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Waning serum antibodies against SARS-CoV-2 have raised questions about long-term immunity. Lower antibody levels to SARS-CoV-2 spike protein are associated with breakthrough infections after vaccination, prompting consideration of booster doses.1,2 Prior infection may enhance protection from vaccination, stimulating inquiry about hybrid immunity.3 Our objective was to examine SARS-CoV-2 spike IgG antibodies in a longitudinal cohort, comparing antibody durability in individuals who received an mRNA SARS-CoV-2 vaccine with or without prior SARS-CoV-2 infection.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Diana Zhong, MD, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E Monument St, Baltimore, MD 21205 (firstname.lastname@example.org).
Accepted for Publication: October 21, 2021.
Published Online: November 1, 2021. doi:10.1001/jama.2021.19996
Author Contributions: Dr Milstone had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Zhong and Xiao contributed equally as co–first authors.
Concept and design: Zhong, Debes, Egbert, Milstone.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Zhong, Xiao, Debes, Colantuoni.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Xiao, Debes, Colantuoni.
Obtained funding: Milstone.
Administrative, technical, or material support: Zhong, Debes, Egbert.
Supervision: Debes, Colantuoni, Milstone.
Conflict of Interest Disclosures: Dr Milstone reported receiving grant support from Merck outside the submitted work. No other disclosures were reported.
Funding/Support: Research reported in this publication was supported in part by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under awards T32AI007291 (Dr Zhong) and K24AI141580 (Dr Milstone) and the generosity of the collective community of donors to the Johns Hopkins University School of Medicine and the Johns Hopkins Health System for COVID-19 research.
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: We thank members of the Johns Hopkins Hospital Clinical Immunology Laboratory, Danielle Koontz, MAS, and Ani Voskertchian, MPH (Johns Hopkins University School of Medicine), for study coordination; Shaun Truelove, PhD (Johns Hopkins University Bloomberg School of Public Health), for intellectual contribution; Avinash Gadala, PhD (Johns Hopkins Health System), for data management; and Benjamin Mark Landrum, MD, Morgan Katz, MD, S. Sonia Qasba, MD, MPH, and Pooja Gupta, MD (Johns Hopkins University School of Medicine), for help with study recruitment. We thank Kirsten Vannice, PhD, MHS (Bill and Melinda Gates Foundation), for providing contribution to the analysis. None of the contributors above received compensation for their roles.
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