{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T04:47:24Z","timestamp":1750308444550,"version":"3.41.0"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["1OT2HL156812-01"],"award-info":[{"award-number":["1OT2HL156812-01"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["75N91019D00024"],"award-info":[{"award-number":["75N91019D00024"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["U01-AI136780"],"award-info":[{"award-number":["U01-AI136780"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017540","name":"NHLBI Division of Intramural Research","doi-asserted-by":"publisher","award":["F32 HL 172463"],"award-info":[{"award-number":["F32 HL 172463"]}],"id":[{"id":"10.13039\/100017540","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001381","name":"National Research Foundation Singapore","doi-asserted-by":"publisher","award":["COVID19RF-0005"],"award-info":[{"award-number":["COVID19RF-0005"]}],"id":[{"id":"10.13039\/501100001381","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_00004\/05"],"award-info":[{"award-number":["MC_UU_00004\/05"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec016\">\n<jats:title>Background<\/jats:title>\n<jats:p>Neutralizing monoclonal antibodies (nMAbs) have been used to treat COVID-19 and are increasingly being used to treat other infections. However, there is concern that by neutralizing the SARS-CoV-2 virus, nMAbs may decrease the availability of antigens to the immune system, potentially impairing the endogenous polyclonal immune response and decreasing long-term immune protection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec017\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We compared 28 and 90-day anti-SARS-CoV-2 spike protein neutralization activity and anti-SARS-CoV-2 nucleocapsid response for patients hospitalized with COVID-19 infection randomized to receive nMAbs or placebo in the large platform ACTIV-3\/TICO trials. We pooled results from four trials of anti-spike nMAbs. For most tested agents, measurements of the spike protein response reflect both the therapeutic and endogenous immune response. Anti-nucleocapsid levels reflect only the endogenous immune response. Data are summarized as mean differences in percent binding inhibition (anti-spike) and signal-to-cutoff (S\/C) ratio (anti-nucleocapsid). Linear mixed effects models were fit to compare the longitudinal trajectory between treatment and placebo groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec018\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 2,254 participants in the ACTIV-3\/TICO trials modified intention-to-treat population, 2,149 (95.3%) had antibody measures at baseline and at least 1 follow-up day (day 1, 3, or 5) and were included in this analysis. Antibody measures were available for 1,556 (72.4%) participants at day 28 and 1,429 (66.5%) participants at day 90. In participants who received nMAbs, anti-spike neutralization activity was higher at day 28 (mean difference in percent binding inhibition: 7.1% [95%CI: 5.3, 8.9], p\u2009&lt;\u20090.001) and day 90 (mean difference in percent binding inhibition: 7.2% [95% CI: 5.4, 9.0], p\u2009&lt;\u20090.001). Anti-nucleocapsid response was similar at day 28 (mean difference in S\/C ratio: 0.02 [95%CI: \u22120.11, 0.15], p\u2009=\u20090.75) and day 90 (mean difference in S\/C ratio: 0.08 [95% CI: \u22120.05, 0.21], p\u2009=\u20090.22). Similar patterns were observed in all trials.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec019\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In patients hospitalized with COVID-19, treatment with nMAbs did not decrease long-term anti-nucleocapsid response compared to placebo, suggesting neutralizing therapies do not suppress the endogenous humoral immune response in this population.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0325561","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T17:54:18Z","timestamp":1750269258000},"page":"e0325561","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term anti-SARS-CoV-2 antibody trajectories after neutralizing monoclonal antibody treatment"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3353-612X","authenticated-orcid":true,"given":"Elizabeth S.","family":"Munroe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg A.","family":"Grandits","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Hyzy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hallie C.","family":"Prescott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas W.","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin L.","family":"Dewar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Engen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0643-9017","authenticated-orcid":true,"given":"Anna L.","family":"Goodman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3755-4309","authenticated-orcid":true,"given":"Timothy J.","family":"Hatlen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helene","family":"Highbarger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7745-9010","authenticated-orcid":true,"given":"Thomas L.","family":"Holland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomas O.","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad A.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Kalomenidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nayon","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvain","family":"Laverdure","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasad","family":"Manian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidya","family":"Menon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srikanth","family":"Ramachandruni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tauseef","family":"Rehman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Shaw-Saliba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit Thorup","family":"R\u00f8ge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Vock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy C.","family":"Weintrob","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barnaby E.","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne P.","family":"Frosch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the STRIVE Network and Therapeutics for Inpatients with COVID-19 (TICO) study groups","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"issue":"3","key":"pone.0325561.ref001","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1542\/peds.102.3.531","article-title":"Palivizumab, a Humanized Respiratory Syncytial Virus Monoclonal Antibody, Reduces Hospitalization From Respiratory Syncytial Virus Infection in High-risk Infants","volume":"102","author":"The IMpact-RSV Study Group","year":"1998","journal-title":"Pediatrics"},{"issue":"24","key":"pone.0325561.ref002","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1056\/NEJMoa1910993","article-title":"A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics","volume":"381","author":"S Mulangu","year":"2019","journal-title":"N Engl J Med"},{"issue":"13","key":"pone.0325561.ref003","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa2109682","article-title":"Subcutaneous REGEN-COV antibody combination to prevent Covid-19","volume":"385","author":"MP O\u2019Brien","year":"2021","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0325561.ref004","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1001\/jama.2021.8828","article-title":"Effect of bamlanivimab vs placebo on incidence of COVID-19 among residents and staff of skilled nursing and assisted living facilities: A randomized clinical trial","volume":"326","author":"MS Cohen","year":"2021","journal-title":"JAMA"},{"key":"pone.0325561.ref005","author":"Food and Drug Administration","year":"2024"},{"issue":"21","key":"pone.0325561.ref006","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1056\/NEJMoa2107934","article-title":"Early Treatment for Covid-19 with SARS-CoV-2 Neutralizing Antibody Sotrovimab","volume":"385","author":"A Gupta","year":"2021","journal-title":"N Engl J Med"},{"issue":"23","key":"pone.0325561.ref007","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa2108163","article-title":"REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19","volume":"385","author":"DM Weinreich","year":"2021","journal-title":"N Engl J Med"},{"issue":"15","key":"pone.0325561.ref008","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1056\/NEJMoa2102685","article-title":"Bamlanivimab plus etesevimab in mild or moderate covid-19","volume":"385","author":"M Dougan","year":"2021","journal-title":"N Engl J Med"},{"issue":"10","key":"pone.0325561.ref009","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1056\/NEJMoa2033130","article-title":"A neutralizing monoclonal antibody for hospitalized patients with covid-19","volume":"384","author":"ACTIV-3\/TICO LY-CoV555 Study Group","year":"2021","journal-title":"N Engl J Med"},{"issue":"5","key":"pone.0325561.ref010","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S1473-3099(21)00751-9","article-title":"Efficacy and safety of two neutralising monoclonal antibody therapies, sotrovimab and BRII-196 plus BRII-198, for adults hospitalised with COVID-19 (TICO): a randomised controlled trial","author":"WH Self","year":"2022","journal-title":"Lancet Infect Dis"},{"issue":"10","key":"pone.0325561.ref011","doi-asserted-by":"crossref","DOI":"10.1016\/S2213-2600(22)00215-6","article-title":"Tixagevimab\u2013cilgavimab for treatment of patients hospitalised with COVID-19: a randomised, double-blind, phase 3 trial","volume":"10","author":"TL Holland","year":"2022","journal-title":"Lancet Respir Med"},{"issue":"1","key":"pone.0325561.ref012","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1056\/NEJMc2214302","article-title":"Efficacy of antiviral agents against omicron subvariants BQ.1.1 and XBB","volume":"388","author":"M Imai","year":"2023","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0325561.ref013","doi-asserted-by":"crossref","DOI":"10.1016\/j.cell.2022.12.018","article-title":"Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants","volume":"186","author":"Q Wang","year":"2023","journal-title":"Cell"},{"issue":"22","key":"pone.0325561.ref014","doi-asserted-by":"crossref","first-page":"2094","DOI":"10.1056\/NEJMc2211845","article-title":"In Vitro Efficacy of Antiviral Agents against Omicron Subvariant BA.4.6","volume":"387","author":"E Takashita","year":"2022","journal-title":"N Engl J Med"},{"issue":"12","key":"pone.0325561.ref015","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1016\/S1473-3099(22)00694-6","article-title":"Resistance of SARS-CoV-2 omicron subvariant BA.4.6 to antibody neutralisation","author":"Q Wang","year":"2022","journal-title":"Lancet Infect Dis"},{"issue":"5","key":"pone.0325561.ref016","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1056\/NEJMc2207519","article-title":"Efficacy of antibodies and antiviral drugs against omicron BA.2.12.1, BA.4, and BA.5 subvariants","volume":"387","author":"E Takashita","year":"2022","journal-title":"N Engl J Med"},{"issue":"7923","key":"pone.0325561.ref017","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1038\/s41586-022-05053-w","article-title":"Antibody evasion by SARS-CoV-2 Omicron subvariants BA.2.12.1, BA.4 and BA.5","volume":"608","author":"Q Wang","year":"2022","journal-title":"Nature"},{"key":"pone.0325561.ref018","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.clicom.2022.08.003","article-title":"Endogenous antibody response to SARS-CoV-2 in patients who received monoclonal antibodies against COVID-19: A systematic review","volume":"2","author":"A Lombardi","year":"2022","journal-title":"Clin Immunol Commun"},{"key":"pone.0325561.ref019","doi-asserted-by":"crossref","first-page":"790469","DOI":"10.3389\/fimmu.2021.790469","article-title":"Endogenous Antibody Responses to SARS-CoV-2 in Patients With Mild or Moderate COVID-19 Who Received Bamlanivimab Alone or Bamlanivimab and Etesevimab Together","volume":"12","author":"L Zhang","year":"2021","journal-title":"Front Immunol"},{"issue":"2","key":"pone.0325561.ref020","first-page":"58","article-title":"Comparison Study of the Bio-Plex and Meso Scale Multiplexed SARS-CoV-2 Serology Assays Reveals Evidence of Diminished Host Antibody Responses to SARS-CoV-2 after Monoclonal Antibody Treatment","volume":"9","author":"UM Parikh","year":"2024","journal-title":"Pathog Immun"},{"key":"pone.0325561.ref021","first-page":"108959","article-title":"Effect of monoclonal antibody therapy on the endogenous SARS-CoV-2 antibody response. Clin Immunol","volume":"236","author":"PS Kim","year":"2022"},{"issue":"6","key":"pone.0325561.ref022","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1038\/s41577-021-00542-x","article-title":"Neutralizing monoclonal antibodies for treatment of COVID-19","author":"PC Taylor","year":"2021","journal-title":"Nat Rev Immunol"},{"issue":"655","key":"pone.0325561.ref023","doi-asserted-by":"crossref","DOI":"10.1126\/scitranslmed.abn3041","article-title":"The anti\u2013SARS-CoV-2 monoclonal antibody bamlanivimab minimally affects the endogenous immune response to COVID-19 vaccination","volume":"14","author":"RJ Benschop","year":"2022","journal-title":"Sci Transl Med"},{"issue":"8","key":"pone.0325561.ref024","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad355","article-title":"Safety, Tolerability, and Pharmacokinetics of Single and Multiple Ascending Intravenous Infusions of PF-07304814 (Lufotrelvir) in Participants Hospitalized With COVID-19","volume":"10","author":"P Robinson","year":"2023","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"pone.0325561.ref025","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1177\/17407745211049829","article-title":"Design and implementation of an international, multi-arm, multi-stage platform master protocol for trials of novel SARS-CoV-2 antiviral agents: Therapeutics for Inpatients with COVID-19 (TICO\/ACTIV-3)","volume":"19","author":"DD Murray","year":"2022","journal-title":"Clin Trials"},{"issue":"9","key":"pone.0325561.ref026","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.7326\/M22-1503","article-title":"Efficacy and Safety of Ensovibep for Adults Hospitalized With COVID-19\u00a0: A Randomized Controlled Trial","volume":"175","author":"ACTIV-3\/TICO Study Group","year":"2022","journal-title":"Ann Intern Med"},{"key":"pone.0325561.ref027","author":"Food and Drug Administration","year":"2022"},{"key":"pone.0325561.ref028","author":"Food and Drug Administration","year":"2022"},{"key":"pone.0325561.ref029","author":"Medicines & Healthcare products Regulatory Agency GovUK"},{"key":"pone.0325561.ref030","author":"European Medicines Agency","year":"2021"},{"issue":"6","key":"pone.0325561.ref031","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1002\/psp4.12958","article-title":"Population pharmacokinetics and exposure-response analysis of a single dose of sotrovimab in the early treatment of patients with mild to moderate COVID-19","volume":"12","author":"JE Sager","year":"2023","journal-title":"CPT Pharmacometrics Syst Pharmacol"},{"issue":"6","key":"pone.0325561.ref032","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofae233","article-title":"The Designed Ankyrin Repeat Protein Antiviral Ensovibep for Nonhospitalized Patients With Coronavirus Disease 2019: Results From EMPATHY, a Randomized, Placebo-Controlled Phase 2 Study","volume":"11","author":"J Kingsley","year":"2024","journal-title":"Open Forum Infect Dis"},{"issue":"12","key":"pone.0325561.ref033","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1002\/cpdd.1174","article-title":"Safety, Tolerability, and Pharmacokinetics of Intravenous Doses of PF-07304814, a Phosphate Prodrug Protease Inhibitor for the Treatment of SARS-CoV-2, in Healthy Adult Participants","volume":"11","author":"T Zhu","year":"2022","journal-title":"Clin Pharmacol Drug Dev"},{"key":"pone.0325561.ref034","article-title":"Effect of neutralizing monoclonal antibody treatment on early trajectories of virologic and immunologic biomarkers in patients hospitalized with COVID-19","author":"TO Jensen","year":"2023","journal-title":"J Infect Dis"},{"key":"pone.0325561.ref035","author":"GenScript"},{"issue":"9","key":"pone.0325561.ref036","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1038\/s41587-020-0631-z","article-title":"A SARS-CoV-2 surrogate virus neutralization test based on antibody-mediated blockage of ACE2-spike protein-protein interaction","volume":"38","author":"CW Tan","year":"2020","journal-title":"Nat Biotechnol"},{"issue":"3","key":"pone.0325561.ref037","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1111\/bcp.15560","article-title":"Viral clearance, pharmacokinetics and tolerability of ensovibep in patients with mild to moderate COVID-19: A phase 2a, open-label, single-dose escalation study","volume":"89","author":"MLM Prins","year":"2023","journal-title":"Br J Clin Pharmacol"},{"issue":"7815","key":"pone.0325561.ref038","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1038\/s41586-020-2349-y","article-title":"Cross-neutralization of SARS-CoV-2 by a human monoclonal SARS-CoV antibody","volume":"583","author":"D Pinto","year":"2020","journal-title":"Nature"},{"key":"pone.0325561.ref039","author":"Bio-Rad"},{"key":"pone.0325561.ref040","author":"Quanterix","year":"2021"},{"issue":"2","key":"pone.0325561.ref041","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1111\/j.0006-341X.1999.00625.x","article-title":"Mixed effects models with censored data with application to HIV RNA levels","volume":"55","author":"JP Hughes","year":"1999","journal-title":"Biometric"},{"issue":"4","key":"pone.0325561.ref042","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1093\/biostatistics\/1.4.355","article-title":"Analysis of left-censored longitudinal data with application to viral load in HIV infection","volume":"1","author":"H Jacqmin-Gadda","year":"2000","journal-title":"Biostatistics"},{"issue":"17","key":"pone.0325561.ref043","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1056\/NEJMoa2312775","article-title":"Subcutaneous administration of a monoclonal antibody to prevent malaria","volume":"390","author":"K Kayentao","year":"2024","journal-title":"N Engl J Med"},{"key":"pone.0325561.ref044","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/j.drudis.2008.04.013","article-title":"DARPins: a new generation of protein therapeutics","volume":"13","author":"MT Stumpp","year":"2008","journal-title":"Drug Discov Today"},{"issue":"7","key":"pone.0325561.ref045","doi-asserted-by":"crossref","first-page":"3910","DOI":"10.4049\/jimmunol.167.7.3910","article-title":"Passively acquired antibodies suppress humoral but not cell-mediated immunity in mice immunized with live attenuated respiratory syncytial virus vaccines","volume":"167","author":"Jr Crowe JE","year":"2001","journal-title":"J Immunol"},{"key":"pone.0325561.ref046","author":"European Medicines Agency","year":"2022"},{"key":"pone.0325561.ref047","author":"Food and Drug Administration","year":"2023"},{"key":"pone.0325561.ref048","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/S1473-3099(22)00801-5","article-title":"Protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease: a systematic review and meta-regression","author":"N Bobrovitz","year":"2023","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"pone.0325561.ref049","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jinf.2023.06.018","article-title":"Nucleocapsid-specific antibodies as a correlate of protection against SARS-CoV-2 reinfection in children","volume":"87","author":"AC Dowell","year":"2023","journal-title":"J Infect"},{"issue":"10","key":"pone.0325561.ref050","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1016\/j.immuni.2022.09.006","article-title":"SARS-CoV-2 in immunocompromised individuals","volume":"55","author":"S DeWolf","year":"2022","journal-title":"Immunity"},{"issue":"4","key":"pone.0325561.ref051","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.bj.2022.04.006","article-title":"SARS-CoV-2 variants - Evolution, spike protein, and vaccines","volume":"45","author":"K-WK Chen","year":"2022","journal-title":"Biomed J"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0325561","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T17:54:29Z","timestamp":1750269269000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0325561"}},"subtitle":[],"editor":[{"given":"Elisabetta","family":"Pilotti","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,6,18]]},"references-count":51,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0325561","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,18]]}}}