Cases, Data, and Surveillance

About these surveys

CDC is working with commercial laboratories to conduct large-scale geographic seroprevalence surveys to estimate the percentage of people who were previously infected with SARS-CoV-2, the virus that causes COVID-19 disease. The strategy involves working with state, local, territorial, academic, and commercial partners to better understand COVID-19 in the United States using serology (antibody) testing for surveillance (“seroprevalence surveys” or “serosurveys”). For the surveys, de-identified clinical blood samples are tested for antibodies to SARS-CoV-2.

Initial Ten-Site Commercial Laboratory Seroprevalence Survey

The commercial laboratory seroprevalence survey used blood samples collected from 10 US sites during March to July 2020. These sites were Connecticut, Louisiana, Minnesota, Missouri, New York City, Philadelphia, San Francisco, South Florida, Utah, and Western Washington State. The survey included blood specimens tested for reasons unrelated to COVID-19, such as for routine medical care or a sick visit. CDC tested about 1,800 samples collected from each of these 10 sites, approximately every 3–4 weeks.

Nationwide Commercial Laboratory Seroprevalence Survey

In July 2020, CDC expanded the seroprevalence survey to include commercial laboratories across 50 US states, Washington, DC, and Puerto Rico. The survey uses blood samples submitted to commercial laboratories for reasons unrelated to COVID-19, such as routine medical care or a sick visit.

This survey aims to collect 50,000 blood samples every 2 weeks for a total of more than 1.2 million samples until August 2021. Seroprevalence estimates for both sexes and specific age groups might not be available for some sites because too few blood samples were collected. The results of the nationwide survey cannot be compared directly with results from the initial 10-site commercial laboratory seroprevalence survey because the laboratories from which samples were collected are different, the SARS-CoV-2 serology tests used in each study vary, and the geographic distribution of the two study populations changed. Researchers are investigating what percentage of blood specimens tested have antibodies against SARS-CoV-2, how this varies across geographic areas and age groups, and whether the percentage of SARS-CoV-2 infections has changed over time during the survey.


Weighted seroprevalence estimates with 95% confidence intervals are calculated for each site every 2 weeks. Seroprevalence estimates are adjusted (weighted) to match age and sex distribution to the sample population within each site and then standardized to the age and sex distribution obtained from the American Community Surveyexternal icon population data for each site. This approach accounts for several sources of variability including biases in sample collection, the demographics of each site, and accuracy of different serology tests (i.e., sensitivity and specificity). This variability is reported as 95% confidence intervals.

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