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Participants reported monthly on vaccine doses, and SARS\u2010CoV\u20102 infections. Serum was collected in December 2023 and April 2024 to determine neutralizing antibody to Wuhan ancestral strain and Omicron XBB.1.5 and JN.1 subvariants. Multivariate analysis assessed protective factors against a new SARS\u2010CoV\u20102 infection between the two sampling times and 10 months follow up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>74% had hybrid immunity and 26% vaccine only immunity at study entry. A neutralizing antibody response was detected in 99% to Wuhan ancestral strain compared to 86% and 79% respectively to Omicron XBB.1.5 and JN.1 subvariants. For those with detectable antibodies the levels decayed, faster in those with vaccine only immunity and to the JN.1 subvariant. Neither the presence or the level of neutralizing antibody to JN.1 was associated with protection with a new SARS\u2010Cov\u20102 infection over the 10\u2010month follow up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Neutralizing antibody levels to Omicron JN.1 subvariant were identified in 79% overall but in only 56% with vaccine only immunity. The presence or level was not associated with protection form a new SARS\u2010CoV\u20102 infection over 10\u2010months. This data supports the development of pan\u2010coronavirus vaccine to expand protection against emerging variants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cti2.70095","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T07:21:11Z","timestamp":1776324071000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neutralising antibody responses to emerging\n                    <scp>SARS<\/scp>\n                    \u2010\n                    <scp>CoV<\/scp>\n                    \u20102 omicron sub\u2010variants are enhanced in persons with hybrid immunity"],"prefix":"10.1002","volume":"15","author":[{"given":"Sharon L","family":"Walmsley","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine University Health Network  Toronto ON Canada"},{"name":"Faculty of Medicine University of Toronto  Toronto ON 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