{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T21:01:59Z","timestamp":1776114119269,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This longitudinal prospective controlled multicenter study aimed to monitor immunity generated by three exposures caused by breakthrough infections (BTI) after COVID\u201019\u2010vaccination considering pre\u2010existing cell\u2010mediated immunity to common\u2010corona\u2010viruses (CoV) which may impact cellular reactivity against SARS\u2010CoV\u20102. Anti\u2010SARS\u2010CoV\u20102\u2010spike\u2010IgG antibodies (anti\u2010S\u2010IgG) and cellular reactivity against Spike\u2010(S)\u2010 and nucleocapsid\u2010(N)\u2010proteins were determined in fully\u2010vaccinated (F) individuals who either experienced BTI (F+BTI) or had booster vaccination (F+Booster) compared to partially vaccinated (P+BTI) and unvaccinated (U) from 1 to 24 weeks post PCR\u2010confirmed infection. High avidity anti\u2010S\u2010IgG were found in F+BTI compared to U, the latter exhibiting increased long\u2010lasting pro\u2010inflammatory cytokines to S\u2010stimulation. CoV was associated with higher cellular reactivity in U, whereas no association was seen in F. The study illustrates the induction of significant S\u2010specific cellular responses in F+BTI building\u2010up basic immunity by three exposures. Only U seem to benefit from pre\u2010existing CoV immunity but demonstrated inflammatory immune responses compared to F+BTI who immunologically benefit from enhanced humoral and cellular immunity after BTI. This study demonstrates that individuals with hybrid immunity from COVID\u201019\u2010vaccination and BTI acquire a stable humoral and cellular immune response that is maintained for at least 6 months. Our findings corroborate recommendations by health authorities to build on basic immunity by three S\u2010protein exposures.<\/jats:p>","DOI":"10.1002\/jmv.29739","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T04:16:05Z","timestamp":1718856965000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hybrid immunity by two COVID\u201019 mRNA vaccinations and one breakthrough infection provides a robust and balanced cellular immune response as basic immunity against severe acute respiratory syndrome coronavirus 2"],"prefix":"10.1002","volume":"96","author":[{"given":"Giovanni","family":"Almanzar","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Pediatric Rheumatology\/Special Immunology University Hospital W\u00fcrzburg W\u00fcrzburg 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