{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T01:16:58Z","timestamp":1793495818146,"version":"4.5.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"Department of Health and Human Services","doi-asserted-by":"publisher","award":["75N93021C00015"],"award-info":[{"award-number":["75N93021C00015"]}],"id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Influenza vaccines are designed to induce hemagglutinin-inhibiting (HAI) antibodies rather than neuraminidase-inhibiting (NAI) antibodies; therefore, NAI antibodies\u2019 protective effects need further investigation. Neuraminidase-inhibiting antibodies\u2019 protective effects, independent of HAI antibodies, have been demonstrated for influenza A viruses, but not influenza B viruses (IBVs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Employing H6NB reassortant virus targets, we evaluated NAI antibodies\u2019 protective effects against IBV in sera from a prospective influenza vaccine effectiveness study among healthcare personnel (HCP) in Israel. Antibody titers against B\/Brisbane\/60\/2008 and B\/Phuket\/3073\/2013 were quantified by HAI and NAI assays. Matched NAI and HAI antibody titers from baseline and postvaccination sera were analyzed for the 2017\u20132018 influenza season.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Laboratory-confirmed IBV infection was recorded in 64\/262 HCP and influenza vaccination in 187\/262 HCP. Vaccination did not consistently elicit rising NAI titers against vaccine strain B\/Brisbane, with a geometric mean fold rise of 1.1 (95% CI: .9\u20131.3). However, comparing baseline NAI titers, geometric mean titer ratios were 1.50 (95% CI: 1.0\u20132.1) times higher against B\/Brisbane and 2.5 (95% CI: 1.7\u20133.6) times higher against circulating B\/Phuket in vaccinated versus unvaccinated HCP. Each 2-fold rise in NAI antibody titers reduced the hazard of symptomatic infection by 42% (95% CI: 36%\u201348%) against B\/Phuket and 23% (95% CI: 13%\u201333%) against B\/Brisbane, adjusting for HAI titers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neuraminidase-inhibiting antibodies were a strong correlate of protection against symptomatic IBV infection, with protective effects independent of those from HAI antibodies. These findings suggest that the use and standardization of neuraminidase content in influenza vaccines could provide broader protection against influenza.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag351","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:57:07Z","timestamp":1783511827000},"page":"573-582","source":"Crossref","is-referenced-by-count":1,"title":["Protective Effects of Influenza B Neuraminidase Antibodies Against Symptomatic Influenza Virus Infection"],"prefix":"10.1093","volume":"234","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5288-0023","authenticated-orcid":false,"given":"Skyler","family":"Rogers","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey M","family":"Sumner","sequence":"additional","affiliation":[{"name":"Influenza Division, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6011-4152","authenticated-orcid":false,"given":"Yangyupei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emileigh","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Balicer","sequence":"additional","affiliation":[{"name":"Clalit Research Institute, Innovation Division, Clalit Health Services , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Peretz","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Social Welfare and Health Studies, University of Haifa , Haifa ,","place":["Israel"]},{"name":"Beilinson Campus, Rabin Medical Center , Petah Tikva ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Saban Children\u2019s Hospital, Soroka University Medical Center , Be\u2019er Sheva ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3393-9853","authenticated-orcid":false,"given":"Avital","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Clalit Research Institute, Innovation Division, Clalit Health Services , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]},{"name":"Clalit Research Institute, Innovation Division, Clalit Health Services , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4121-776X","authenticated-orcid":false,"given":"Florian","family":"Krammer","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Icahn School of Medicine at Mount Sinai , NewYork, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-435X","authenticated-orcid":false,"given":"Arnold S","family":"Monto","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5771-8895","authenticated-orcid":false,"given":"Emily T","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of 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