The median ACE2-RBD binding inhibition was 13% in natural infection (mean 24.3%, range 0–87.8, n = 30), a median 415 days from infection to sampling (range 22–623 days, IQR 309.25–591.5) and was higher in those with vaccination plus natural infection (median 16.2%, mean 25.8%, range 0–87.8%, n = 27) compared to those with natural infection alone (7.0, 11.5, and 13% respectively, n = 3). Here, ACE2 is linked to infection.