{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:18:30Z","timestamp":1760145510437,"version":"build-2065373602"},"reference-count":41,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control","doi-asserted-by":"publisher","award":["75D30120C08379"],"award-info":[{"award-number":["75D30120C08379"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Arizona","award":["75D30120C08379"],"award-info":[{"award-number":["75D30120C08379"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Hybrid immunity, as a result of infection and vaccination to SARS-CoV-2, has been well studied in adults but limited evidence is available in children. We evaluated the antibody responses to primary SARS-CoV-2 infection among vaccinated and unvaccinated children aged \u2265 5 years. Methods: A longitudinal cohort study of children aged \u2265 5 was conducted during August 2021\u2013August 2022, at sites in Arizona, Texas, Utah, and Florida. Children submitted weekly nasal swabs for PCR testing and provided sera 14\u201359 days after PCR-confirmed SARS-CoV-2 infection. Antibodies were measured by ELISA against the receptor-binding domain (RBD) and S2 domain of ancestral Spike (WA1), in addition to Omicron (BA.2) RBD, following infection in children, with and without prior monovalent ancestral mRNA COVID-19 vaccination. Results: Among the 257 participants aged 5 to 18 years, 166 (65%) had received at least two mRNA COVID-19 vaccine doses \u2265 14 days prior to infection. Of these, 53 occurred during Delta predominance, with 37 (70%) unvaccinated at the time of infection. The remaining 204 infections occurred during Omicron predominance, with 53 (26%) participants unvaccinated. After adjusting for weight, age, symptomatic infection, and gender, significantly higher mean RBD AUC values were observed among the vaccinated group compared to the unvaccinated group for both WA1 and Omicron (p &lt; 0.0001). A smaller percentage of vaccinated children reported fever during illness, with 55 (33%) reporting fever compared to 44 (48%) unvaccinated children reporting fever (p = 0.021). Conclusions: Children with vaccine-induced immunity at the time of SARS-CoV-2 infection had higher antibody levels during convalescence and experienced less fever compared to unvaccinated children during infection.<\/jats:p>","DOI":"10.3390\/diseases12080171","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T11:34:20Z","timestamp":1722512060000},"page":"171","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Immunologic and Illness Outcomes of SARS-CoV-2 Infection in Vaccinated and Unvaccinated Children Aged \u2265 5 Years, in a Multisite Longitudinal Cohort"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9232-0279","authenticated-orcid":false,"given":"Cynthia","family":"Porter","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3631-8072","authenticated-orcid":false,"given":"Zoe L.","family":"Lyski","sequence":"additional","affiliation":[{"name":"Immunobiology, College of Medicine\u2014Tucson, University of Arizona, Health Sciences, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7745-0179","authenticated-orcid":false,"given":"Jennifer L.","family":"Uhrlaub","sequence":"additional","affiliation":[{"name":"Immunobiology, College of Medicine\u2014Tucson, University of Arizona, Health Sciences, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7624-312X","authenticated-orcid":false,"given":"Katherine D.","family":"Ellingson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuha","family":"Jeddy","sequence":"additional","affiliation":[{"name":"Abt Associates, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Gwynn","sequence":"additional","affiliation":[{"name":"Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5195-518X","authenticated-orcid":false,"given":"Patrick","family":"Rivers","sequence":"additional","affiliation":[{"name":"Family and Community Medicine, College of Medicine\u2014Tucson, University of Arizona Health Sciences, Tucson, AZ 85711, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Sprissler","sequence":"additional","affiliation":[{"name":"Center for Applied Genetics and Genomic Medicine, University of Arizona, Tucson, AZ 85721, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurt T.","family":"Hegmann","sequence":"additional","affiliation":[{"name":"Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT 84111, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa M.","family":"Coughlin","sequence":"additional","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley L.","family":"Fowlkes","sequence":"additional","affiliation":[{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4328-1071","authenticated-orcid":false,"given":"James","family":"Hollister","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"LeClair","sequence":"additional","affiliation":[{"name":"Abt Associates, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josephine","family":"Mak","sequence":"additional","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn C.","family":"Beitel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sammantha","family":"Fuller","sequence":"additional","affiliation":[{"name":"Abt Associates, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pearl Q.","family":"Zheng","sequence":"additional","affiliation":[{"name":"Abt Associates, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Abt Associates, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3225-6919","authenticated-orcid":false,"given":"Ramona P.","family":"Rai","sequence":"additional","affiliation":[{"name":"Abt Associates, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Grant","sequence":"additional","affiliation":[{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4411-0370","authenticated-orcid":false,"given":"Gabriella","family":"Newes-Adeyi","sequence":"additional","affiliation":[{"name":"Abt Associates, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young M.","family":"Yoo","sequence":"additional","affiliation":[{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4503-9745","authenticated-orcid":false,"given":"Lauren","family":"Olsho","sequence":"additional","affiliation":[{"name":"Abt Associates, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2362-9509","authenticated-orcid":false,"given":"Jefferey L.","family":"Burgess","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5960-1308","authenticated-orcid":false,"given":"Alberto J.","family":"Caban-Martinez","sequence":"additional","affiliation":[{"name":"Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarang K.","family":"Yoon","sequence":"additional","affiliation":[{"name":"Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT 84111, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amadea","family":"Britton","sequence":"additional","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjusha","family":"Gaglani","sequence":"additional","affiliation":[{"name":"Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, TX 76508, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew L.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT 84111, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4505-2907","authenticated-orcid":false,"given":"Matthew S.","family":"Thiese","sequence":"additional","affiliation":[{"name":"Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT 84111, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa Briggs","family":"Hagen","sequence":"additional","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jefferson M.","family":"Jones","sequence":"additional","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3480-849X","authenticated-orcid":false,"given":"Karen","family":"Lutrick","sequence":"additional","affiliation":[{"name":"Family and Community Medicine, College of Medicine\u2014Tucson, University of Arizona Health Sciences, Tucson, AZ 85711, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2021052173","DOI":"10.1542\/peds.2021-052173","article-title":"Mild SARS-CoV-2 Infections and Neutralizing Antibody Titers","volume":"148","author":"Bonfante","year":"2021","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"422","DOI":"10.15585\/mmwr.mm7111e1","article-title":"Effectiveness of 2-Dose BNT162b2 (Pfizer BioNTech) mRNA Vaccine in Preventing SARS-CoV-2 Infection among Children Aged 5\u201311 Years and Adolescents Aged 12\u201315 Years-PROTECT Cohort, July 2021-February 2022","volume":"71","author":"Fowlkes","year":"2022","journal-title":"MMWR Morb. 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