{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:24:16Z","timestamp":1784035456509,"version":"3.55.0"},"reference-count":63,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union\u2019s Horizon 2020 research and innovation program","doi-asserted-by":"publisher","award":["101016167"],"award-info":[{"award-number":["101016167"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Antibody studies analyze immune responses to SARS-CoV-2 vaccination and infection, which is crucial for selecting vaccination strategies. In the KoCo-Impf study, conducted between 16 June and 16 December 2021, 6088 participants aged 18 and above from Munich were recruited to monitor antibodies, particularly in healthcare workers (HCWs) at higher risk of infection. Roche Elecsys\u00ae Anti-SARS-CoV-2 assays on dried blood spots were used to detect prior infections (anti-Nucleocapsid antibodies) and to indicate combinations of vaccinations\/infections (anti-Spike antibodies). The anti-Spike seroprevalence was 94.7%, whereas, for anti-Nucleocapsid, it was only 6.9%. HCW status and contact with SARS-CoV-2-positive individuals were identified as infection risk factors, while vaccination and current smoking were associated with reduced risk. Older age correlated with higher anti-Nucleocapsid antibody levels, while vaccination and current smoking decreased the response. Vaccination alone or combined with infection led to higher anti-Spike antibody levels. Increasing time since the second vaccination, advancing age, and current smoking reduced the anti-Spike response. The cumulative number of cases in Munich affected the anti-Spike response over time but had no impact on anti-Nucleocapsid antibody development\/seropositivity. Due to the significantly higher infection risk faced by HCWs and the limited number of significant risk factors, it is suggested that all HCWs require protection regardless of individual traits.<\/jats:p>","DOI":"10.3390\/v15071574","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:47:38Z","timestamp":1689727658000},"page":"1574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Prospective COVID-19 Post-Immunization Serological Cohort in Munich (KoCo-Impf): Risk Factors and Determinants of Immune Response in Healthcare Workers"],"prefix":"10.3390","volume":"15","author":[{"given":"Christina","family":"Reinkemeyer","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeganeh","family":"Khazaei","sequence":"additional","affiliation":[{"name":"Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstra\u00dfe 33, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Weigert","sequence":"additional","affiliation":[{"name":"Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstra\u00dfe 33, 80539 Munich, Germany"},{"name":"Munich Center for Machine Learning (MCML), 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Hannes","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronan","family":"Le Gleut","sequence":"additional","affiliation":[{"name":"Institute of Computational Biology, Helmholtz Munich, 85764 Neuherberg, Germany"},{"name":"Core Facility Statistical Consulting, Helmholtz Munich, 85764 Neuherberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Plank","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Winter","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Nore\u00f1a","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Meier","sequence":"additional","affiliation":[{"name":"Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstra\u00dfe 33, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Xu","sequence":"additional","affiliation":[{"name":"Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstra\u00dfe 33, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Rubio-Acero","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Wiegrebe","sequence":"additional","affiliation":[{"name":"Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstra\u00dfe 33, 80539 Munich, Germany"},{"name":"Department of Genetic Epidemiology, University of Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thu Giang","family":"Le Thi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, University Hospital, LMU Munich, Lindwurmstrasse 4, 80337 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3565-8315","authenticated-orcid":false,"given":"Christiane","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Institute of Computational Biology, Helmholtz Munich, 85764 Neuherberg, Germany"},{"name":"Core Facility Statistical Consulting, Helmholtz Munich, 85764 Neuherberg, Germany"},{"name":"Faculty of Business Administration and Economics, Bielefeld University, 33615 Bielefeld, Germany"},{"name":"Center for Mathematics, Technische Universit\u00e4t M\u00fcnchen, 85748 Garching, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Radon","sequence":"additional","affiliation":[{"name":"Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany"},{"name":"Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany"},{"name":"Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), 89337 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Paunovic","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9262-1597","authenticated-orcid":false,"given":"Christian","family":"Janke","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Wieser","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"},{"name":"German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799 Munich, Germany"},{"name":"Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"K\u00fcchenhoff","sequence":"additional","affiliation":[{"name":"Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstra\u00dfe 33, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7642-1835","authenticated-orcid":false,"given":"Michael","family":"Hoelscher","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"},{"name":"Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany"},{"name":"German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Castelletti","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799 Munich, Germany"},{"name":"Institute of Radiation Medicine, Helmholtz Zentrum M\u00fcnchen, 85764 Neuherberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105924","DOI":"10.1016\/j.ijantimicag.2020.105924","article-title":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges","volume":"55","author":"Lai","year":"2020","journal-title":"Int. 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