{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:08:39Z","timestamp":1787580519100,"version":"build-2736575974"},"reference-count":54,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>We have developed Convacell\u00ae\u2014a COVID-19 vaccine based on the recombinant nucleocapsid (N) protein of SARS-CoV-2. This paper details Convacell\u2019s\u00ae combined phase I\/II and IIb randomized, double-blind, interventional clinical trials. The primary endpoints were the frequency of adverse effects (AEs) and the titers of specific anti-N IgGs induced by the vaccination; secondary endpoints included the nature of the immune response. Convacell\u00ae demonstrated high safety in phase I with no severe AEs detected, 100% seroconversion by day 42 and high and sustained for 350 days anti-N IgG levels in phase II. Convacell\u00ae also demonstrated a fused cellular and humoral immune response. Phase IIb results showed significant post-vaccination increases in circulating anti-N IgG and N protein-specific IFN\u03b3+-producing PBMC quantities among 438 volunteers. Convacell\u00ae showed same level of immunological efficacy for single and double dose vaccination regimens, including for elderly patients. The clinical studies indicate that Convacell\u00ae is safe and highly immunogenic.<\/jats:p>","DOI":"10.3390\/vaccines12010100","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T03:33:41Z","timestamp":1705635221000},"page":"100","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Safety and Immunogenicity of the Convacell\u00ae Recombinant N Protein COVID-19 Vaccine"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0481-5488","authenticated-orcid":false,"given":"Sevastyan","family":"Rabdano","sequence":"first","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellina","family":"Ruzanova","sequence":"additional","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Makarov","sequence":"additional","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasiya","family":"Vertyachikh","sequence":"additional","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeriya","family":"Teplykh","sequence":"additional","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1526-1161","authenticated-orcid":false,"given":"German","family":"Rudakov","sequence":"additional","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iuliia","family":"Pletyukhina","sequence":"additional","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Saveliev","sequence":"additional","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Zakharov","sequence":"additional","affiliation":[{"name":"LLC \u201cNIC Eco-bezopasnost\u201d, St. Petersburg 191119, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Alpenidze","sequence":"additional","affiliation":[{"name":"State Budgetary Health Institution \u201cCity Polyclinic No. 117\u201d, St. Petersburg 194358, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliy","family":"Vasilyuk","sequence":"additional","affiliation":[{"name":"Department of Toxicology, Extreme and Diving Medicine, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg 191015, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergei","family":"Arakelov","sequence":"additional","affiliation":[{"name":"Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Skvortsova","sequence":"additional","affiliation":[{"name":"Federal Medical-Biological Agency of Russia, Moscow 115682, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Miao, G., Chen, Z., Cao, H., Wu, W., Chu, X., Liu, H., Zhang, L., Zhu, H., Cai, H., and Lu, X. (2023). From Immunogen to COVID-19 vaccines: Prospects for the post-pandemic era. Biomed. Pharmacother., 158.","DOI":"10.1016\/j.biopha.2022.114208"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1080\/23744235.2021.1924397","article-title":"Long COVID or post-COVID-19 syndrome: Putative pathophysiology, risk factors, and treatments","volume":"53","author":"Yong","year":"2021","journal-title":"Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.dsx.2021.04.007","article-title":"Long COVID: An overview","volume":"15","author":"Raveendran","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bloom, N., Bunn, P., Mizen, P., Smietanka, P., and Thwaites, G. (2023). The Impact of COVID-19 on Productivity. Rev. Econ. Stat., 1\u201345.","DOI":"10.1162\/rest_a_01298"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Rabdano, S.O., Ruzanova, E.A., Pletyukhina, I.V., Saveliev, N.S., Kryshen, K.L., Katelnikova, A.E., Beltyukov, P.P., Fakhretdinova, L.N., Safi, A.S., and Rudakov, G.O. (2023). Immunogenicity and In Vivo Protective Effects of Recombinant Nucleocapsid-Based SARS-CoV-2 Vaccine Convacell\u00ae. Vaccines, 11.","DOI":"10.22541\/au.167608809.97775460\/v1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5418","DOI":"10.1016\/j.vaccine.2020.06.022","article-title":"Emerging manufacturers engagements in the COVID \u221219 vaccine research, development and supply","volume":"38","author":"Pagliusi","year":"2020","journal-title":"Vaccine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2710.2009.01150.x","article-title":"Quadrivalent human papillomavirus (HPV) vaccine: A review of safety, efficacy, and pharmacoeconomics","volume":"36","author":"Pomfret","year":"2011","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1032531","DOI":"10.3389\/fmed.2023.1032531","article-title":"Safety profile, antiviral capacity, and liver protection of a nasal therapeutic vaccine in patients with chronic hepatitis B: Five-year-follow-up outcomes after the end of treatment","volume":"10","author":"Akbar","year":"2023","journal-title":"Front. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e00647-20","DOI":"10.1128\/JVI.00647-20","article-title":"The Nucleocapsid Protein of SARS\u2013CoV-2: A Target for Vaccine Development. Dutch RE, editor","volume":"94","author":"Dutta","year":"2020","journal-title":"J. Virol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Thura, M., Sng, J.X.E., Ang, K.H., Li, J., Gupta, A., Hong, J.M., Hong, C.W., and Zeng, Q. (2021). Targeting intra-viral conserved nucleocapsid (N) proteins as novel vaccines against SARS-CoVs. Biosci. Rep., 41.","DOI":"10.1042\/BSR20211491"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1038\/s41579-021-00630-8","article-title":"Structural biology of SARS-CoV-2 and implications for therapeutic development","volume":"19","author":"Yang","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1038\/s41577-020-00480-0","article-title":"Viral targets for vaccines against COVID-19","volume":"21","author":"Dai","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pack, S.M., and Peters, P.J. (2022). SARS-CoV-2-Specific Vaccine Candidates; the Contribution of Structural Vaccinology. Vaccines, 10.","DOI":"10.3390\/vaccines10020236"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2681","DOI":"10.1016\/j.immuni.2021.11.016","article-title":"Antigenic drift: Understanding COVID-19","volume":"54","author":"Yewdell","year":"2021","journal-title":"Immunity"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Rabdano, S., Mukhin, V., Makarov, V., Rudakov, G., Ruzanova, E., Arakelov, S., Khaitov, M.R., Yudin, S.M., Kryuchko, D.S., and Berzin, I.A. (2023, March 27). N protein based vaccine against SARS-CoV-2 produces a strong T cell immune response to N Protein of novel strains. MES [Internet]. Available online: https:\/\/mes.fmba.press\/archive\/2022\/3\/11\/abstract?lang=en.","DOI":"10.47183\/mes.2022.033"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2653","DOI":"10.1080\/22221751.2020.1855945","article-title":"Biochemical and antigenic characterization of the structural proteins and their post-translational modifications in purified SARS-CoV-2 virions of an inactivated vaccine candidate","volume":"9","author":"Zhang","year":"2020","journal-title":"Emerg. Microbes Infect."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Yu, S., Wei, Y., Liang, H., Ji, W., Chang, Z., Xie, S., Wang, Y., Li, W., Liu, Y., and Wu, H. (2022). Comparison of Physical and Biochemical Characterizations of SARS-CoV-2 Inactivated by Different Treatments. Viruses, 14.","DOI":"10.3390\/v14091938"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"eabp9770","DOI":"10.1126\/sciadv.abp9770","article-title":"Cell surface SARS-CoV-2 nucleocapsid protein modulates innate and adaptive immunity","volume":"8","author":"Kosik","year":"2022","journal-title":"Sci. Adv."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e74489","DOI":"10.7554\/eLife.74489","article-title":"SARS-CoV-2 host-shutoff impacts innate NK cell functions, but antibody-dependent NK activity is strongly activated through non-spike antibodies","volume":"11","author":"Fielding","year":"2022","journal-title":"eLife"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1038\/s41590-021-01084-z","article-title":"An immunodominant NP105-113-B*07:02 cytotoxic T cell response controls viral replication and is associated with less severe COVID-19 disease","volume":"23","author":"Peng","year":"2022","journal-title":"Nat. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.cell.2020.05.015","article-title":"Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals","volume":"181","author":"Grifoni","year":"2020","journal-title":"Cell"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.virol.2006.03.036","article-title":"Long-lived memory T lymphocyte responses against SARS coronavirus nucleocapsid protein in SARS-recovered patients","volume":"351","author":"Peng","year":"2006","journal-title":"Virology"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Tso, F.Y., Lidenge, S.J., Poppe, L.K., Pe\u00f1a, P.B., Privatt, S.R., Bennett, S.J., Ngowi, J.M., Belshan, M., Siedlik, J.A., and Raine, M.A. (2021). Presence of antibody-dependent cellular cytotoxicity (ADCC) against SARS-CoV-2 in COVID-19 plasma. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0247640"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1002\/eji.202149470","article-title":"Natural killer cell-mediated ADCC in SARS-CoV-2-infected individuals and vaccine recipients","volume":"52","author":"Hagemann","year":"2022","journal-title":"Eur. J. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1038\/s41392-021-00759-1","article-title":"Antibody-dependent cellular cytotoxicity response to SARS-CoV-2 in COVID-19 patients","volume":"6","author":"Yu","year":"2021","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bai, Z., Cao, Y., Liu, W., and Li, J. (2021). The SARS-CoV-2 Nucleocapsid Protein and Its Role in Viral Structure, Biological Functions, and a Potential Target for Drug or Vaccine Mitigation. Viruses, 13.","DOI":"10.3390\/v13061115"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.micinf.2020.04.002","article-title":"Comparative computational analysis of SARS-CoV-2 nucleocapsid protein epitopes in taxonomically related coronaviruses","volume":"22","author":"Tilocca","year":"2020","journal-title":"Microbes Infect."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Sieling, P., King, T., Wong, R., Nguyen, A., Wnuk, K., Gabitzsch, E., Rice, A., Adisetiyo, H., Hermreck, M., and Verma, M. (2021). Prime hAd5 Spike + Nucleocapsid Vaccination Induces Ten-Fold Increases in Mean T-Cell Responses in Phase 1 Subjects that are Sustained Against Spike Variants. medRxiv.","DOI":"10.1101\/2021.04.05.21254940"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"376","DOI":"10.4049\/jimmunol.2100421","article-title":"Cutting Edge: Nucleocapsid Vaccine Elicits Spike-Independent SARS-CoV-2 Protective Immunity","volume":"207","author":"Matchett","year":"2021","journal-title":"J. Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"104765","DOI":"10.1016\/j.jcv.2021.104765","article-title":"Longitudinal follow-up of IgG anti-nucleocapsid antibodies in SARS-CoV-2 infected patients up to eight months after infection","volume":"136","author":"Oyaert","year":"2021","journal-title":"J. Clin. Virol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3010","DOI":"10.1038\/s41467-021-23333-3","article-title":"Peripheral and lung resident memory T cell responses against SARS-CoV-2","volume":"12","author":"Massana","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/s41541-021-00321-8","article-title":"Replicating bacterium-vectored vaccine expressing SARS-CoV-2 Membrane and Nucleocapsid proteins protects against severe COVID-19-like disease in hamsters","volume":"6","author":"Jia","year":"2021","journal-title":"npj Vaccines"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/s41586-020-2550-z","article-title":"SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls","volume":"584","author":"Tan","year":"2020","journal-title":"Nature"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1093\/intimm\/dxp082","article-title":"Recombinant nucleocapsid-like particles from dengue-2 virus induce protective CD4+ and CD8+ cells against viral encephalitis in mice","volume":"21","author":"Gil","year":"2009","journal-title":"Int. Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1099\/0022-1317-68-2-433","article-title":"Purified Influenza Virus Nucleoprotein Protects Mice from Lethal Infection","volume":"68","author":"Wraith","year":"1987","journal-title":"J. Gen. Virol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1186\/1743-422X-9-322","article-title":"Influenza A virus nucleoprotein derived from Escherichia coli or recombinant vaccinia (Tiantan) virus elicits robust cross-protection in mice","volume":"9","author":"Huang","year":"2012","journal-title":"Virol. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1111\/all.15305","article-title":"Vaccine based on folded receptor binding domain-PreS fusion protein with potential to induce sterilizing immunity to SARS-CoV-2 variants","volume":"77","author":"Gattinger","year":"2022","journal-title":"Allergy"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"889138","DOI":"10.3389\/fimmu.2022.889138","article-title":"SARS-CoV-2-mRNA Booster Vaccination Reverses Non-Responsiveness and Early Antibody Waning in Immunocompromised Patients\u2014A Phase Four Study Comparing Immune Responses in Patients With Solid Cancers, Multiple Myeloma and Inflammatory Bowel Disease","volume":"13","author":"Wagner","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.ccell.2022.04.003","article-title":"Enhanced SARS-CoV-2 breakthrough infections in patients with hematologic and solid cancers due to Omicron","volume":"40","author":"Mair","year":"2022","journal-title":"Cancer Cell."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1136\/postgradmedj-2021-140654","article-title":"Review of COVID-19 vaccine subtypes, efficacy and geographical distributions","volume":"98","author":"Francis","year":"2022","journal-title":"Postgrad. Med. J."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Garcia, P., Anand, S., Han, J., Montez-Rath, M., Sun, S., Shang, T., Parsonnet, J., Chertow, G.M., Schiller, B., and Abra, G. (2021). COVID19 vaccine type and humoral immune response in patients receiving dialysis. medRxiv.","DOI":"10.1101\/2021.08.02.21261516"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"102744","DOI":"10.1016\/j.jaut.2021.102744","article-title":"Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients\u2019 subgroups","volume":"125","author":"Ferri","year":"2021","journal-title":"J. Autoimmun."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/pst.175","article-title":"Assurance in clinical trial design","volume":"4","author":"Stevens","year":"2005","journal-title":"Pharm. Stat."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.ebiom.2016.04.029","article-title":"What Lies Beneath: Antibody Dependent Natural Killer Cell Activation by Antibodies to Internal Influenza Virus Proteins","volume":"8","author":"Vanderven","year":"2016","journal-title":"EBioMedicine"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.coviro.2016.12.002","article-title":"Antibody-dependent cellular cytotoxicity and influenza virus","volume":"22","author":"Vanderven","year":"2017","journal-title":"Curr. Opin. Virol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.3389\/fimmu.2019.01457","article-title":"Influenza and Antibody-Dependent Cellular Cytotoxicity","volume":"10","author":"Moody","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"178","DOI":"10.30895\/2221-996X-2021-21-3-178-192","article-title":"Assessment of T-cell immunity to SARS-CoV-2 in COVID-19 convalescents and vaccinated subjects, using TigraTest\u00ae SARS-CoV-2 ELISPOT kit","volume":"21","author":"Poteryaev","year":"2021","journal-title":"Biol. Products. Prev. Diagn. Treat."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1038\/s41590-020-0782-6","article-title":"Broad and strong memory CD4+ and CD8+ T cells induced by SARS-CoV-2 in UK convalescent individuals following COVID-19","volume":"21","author":"Peng","year":"2020","journal-title":"Nat. Immunol."},{"key":"ref_49","unstructured":"(2021, September 15). R Project [Internet]. Available online: https:\/\/www.r-project.org\/doc\/R-FDA.pdf."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Shang, W., Kang, L., Cao, G., Wang, Y., Gao, P., Liu, J., and Liu, M. (2022). Percentage of Asymptomatic Infections among SARS-CoV-2 Omicron Variant-Positive Individuals: A Systematic Review and Meta-Analysis. Vaccines, 10.","DOI":"10.3390\/vaccines10071049"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Buitrago-Garcia, D., Ipekci, A.M., Heron, L., Imeri, H., Araujo-Chaveron, L., Arevalo-Rodriguez, I., Ciapponi, A., Cevik, A., Hauser, A., and Alam, M.I. (2022). Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: Update of a living systematic review and meta-analysis. PLoS Med., 19.","DOI":"10.1101\/2022.01.20.22269581"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"655","DOI":"10.7326\/M20-6976","article-title":"The Proportion of SARS-CoV-2 Infections That Are Asymptomatic: A Systematic Review","volume":"174","author":"Oran","year":"2021","journal-title":"Ann. Intern. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1002\/jmv.25904","article-title":"Serological tests facilitate identification of asymptomatic SARS-CoV-2 infection in Wuhan, China","volume":"92","author":"Wu","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e80552","DOI":"10.7554\/eLife.80552","article-title":"Taking on SARS-CoV-2","volume":"11","year":"2022","journal-title":"eLife"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/1\/100\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:45:46Z","timestamp":1760103946000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/1\/100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,19]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["vaccines12010100"],"URL":"https:\/\/doi.org\/10.3390\/vaccines12010100","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,19]]}}}