Top 5 Takeaways

1. 41.6% of adults had antibodies indicating past SARS-CoV-2 infection during August 2021–May 2022, with 43.7% potentially asymptomatic.
2. Seropositivity without vaccination was more common among younger adults, Hispanic and non-Hispanic Black adults, and those with less education.
3. The NHANES data suggests disparities in COVID-19 infection rates and vaccination, especially among minority groups.
4. Preliminary NHANES data indicates disparities in seropositivity patterns, with higher infection rates and lower vaccination rates among specific demographic groups.
5. The findings emphasize the need for equity in COVID-19 vaccination efforts, as NHANES data offers more representative insights into asymptomatic infections and vaccination status.

Original Article Author and Citation

Corresponding Author

Lara J. Akinbami,

Suggested Citation

Akinbami LJ, Kruszon-Moran D, Wang C, et al. SARS-CoV-2 Serology and Self-Reported Infection Among Adults — National Health and Nutrition Examination Survey, United States, August 2021–May 2022. MMWR Morb Mortal Wkly Rep 2022;71:1522–1525. DOI:


The MMWR article reports on SARS-CoV-2 serology and self-reported infection among U.S. adults, based on data from the National Health and Nutrition Examination Survey (NHANES) from August 2021 to May 2022. It reveals that a significant portion of the population had antibodies indicative of past infection, with a notable proportion potentially asymptomatic. Serologic patterns consistent with vaccination without infection varied significantly across different demographic groups.


The NHANES used a 2-year sample design, including 30 primary sampling units, to collect data on SARS-CoV-2 antibodies and self-reported COVID-19 history. Antibodies were tested using specific reagents to distinguish between responses due to infection or vaccination. The study analyzed data from the first 10 units as a convenience sample, acknowledging limitations due to the unavailability of final survey weights and the unrepresentative nature of the unweighted sample.


The study found disparities in seroprevalence by age, race, and educational level. These disparities align with previous studies showing higher infection rates among younger individuals and racial and ethnic minority groups, as well as lower vaccination rates in these populations. The NHANES data provided a more comprehensive view of asymptomatic infections and vaccination status than previous studies, highlighting the importance of addressing health equity in vaccination efforts.


The findings emphasize the need for continued efforts to ensure equitable access to COVID-19 vaccinations. The data from NHANES, representing a more diverse population, underscores the disparities in infection and vaccination rates among various demographic groups, particularly among minority communities. This insight can guide public health strategies to achieve better equity in vaccine distribution and uptake.


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