(HealthDay News) — More than 40% of US adults have serology indicative of past COVID-19 infection, of whom 43.7% report never having had COVID-19, according to research published in the US Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Noting that the National Health and Nutrition Examination Survey (NHANES) collects severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology data and collects self-reported COVID-19 vaccination and disease history, Lara J. Akinbami, MD, from the CDC in Atlanta, and colleagues used data from NHANES to quantify asymptomatic SARS-CoV-2 infection prevalence and seropositivity attained through infection without vaccination.

The researchers found that based on preliminary NHANES 2021 to 2022 results, 41.6% of adults aged 18 years and older had serology indicative of past infection and 43.7% of these adults reported never having had COVID-19, including 57.1% of non-Hispanic Black or African American adults; this may represent asymptomatic infections. Furthermore, 25.5% of adults with serology indicative of past infection reported not having received a COVID-19 vaccine. Young adults and Black adults had higher prevalence rates of seropositivity in the absence of vaccination, reflecting lower vaccination rates in these groups.

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“Consistent with findings from other seroprevalence studies, preliminary NHANES 2021 to 2022 results raise health equity concerns given the disparities observed in SARS-CoV-2 infection and COVID-19 vaccination,” the authors write. “These results can guide ongoing efforts to achieve vaccine equity in COVID-19 primary vaccination series and booster dose coverage.”

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