Inferring COVID-19 testing and vaccination behavior from New Jersey testing data.

Area of Science:

• Epidemiology
• Public Health
• Behavioral Science

Background:

• Disease testing behaviors significantly impact infectious disease dynamics at both individual and population levels.
• The COVID-19 pandemic provided extensive data on current infection (PCR, antigen) and past infection (serology) testing, enabling detailed analysis of testing behavior.
• Individual testing decisions and population-level epidemic knowledge create a feedback loop influencing overall testing participation.

Purpose of the Study:

• To analyze the complex relationship between COVID-19 testing behaviors (PCR, serology), infection status, and vaccination.
• To quantify how individual testing tendencies interact with past testing and infection histories.
• To infer vaccination trends and identify factors influencing vaccination rates using serology data.

Main Methods:

• Utilized a comprehensive database of individualized COVID-19 testing histories from New Jersey.
• Quantified associations between PCR tests, serology tests, infection status, and vaccination status.
• Modeled serology test titer values to estimate vaccination trends over time.

Main Results:

• PCR tests were predominantly used by individuals with current infections; serology tests were favored by those with past infections or vaccinations.
• The impact of previous positive test results on subsequent testing behavior varied over the epidemic's course.
• A notable decline in vaccination rates was observed among individuals with a prior positive PCR test result.

Conclusions:

• Individualized testing histories are crucial for uncovering behavioral factors influencing disease testing and vaccination patterns.
• Understanding these behavioral dynamics can inform more effective public health strategies during epidemics.
• The study demonstrates the value of granular testing data in public health research and intervention planning.