All Immunity and Titer Tests

All Immunity and Titer Tests brings together the blood tests used to document vaccine immunity, check past infection, and screen immune function. Common reasons to test include school or employment requirements, health-care onboarding, travel, proof of hepatitis B response, TB screening before certain medicines, or evaluation of frequent infections.

A proactive plan starts by matching the exact titers you need (MMR, varicella, hepatitis B, tetanus/diphtheria). For past exposure questions, add COVID-19 antibodies (spike ± nucleocapsid). For tuberculosis screening, choose a TB blood test (IGRA) such as QuantiFERON or T-SPOT. When infections are frequent or severe, add immunoglobulins (IgG/IgA/IgM)IgG subclassespneumococcal serotype responseslymphocyte subsets, and complement. These labs support screeningdocumentation, and monitoring, but they do not diagnose active illness or replace clinical evaluation.

Signs, Symptoms & Related Situations

  • Documentation & compliance

    • School, healthcare employment, immigration, travel, volunteer clearance

    • Proof of immunity: MMRvaricellahepatitis Btetanus/diphtheria (± pertussis per program)

  • Exposure & pre-treatment

    • TB screening for close contacts or before immunosuppressive therapy

    • COVID-19 antibody testing for past infection or vaccine response (not for current illness)

  • Frequent or unusual infections

    • Recurrent sinus/ear/chest infections, pneumonia, poor vaccine responses

  • Family planning

    • Rubella or varicella IgG status before pregnancy (clinician-guided)

  • Urgent care now

    • Trouble breathing, chest pain, confusion, severe dehydration, or rapidly worsening symptoms

Testing choices and symptoms should be reviewed with a qualified clinician.

Why These Tests Matter

What testing can do

  • Provide proof of immunity for schools, employers, and programs

  • Detect TB infection (latent or active) via IGRA screening; unaffected by BCG vaccination

  • Characterize immune status (immunoglobulins, subclasses, functional antibody) and guide next steps

What testing cannot do

  • Diagnose active infection or confirm contagiousness

  • Guarantee lifelong protection—antibodies can wane and cutoffs vary by disease/assay

  • Replace vaccinations/boosters, imaging, or clinician judgment when indicated

What These Tests Measure (at a glance)

  • Vaccine/Exposure Titers (IgG): Measles, Mumps, Rubella; Varicella-Zoster; Hepatitis B surface antibody (anti-HBs); Tetanus/Diphtheria; Hepatitis A IgG; others as requested.

  • COVID-19 Antibodies: Spike (S) IgG for vaccine response/previous exposure; Nucleocapsid (N) IgG for prior infection; some panels include surrogate neutralizing activity.

  • TB Blood Tests (IGRAs): QuantiFERON-TB Gold Plus or T-SPOT.TB—single visit, not affected by BCG; results are positive/negative/indeterminate and require clinical follow-up.

  • Immunoglobulin Profile: IgG/IgA/IgM (± IgE); low levels can signal immune deficits, high levels may reflect inflammation.

  • IgG Subclasses (1–4): supportive when total IgG is normal but infections persist; interpret with functional antibody testing.

  • Functional Antibody Testing: Pneumococcal serotype IgG before/after vaccination to assess antibody production.

  • Lymphocyte Subsets (Flow): CD3/CD4/CD8 T cellsCD19/20 B cellsCD16/56 NK cells—screens cellular immunity.

  • Complement System: C3, C4, CH50 (± AH50) to evaluate classical/alternative pathway activity.

  • Context labs: CBC with differential and CRP/ESR for infection/inflammation clues.

Quick Build Guide

Goal Start with Add if needed
School/health-care onboarding MMR IgG • Varicella IgG • Hep B surface Ab • Tetanus/Diphtheria IgG Pertussis IgG if your program accepts it
Post-vaccine proof (Hep B) Hep B surface Ab (draw ≥3–4 weeks post-series) Repeat after booster if nonreactive (clinician-directed)
TB screening (employment/exposure) QuantiFERON-TB Gold Plus T-SPOT.TB if indeterminate or immunosuppressed
COVID-19 past exposure/response Spike IgG Nucleocapsid IgG ± Neutralizingactivity
Frequent infections—initial screen IgG/IgA/IgM • CBC with differential IgG Subclasses • Pneumococcal serotypes (pre/post)
Suspected complement issue C3 • C4 CH50 (± AH50)
Pregnancy planning Rubella IgG • Varicella IgG Follow timing per clinician

How the Testing Process Works

  1. Match your checklist: pick the exact titers or screens your program or clinician requests.

  2. Time your draw: for post-vaccine checks, test ≥3–4 weeks after the last dose. IGRAs do not require fasting.

  3. Visit a draw site: one blood draw; some tests use additional tubes or same-day processing.

  4. Review results: compare to your report’s reference ranges and program criteria; your clinician may add imaging or confirmatory tests if indicated.

  5. Plan follow-up: vaccination, booster, or repeat testing may be advised for nonreactive or indeterminate results.

Interpreting Results (General Guidance)

  • Titers (IgG): Reactive/positive suggests immunity; nonreactive/negative may reflect no immunity, early testing, or waning antibodies.

  • COVID-19 antibodies: Spike+ / N− aligns with vaccination; Spike+ / N+ suggests prior infection; both negativecan mean no exposure or early/waning response.

  • TB IGRAs: Positive indicates TB infection (latent or active) and needs clinical evaluation, often with chest X-rayindeterminate often requires repeat or alternate IGRA.

  • Immunoglobulins/subclasses: low levels or poor vaccine responses can suggest immune deficits; high polyclonal levels may reflect inflammation.
    Always interpret results with a qualified healthcare professional; patterns, timing, and context matter more than a single value.

Choosing Panels vs. Individual Tests

  • Program bundle: select a titer package (MMR, varicella, hepatitis B, tetanus/diphtheria) that mirrors your form.

  • Single-question check: order one marker (e.g., anti-HBs after vaccination).

  • Immune-function screen: IgG/IgA/IgM + CBC with differential, and add subclassespneumococcal serotypeslymphocyte subsets, or complement based on findings.

  • TB pathway: choose a single IGRA (QuantiFERON or T-SPOT) rather than TST when possible.

FAQs

Do I need to fast for these tests?
No. Titers, IGRAs, and immunoglobulins do not require fasting.

How soon after a vaccine should I draw a titer?
Wait at least 3–4 weeks after the final dose for the clearest result.

Will BCG affect my TB test?
BCG does not affect IGRA blood tests; it can affect the skin test (TST).

Can titers prove I’m fully protected?
Titers correlate with protection, but no test guarantees immunity for every disease. Follow your program rules and clinician advice.

What if my TB IGRA is positive?
You’ll need a clinician evaluation, usually a chest X-ray, and possibly sputum testing to rule out active disease.

My hepatitis B titer is negative—now what?
Your clinician may recommend a booster or repeat series and a follow-up titer.

Do recurrent infections mean immune deficiency?
Not always. Baseline Ig levelsCBC, and functional antibody tests help clarify next steps.

Related Categories & Key Tests

References

Available Tests & Panels

Your All Immunity and Titer Tests menu is pre-populated in the Ulta Lab Tests system. Use filters to build your package—required titersCOVID-19 antibodiesTB blood tests, and immune-function screens—and schedule your draw. Follow timing guidance (especially ≥3–4 weeks post-vaccination) and review results with your clinician before submitting documentation or planning next steps.

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