{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:35:40Z","timestamp":1786545340124,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01 AI120997"],"award-info":[{"award-number":["R01 AI120997"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["HHSN272201400008C"],"award-info":[{"award-number":["HHSN272201400008C"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["75N93019C00051"],"award-info":[{"award-number":["75N93019C00051"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["HHSN272201400006C"],"award-info":[{"award-number":["HHSN272201400006C"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["75N93021C00016"],"award-info":[{"award-number":["75N93021C00016"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020166","name":"Flu Lab","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although the hemagglutination inhibition (HAI) titer remains the gold standard correlate of protection against influenza, it does not fully capture the broader antibody responses that contribute to immunity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed immune responses in paired pre\u2010infection and convalescent sera from 306 RT\u2010PCR\u2013confirmed A(H3N2) infections from two household studies (2014\u20132018) in Managua, Nicaragua. Antibody responses were measured by HAI and enzyme\u2010linked immunosorbent assays (ELISAs) against full\u2010length hemagglutinin (HA), the HA stalk, and neuraminidase (NA). Participants were classified as HAI responders (\u2265\u20094\u2010fold HAI rise), alternate responders (no HAI rise but \u2265\u20094\u2010fold boost in \u2265\u20091 ELISA), or no\u2010response individuals (no \u2265\u20094\u2010fold rise in any assay). We compared demographic, clinical, and pre\u2010infection antibody characteristics across these groups. We also analyzed predictors of an NA response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 77% of participants had HAI seroconversion or a fourfold rise. Among the 23% HAI non\u2010responders, 62% had alternate antibody responses. No\u2010response individuals had the highest pre\u2010infection HAI and full\u2010length HA titers (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), the lowest viral loads, and the lowest frequency of fever or influenza\u2010like illness symptoms (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). An NA response was more common among symptomatic individuals and moderate baseline titers, with both low and high extremes reducing NA response odds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High baseline HAI titers can limit detectable fourfold rises and are associated with milder illness. Evaluating additional immune responses may capture a more complete picture of the host response to infection, thereby improving surveillance and informing vaccine development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.70292","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:35:51Z","timestamp":1783902951000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemagglutination Inhibition and Alternate Serologic Responses Following Influenza A(H3N2) Virus Infection"],"prefix":"10.1111","volume":"20","author":[{"given":"Boshu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-6173","authenticated-orcid":false,"given":"Jos\u00e9 Victor","family":"Zambrana","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health University of Michigan  Ann Arbor Michigan USA"},{"name":"Sustainable Sciences Institute  Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Shotwell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nery","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute  Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Plazaola","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute  Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Ojeda","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute  Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Lopez","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute  Managua Nicaragua"},{"name":"Centro de Salud S\u00f3crates Flores Vivas, Ministry of Health  Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Stadlbauer","sequence":"additional","affiliation":[{"name":"Department of Microbiology Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermina","family":"Kuan","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute  Managua Nicaragua"},{"name":"Centro de Salud S\u00f3crates Flores Vivas, Ministry of Health  Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Balmaseda","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute  Managua Nicaragua"},{"name":"Centro Nacional de Diagn\u00f3stico y Referencia, Ministry of Health  Managua Nicaragua"}],"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  New York New York USA"},{"name":"Center for Vaccine Research and Pandemic Preparedness (C\u2010VaRPP) Icahn School of Medicine at Mount Sinai  New York New York USA"},{"name":"Department of Pathology, Molecular and Cell\u2010Based Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"},{"name":"Ignaz Semmelweis Institute, Interuniversity Institute for Infection Research Medical University of Vienna  Vienna Austria"},{"name":"Ludwig Boltzmann Institute for Science Outreach and Pandemic Preparedness at the Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9352-7877","authenticated-orcid":false,"given":"Aubree","family":"Gordon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.21324"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofv067"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiy103"},{"key":"e_1_2_11_5_1","first-page":"63","article-title":"Haemagglutination\u2010Inhibiting Antibody to Influenza Virus","volume":"115","author":"Jong J. C.","year":"2003","journal-title":"Developmental Biology"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3182367662"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-10-18"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-29310-8"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.12.122"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2018.1462639"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2020.04.069"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2410.161258"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa928"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02636-10"},{"key":"e_1_2_11_15_1","unstructured":"\u201cManual for the Laboratory Diagnosis and Virological Surveillance of Influenza \u201d accessed November 14 2025 https:\/\/www.who.int\/publications\/i\/item\/manual\u2010for\u2010the\u2010laboratory\u2010diagnosis\u2010and\u2010virological\u2010surveillance\u2010of\u2010influenza."},{"issue":"81","key":"e_1_2_11_16_1","article-title":"Expression of Functional Recombinant Hemagglutinin and Neuraminidase Proteins From the Novel H7N9 Influenza Virus Using the Baculovirus Expression System","volume":"6","author":"Margine I.","year":"2013","journal-title":"Journal of Visualized Experiments (JoVE)"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01463-17"},{"key":"e_1_2_11_18_1","unstructured":"\u201cRecommended Composition of Influenza Virus Vaccines for Use in the 2016\u20102017 Northern Hemisphere Influenza Season \u201d accessed November 13 2025 https:\/\/www.who.int\/publications\/m\/item\/recommended\u2010composition\u2010of\u2010influenza\u2010virus\u2010vaccines\u2010for\u2010use\u2010in\u2010the\u20102016\u20102017\u2010northern\u2010hemisphere\u2010influenza\u2010season."},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiae258"},{"key":"e_1_2_11_20_1","unstructured":"R Core Team \u201cR: A Language and Environment for Statistical Computing \u201d Vienna Austria R Foundation for Statistical Computing (2024)."},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.21105\/joss.01686"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0463-x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.786617"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz141"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241693"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.00417\u201016"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.02134\u201018"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9050426"}],"container-title":["Influenza and Other Respiratory Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.70292","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/irv.70292","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.70292","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:40:00Z","timestamp":1786542000000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/irv.70292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":27,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/irv.70292"],"URL":"https:\/\/doi.org\/10.1111\/irv.70292","archive":["Portico"],"relation":{},"ISSN":["1750-2640","1750-2659"],"issn-type":[{"value":"1750-2640","type":"print"},{"value":"1750-2659","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70292"}}