Beyond Vaccination Rates: A Synthetic Random Proxy Metric of Total SARS- CoV-2 Immunity Seroprevalence in the Community

Explicit knowledge of total community-level immune seroprevalence is critical to developing policies to mitigate the social and clinical impact of SARS-CoV-2. Publicly available vaccination data are frequently cited as a proxy for population immunity, but this metric ignores the effects of naturally-acquired immunity, which varies broadly throughout the country and world. Without broad or random sampling of the population, accurate measurement of persistent immunity post natural infection is generally unavailable. To enable tracking of both naturally-acquired and vaccine-induced immunity, we set up a synthetic random proxy based on routine hospital testing for estimating total Immunoglobulin G (IgG) prevalence in the sampled community. Our approach analyzes viral IgG testing data of asymptomatic patients who present for elective procedures within a hospital system. We apply multilevel regression and poststratification to adjust for demographic and geographic discrepancies between the sample and the community population. We then apply