic purposes, evaluate possible past undiagnosed COVID-19, and in clinical and research settings where natural versus vaccine-induced immunity matters. It does not assess current infection — molecular testing is needed for that. Sample type is serum.
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